Oticon Announces Oticon Intent™, the World’s First Hearing Aid with User-Intent Sensors

[Volusiano]

Some new pics on YouTube videos that I captured here for reference:

The table below clarifies something for me. Before in previous Oticon Intent videos, they claim a “full” day of use with just 1 hour of charging. But now it seems like 1 hour of charging gives you 16 hours of use (which they call “a full day of use”). But apparently “a full day of use” of 16 hours is not the same as “a full charge” of 20 hours, which will take another 60 minutes to get the remaining 4 extra hours of use, to reach a “full charge”. I also read somewhere that a full charge of 20 hours use is with (average amount of?) streaming included. With no streaming, I heard that it can last up to 24 hours.

[Volusiano]

As part of the new Oticon Genie 2 2024.1, I notice that they now have the ACT (Audible Contrast Threshold) feature available in the 2024.1 version. I think ACT was introduced October 2023, and it seems like Oticon is actively promoting the use of ACT along with their introduction of the Oticon Intent.

To summarize what ACT is for folks who don’t have time to watch the videos below, it’s a way to measure your personal speech in noise detection threshold (and people’s thresholds can be different, even if they have the same or very similar tone-generated audiograms) and this information can be used to best program your hearing aids to give you optimum speech in noise settings that is personalized to your ACT result.

As for the process of doing the ACT test, after your HCP does the normal tone generated audiometry test for you, the ACT test can be done immediately after that, if your HCP is so equipped with the hardware and license for the ACT test. What ACT does is that it uses the result of the tone generated audiometry to figure out your hearing loss, then that feeds into the ACT test, where you’ll hear sounds of waves (like waves at the sea side), and from time to time, you’ll hear siren-like sound (like from an ambulance), where your job is to detect the presence of the siren-like sound and push a button to let the clinician know that you detected the siren sound. The ACT test is very quick, maybe on the average of only a few minutes.

So although this is a non-speech test, it still simulates speech detection (the siren sound here represent speech) in noise (the wave sound represents the noise). And because it’s a non-speech test, it’s also a universally language-non-specific test. The end result is that you’re assigned with an ACT value for your test, and this value can be input into the Oticon Genie 2 software so that the software can apply this result into give you prescribed gains and settings that would be optimal for your speech in noise situations.

I would strongly advise folks who plan to buy the Oticon Intent to ask the HCP whom they’re considering buying from whether they are equipped to do the ACT test or not, and to pick one who can do this test over those who can’t, all things else being equal. I guess it can be done by somebody else later on and the ACT value gets added into Genie 2 retrospectively as well, if you can get the best pricing from somebody who are not equipped to do ACT, and pay somebody else later to get ACT done and added in.

Hopefully, with this additional ACT test, at least it’ll give you a better initial starting point in setting your hearing aids up for speech in noise, and help reduce the number of trips you have to go see your HCP after fitting to get the hearing aids dialed in for you, especially for speech in noise. Who knows? Maybe before ACT, you thought you had your speech in noise setup dialed in pretty good already. But with ACT, you may find it even better, that is, if there were still room for improvement from before that you didn’t know about.

Audible Contrast Threshold (ACT) - An introduction

Behind the scenes of ACT

Audio Contrast Threshold (ACT™) In the Clinic

Below are a couple of whitepapers on ACT from Oticon for those interested in reading them.

15500-0202---act-whitepaper.pdf

act-counselling-wp.pdf

[Lostdeaf]

I think this is all complete nonsense. The ACT test defines 16 levels, which are then divided into 4 or 5 points for adjustment in Genie. The questionnaire provides more answer options. In addition, we may prefer different sounds - comfortable, detailed, loud - and the ACT test does not answer such questions.

[Volusiano]

Let me give more context to what @Lostdeaf is trying to say here so people can understand why he’s saying what he’s saying better. In Oticon Genie 2, you are given only 1 of 2 choices, either use your ACT result as 1 of the 2 personalization methods (a new feature in Genie 2 2024.1), or answer a personalization questionnaire to indicate your preferences (the old option that has been available before in previous versions of Genie 2), like whether you like a full range of sound or not, whether you’re easily disturbed by sounds around you or not, whether you prefer your sounds to be sharp and distinct, or soft and round; whether you like to have a more comfortable sound at the expense of losing some of the details on the sound or not; whether your daily listening environment is mostly the same or varies a lot, etc.

