Which hearing aid is the most flexible to adjust

Hi ZCT or Xbulder and others:
I have tried so many different models of hearing aids, but still cannot find one that is comparable to my Beltone CSP-II, sounds wierd. Finally, my dispenser told me that Starkey Destiny 1200 or 1600 should give me a lot of features to adjust like kneepoint, compression, gain, maximum output etc. I know even top model like Beltone ONE cannot be adjusted for kneepoint. I know Xbulder never recommend Starkey while ZCT always Starkey fans. Any comments?

Thanks
Paul

to be fair, I do not know all the starkey products- therefore i could not recomend something I do not know. But i could tell you a couple of things,
3 companies dominates almost 75% of all hearing aid market world wide.
An truthfully, Starkey is not one of them. However, This is a fact, and by no means implies starkey is a bad product.

On to the next question, some of the manufactures do not like to manipulate
on the knee points or attack and release times. I do not know if starkey is capable of doing so, ZCT has said the software has a lot of controls and thus it might be capable of…

I can tell you who doesnt… GN resound do not, Beltone do not, Oticon Do not and I suspect neither do bernafon…

I believe, I have seen the Phonak software and Believe is capable of such thing (but I cant give you a specific model, hearnow could give you that info)

I have also seen Audifon fitting soft. and it does allow to change compre. threshold and also Audina . This are tinny , tinny companies… So I would recomend this…

My recomendation is to follow your audi advice, meaning - it is not only what the HI is capable of doing but the audi needs to be proficient at doing so…

One piece of advice, If I was in you audi shoes, I would do the following
I would run a HI test to see how the instrument you like performs,
and try to fit one in an almost identical way.

This would require programing use the HI analizer to try it to produce a
similar Frequency response… This could be a very lenghty process…

Sorry I meant I wouldnt recomend audina neither audifon

By the way, some of the HI users in this forum
has given good reviews to the starkey destiny products,
So I assume it is good product…

Now a days, mid price instruments are great across all board…
They are similar if not identical…

Hi Xbulder:
Thanks for your advice.
What is HI testing?
Actually I went to Starkey manufacturing plant directly in Toronto, ON and a very knowledgable and nice lady told me to do these two things:

  1. Audiological evaluation
  2. Real Ear Measure
    RECO old/present hearing aid
    to beat set up
    TK
    CR
    GAIN
    output
    features
    for 1200 series
    I think ZCT will know more about this.

Paul

I know I’ve been accused of bias on this board, because I am a Starkey fan. But to be clear I have spent many years fitting a variety of brands. I like Starkey because I think they do a great job, not because I’ve been brainwashed by their corporate literature. In my career I’ve fitted Danavox, Resound, Oticon, Widex, Phillips, Phonak, Siemens, A&M and Unitron. But I’ve always come back to Starkey as a favorite, but that is not to say that other brands don’t have some good stuff. And to tell you the truth in very recent years I have been exclusively Starkey / Audibel, so I am not up with the very latest stuff from the other brands.

With the disclaimer out of the way, the two aids you mentioned probably have more adjustment parameters than any other aid on the market. Like most aids you’ve got various channels and bands. In this case 12 bands and 8 channels. And unlike many other aids out there if you adjust one of these, it doesn’t drag other adjustments with it. I’ve seen aids that brag about all these bands, but if you adjust one of them several other others move, which means they are not truly independent.

You have knee point and compression controls for each channel too. Allowing extensive control over when and if the compression kicks in and how much it is from 1.0 to 3.0. You also have an output limiter on each band.

Then there are four environmental filters which can be set to off, minimum and maximum. One is for quiet situations to eliminate circuit/mic noise, another for background noise, another for mechanical noises (fans / air conditioning etc), and another for wind noise.

There is extensive data logging with intelligent recommendations for the hearing professional based on your real life use of the aids.

Up to four multi memories exist, allowing a unique program in each memory. They have about 12 or so different filters available for each memory customized to patient life style choices such as restaurant, crowd, music etc. These programs can be used to provide custom multi memory settings designed for specific things in your life. Of course, that is hardly a new concept in hearing aids.

The 1600 had all these features including verbal reports. The aid will beep in your ear and then actually say “Battery” or “Make Appointment” or “Good.” Based on certain things happening. It can say this in a British accent, American accent, a male or a female, and can also be programmed to speak in one of a couple of dozen non-English languages.

The 1600 also has real ear measurement built in. And both aids have a built in hearing test to verify what you are hearing.

There are up to 8 different mathematical formulas that translate your test result into an amplification prescription. This can be very helpful since some of these formulas are aimed at analog lovers like yourself!

So how adjustable. My guess would be this:

12 bands, with lets say 20 adjustments in each:

12^20 = 3833759992447475122176

Then add in the acoustic signatures, and you can multiply that number by 81, which is the number of signature settings and you get:

310,534,559,388,245,484,896,256

Now add in compression, voice features, knee point, output limits, and you have a larger number than I am really prepared to calculate.

Whichever way you look at it, it’s a LOT of adjustment potential. But frankly, there in lies the problem. The more adjustable an aid is, the more potential there is for a hearing professional to screw it up. So it is very important to find a good one.

In April, Starkey are releasing the latest version of their aid programming software called Inspire OS 3.0. Because of the nFusion technology they are going to be able to introduce new features to existing hearing aids, so people who currently own Destiny will be able to have access to new bells and whistles.

One of the improvements I understand is going to happen is the introduction of the auto-path routines that only used to exist on the 1600. I believe this will now be made available to the 400, 800 and 1200. Autopath is like an idiot set up button, so even the most technologically retarded hearing professional should be able to start a patient off on the right path to better hearing.