Apparently, the settings based on a personalization questionnaire can come into conflict with ACT, which is not focused on personalized preferences, but is prioritized to focus on giving you the most optimal speech in noise performance settings. That is probably why you cannot do both and must pick one or the other option.

My personal opinion is that if you score well in the ACT test, meaning that you don’t need as much help with more aggressive speech in noise settings, then you can probably afford to throw all the weight to your personal preferences, and choose the Personalization Questionnaire option instead of the ACT input option.

But if you score badly on the ACT test, indicating that you need a lot more help with speech in noise, then it would make more sense to forgo your personal preferences in wanting to hear how things sound, in order to be able to achieve the more important goal of getting better speech in noise performance out of the hearing aids. After all, speech in noise performance has been the holy grail of many hearing aid wearers for ages.

By the way, I remember reading somewhere that the ACT result would only apply to the General program and the Speech in Noise program in the Oticon Intent. So you can still have your 2 other programs where you can manually adjust to meet your personalization preference better. If you’re not sure of what adjustments to make to arrive at your personalized preferences, maybe choose the Personalized Questionnaire option first and generates up to 4 programs of your choice, with 2 of them being Muic and/or Comfort or whatever, and have your Personalization Questionnaire drive those 2 programs. Then switch over and select the ACT option in the next session so that the ACT result will drive the General and Speech in Noise program settings, with the presumption that it won’t re-prescribed the Music and Comfort programs which already were prescribed earlier based on your Personalization Questionnaire. So that may be an acceptable work-around to utilize both methods of personalization.

[Neville]

@Volusiano

I would strongly advise folks who plan to buy the Oticon Intent to ask the HCP whom they’re considering buying from whether they are equipped to do the ACT test or not, and to pick one who can do this test over those who can’t, all things else being equal.

The ACT is nice because it offers a speech in noise test that doesn’t involve language (so is more accessible) and doesn’t involve speech (so is potentially less impacted by cognitive concerns). BUT, it’s still just a speech in noise test. Be aware that unlike many other clinical tests that can be purchased separately by any clinician and plugged into their audiometer, it is only available in certain (newer) model audiometers. This means that it isn’t simply a matter of an audiologist adopting a relatively accessible test, they are potentially replacing a $20,000 piece of equipment. I suspect that few clinicians will make this choice soley for the ACT, so their ability to apply it will depend on them, by chance, having the correct equipment.

Other speech in noise tests are still valid and can be applied the same way as the ACT.

[Volusiano]

Thanks for your perspective on this as an HCP, @Neville . I didn’t realize that obtaining the hardware and license necessary to do ACT is that complicated and potentially expensive. The videos make it sounds so simple → “Oh, you just need to obtain an audiometer with the ACT license”. No wonder they never said that any audiometer can be used for ACT as long as the ACT license is obtained.

[Lostdeaf]

I read this The Audible Contrast Threshold Test: 10 Key Questions Answered | Hearing Health & Technology Matters, and still don’t see much point in such a test. The noise reduction in hearing aids is not so clearly regulated - it still has 3-4 degrees of adjustment.

[Volusiano]

Of course you’re entitled to your opinion about the test. I read the same link you shared, and I see the point in such a test (item 9 articulates it well). The way I see it is that it’s just another new tool now made available in the Oticon Genie 2, so if the HCP has access to doing this test, then why not do it? It doesn’t cost anything but a few minutes of my time.

If one HCP doesn’t have ACT or some other equivalent speech in noise test, but charges less for the hearing aids than another HCP who has ACT or another SIN test, then OK, the availability of ACT for the price difference in the hearing aids would have to be carefully considered, and it might not be worth pushing for the ACT HCP if the price saving is big enough. But if the price is the same, then I would go with the one who also has the ACT or SIN test, assuming that their fitting skills are the same.

On a personal level, I would be VERY interested in knowing how well or how badly I would personally score in such a test, because it will tell me about my capacity to understand speech in noise unaided by the technologies inside a hearing aid. The fact that two people with the same or very similar tone-generated audiograms can have different ACT results is very telling and interesting in terms of the ability in their brain to discern the speech sound contrast in noise. Even if I prefer to use the Personalization Questionnaire in Genie 2 to prescribe the settings to my personal preferences instead of opting for the ACT personalization method, I would still want to know what value my ACT score would be.

[Lostdeaf]

If you read this file https://wdh02.azureedge.net/-/media/oticon-us/main/download-center---myoticon---product-literature/whitepapers/15500-0202---act-whitepaper.pdf?la=en&rev=11D3&hash=97C2CD9988B564F4A493088CDD719A87 you can see only 4 levels of contrast loss severity

So you can ask yourself, how do you can hear speech in noise - ideally (no, we with hearing loss cannot do it), or with some problems, or with serious problems, or cannot hear any speech in noise. Congratulations, you have made home ACT test! So what’s next? Ok, Genie has only 2-3 levels of noise reduction relevant to hearing in noise. Most profound hearing loss requires additional accessories (Connectclip, Roger, telecoil) anyway.

[Volusiano]

If you look below in the Genie 2 ACT screenshot, there are 21 possible ACT values you can specify, between -4 through 16. So while it’s only 4 groupings on contrast loss severity like you pointed out, there are actually multiple incremental values at each grouping. So it’s not just 4 levels, it’s 21 possible levels in 4 groupings. And 21 levels here is if I round off to the nearest unit value. But Genie 2 does allow me to specify something like a 7.8 instead of 8 as well.

Sure, you can just take a rough guess as to where your contrast level falls in to which of the 4 groups, but I prefer a more accurate and scientific measurement that has a resolution of 21 values instead of a guess that has the resolution of 4 groups.

Also, by way of your argument, maybe you can also argue that who needs an accurate audiogram? You can do something similar if you want just as easily by dividing the frequency ranges into 4 groupings, maybe 0-1 KHz, 1-2 KHz, 2-4 KHz, and 4-10 KHz, and just make your best guess and assign 4 loss levels only, one to each group.

And I wouldn’t want to just make a guess out of thin air on what I think my contrast loss severity group is out of the 4. If I were to make this guess, I would probably need to create a program in my hearing aids that has no noise suppression at all, but does have hearing loss compensated amplification based on my tone generated audiogram. Then I would need to go to a number of noisy places (probably not just 1 place but more like several places) and use that program to see how well or badly I do in order to be able to come up with an “educated” guess based on real life observations of my own.

To me, that’s A LOT of work and time investment just for an educated guess. I’d rather take a 2 minute ACT test to achieve a much more accurate and higher resolution ACT number to feed into Genie 2.

[Liviu]

i guess a hardware is neede to perform ACT.

[Lostdeaf]

Yes, this requires quite expensive audiometers with an additional license.

[Neville]

Oticon are adding the software thing to help market it. But the ACT wasn’t made FOR that purpose. It’s a good little clinical speech in noise test. Think of it separately. The QuickSIN isn’t available in all languages. You could say the same about any clinical speech in noise test “why measure, I can just tell you that I have trouble in noise”. You’re not wrong, but the measurement does give us useful information.

[Lostdeaf]

I know about it. But the point of what I’m saying is that ACT has little application to device settings. It would be good if the noise reduction was set exactly to the value of the measured threshold. But here it is divided into 4 levels and uses standard hearing aid settings.

[seabeast]

@Lostdeaf

Yes, this requires quite expensive audiometers with an additional license.

I don’t believe this is accurate. That white paper clearly states the ACT is designed to use existing equipment:

The guiding principle
was to create a procedure for ACT which would be as
close as possible to that of the pure-tone audiogram,
to make ACT easy to adopt for HCPs. More specifically,
the requirements were (i) to shorten the test time to
something clinically acceptable , (ii) to make use of only
the equipment already available in a typical clinic (head-
phones/insert earphones and response button),

Furthermore, the ACT test is intended to set a better starting point for the speech-in-noise settings, but full individual customization is still available. Seems like a pure win if it works, and no harm if it doesn’t work.