I believe, I have seen the Phonak software and Believe is capable of such thing (but I cant give you a specific model, hearnow could give you that info)

Starkey seems to be almost as flexible as Phonak. Phonak allows Compression, Kneepoint, MPO, 40db, 80dB, 60dB gain, output compression etc to be adjusted in up to 20 bands (the more basic the device the less bands) - this is also very independent unlike some other manufacturers as ZCT has pointed out. It also allows multiple degrees (4 steps) of Noise reduction, wind noise reduction, EchoBlock, Phase canceling, SoundRelax etc to be adjusted for each individual program as well as for the 4 automatic programs(Savia and Exelia). More basic aids may only have 3 or 2 automatic programs. The individual frequency response of each automatic program can also be adjusted.

But, Like Xbulder says all these mean nothing if the fitter does not know the software.

when i said HI testing, what i meant is to put the aid in an instrument test box, or hearing aid analizer to measure what the frequency response is…

You see, I look at it this way- it is like you saying to the optician, this are the best glasses i had i want a pair that is identical. The takes the glasses and measures them with a lens meter and order an identical set…

I tried to say, run the test box and find out who the old instrument performs
and tweak one just like it…

this is a difficult job… If she is performing rem, she has a test box as you normally buy equiment that has rem and HI analizer

Hi Hearnow,
Can you specify which Phonak model can have all these adjustable features?

Thanks ZCT for the detailed description of Destiny adjustments. I will certainly give this to my dispenser Wednesday. Actually, I told her to ask a Starkey technician to come to her office directly to help her to do the settings since I know she is not good at computer.

Thanks
Paul

There are two models which allow 20 bands, these are the Savia and Exelia. The Naida V and Eleva allows 16 bands, but with similar flexibility for other features.

I’ve read articles that show that any more than 8 channels is pretty much an overkill. For example it was shown that the human ear cannot detect much improvement beyond the 44.1KHz used in a compact disc.

Is there a study you can point me to that indicates that the human ear can detect and utilize more than eight independent channels in a way that provides real improvement or patient benefit?

Let’s face it, a typical hearing test is only 10 frequencies. So would you really need more than 10 bands?

I’m not trying to be difficult here, but I am genuinely interested in the correlation between more channels and bands, and the ability of the patient to tell any meaningful difference.

Hi ZCT,

Interesting point. Most studies show that 4 channels is optimal for speech discrim and that there is no more benefit with more channels. How could that article state that the human ear cannot detect more than 8 bands as this would mean we can only distinguish 8 main frequencies - just does not make sense? Hearing aid channels are devided in their frequency bandwidth thus about 80Hz to 7 or 8Khz in most modern models (a few higher frequency expeptions exist). Ie in Phonak there would be 20 channels in this range, definately not up to 44Khz (which has more to do with the sampling rate in CD’s than frequency range - I might be wrong on this one). We do only test 10 frequencies (Octaves, but the human ear can detect many more frequencies that this - there are 24 cochlear bands (if I remember correctly - thus also the numebr of electrodes on CI). The extra channels do not necessarily improve the comprehension of speech as studies have shown, but there are quite a few areas where the extra bands may be an advantage:

  1. Modulated noise reduction and speech enhancement: The hearing aid determines the SNR in each channel and determines if the channlel contains predominantly speech or noise and how improtant the channel is for speech discrim. If there is noise and no speech, gain is reduced, if noise and some speech, but it is an important speech frequency - channel is unaltered, if it contains more speech than noise - might be altered etc - different aids apply different algorithms - so this in an example only. The more channels the higher the resolution and the more effective the seperation of modulated noise from speech.

  2. Windnoise reduction - same as above, but only applies in Low freq’s.

  3. Multichannel FB Mx - The more channels, the more accurate the out of phase signal can be, the more accurate reduction.

  4. Frequency shaping - especially to compensate for ear canal and coupling acoustics as well as unausual audiogram configuarations.

  5. multi-channel adaptvie directionality - each band can have its own polar polot and thus own direcitonal notch - more resolution.

  6. Recruitment - MPO and gain reduction gan be applied in frequencies where recruitment occurs (lower UCL’s)

and probably a few more I did not think of.

I am happy to be corrected on any point as these are my views only.

What would you guys say most high end instrument would have as far

as channels, 8 to 10?,

How much would you think is enough? based on your experience?

Most high end devices have 12 to 24 channels. Starkey Destiny has 12, Epoq has 15, Siemens Centra has 16, Inteo has 15, Resound dot and Azure have 17(I Think),Savia and Exelia have 20, Sonic velocity has 24. I suspect if there are too many channels then smearing becomes more of an issue. I have heard that some Adro aids have up to 64 channels! (Never seen them or read much info on them). XBulder - doesn’t that new book of your have some info on this? :slight_smile: I personally find anything from 12 to 20 enough for adjustment flexibility, but for NR the more might be better due to higher resolution - again depending on how the algoritm is employed.

With respect, I think you are confusing the terms bands and channels. The Starkey Destiny has 8 channels split into 12 bands for fine tuning. It’s really important to specify which you are talking about here.

Not to nit pick (well okay actually to nitpick!) we do not test ten octaves of hearing.

Even if you test at 125Hz, which is utterly pointless since it is low enough to produce a vibrotactile response rather than a hearing response, you are looking at:

125, 250, 500, 1000, 2000, 4000, 8000

That’s six octaves. Any other frequencies tested are on the half octave (like 750, 1500, 3000, 6000). So since most tests rightly skip 125Hz, it’s really only five octaves.

I agree with you to a point, but I think my original post was referring to the concept of the law of diminishing returns.

Yes, as you increase the number of channels and bands there are certain benefits as you describe.

For example, if a hearing aid is trying to cut down the noise of an air conditioning fan, with just 2 channels, it would be impacting a wide range of frequencies in it’s attempt to reduce that noise. Whereas