[Volusiano]

I assuming that you’re talking about how the 4 groupings in ACT (normal, mild, moderate and severe) would simply map into 1 of the 4 Neural Noise Suppression max values for Easy and Difficult environments as shown in the Genie 2 screenshots below.

You’re presuming that if your ACT value is anywhere within a range, let’s say the Mild range, for example, then Genie 2 would just pick 2 dB max NNR for Easy and 8 dB max NNR for Difficult. So if your guess is accurate enough to pick 1 of the 4 groups correctly, you can simply just do the direct translation of the 4 groupings yourself, why bother with ACT? I think this is what you’re arguing.

However, this is just your presumption. We don’t really know if Genie 2 just does the mapping into 1 of the 4 NNR max values like you think. It might be possible that Genie 2 might have been programmed to use more resolution that it shows on the interface as well, you just don’t know, and I wouldn’t presume otherwise.

The ACT value would probably also translate into the Easy and Difficult environment classifications above the NNR settings as well, beside the 4 groupings that can be mapped easily like you mentioned. There can be 5 possible combinations here for that configuration. Again, of course you can guess it and map it yourself. But if it takes only 2 minutes of testing to get an ACT value to help shorten up all this guesswork, and begin with a better starting point than just a guess, then why not use the measurement?

ACT does not have “little application” to device settings like you think. ACT has significant enough application to device settings in that it gives you a good starting point right off the bat based on scientific measurements instead of based on personal guesswork. Besides, not everyone can make good guesses about their own hearing. They just know that they have hearing issues, and they rely on their HCP to set things up for them. If the HCP can quickly measure rather than guess about somebody else’s contrast loss in order to help the patient efficiently, then measurements will always trump guessing.

The whole point is time saving. The 2 minutes it takes to do the ACT measurements will most likely be less time than guessing, then needing to make multiple subsequent adjustments to arrive at a good place in Genie 2. Not to mention that it’s possible that Genie 2 might use more accurate setting values behind the scenes than what it gives the user at the interface.

[Volusiano]

@Lostdeaf

Yes, this requires quite expensive audiometers with an additional license.

Just to clarify, I think @Neville said that ACT cannot be plug and play with any audiometer, but only with certain (newer) model audiometers. This is not the same as requiring the purchase of a new audiometer just for ACT in every case. Only if an HCP doesn’t have the right audiometer that is compatible with ACT, then would it become an expensive proposition to purchase yet another audiometer just so that it’s compatible with ACT.

And of course the license cost is required, but this applies regardless of which audiometer it is as long as it’s an ACT compatible audiometer.

[Neville]

Yes. If we happened to have an audioscan pro version 2 it could be upgraded to run the ACT, but we do not and the act is not compatible with the audioscan pro 1 that we do have. BUT, the expectation when we got the audioscan pro when it came out, maybe 6 years ago, that it should last us about 20 years. It’s an expensive piece of equipment. This is going to be the situation for a lot of clinics.

Annoyingly, I can’t see why the ACT couldn’t have been made to be compatible with all old devices, like many other clinical tests are. Sure the old devices may not have automatic scoring options, but if they had the audio you could just do it with a score sheet.

I do suspect, though, that Volusiano and Lostdeaf are both correct in what they are suggesting about the ACT integration into Genie. Lostdeaf is very probably right that it is just a basic adjustment on a limited set of options that could theoretically be adjusted fairly easily using other indicators. However, Volusiano is right that it still provides a more dialed-in starting place which may reduce required appointments as well as benefit the loads and loads of people who never go back for adjustments in the first place. Same as most other Oticon developments, it’s a nifty little idea with maybe a bit too much marketting hype.

[brec]

Yes, audiometer hardware with the ACT feature is required. But there’s nothing preventing a DIY user of Genie 2 from estimating a value based on personal experience. (No, I’m not saying this is “just as good.”)

[brec]

Hey! How did you get the -4 to 16 scale representation? My Genie 2 just updated this morning, and this is all I see: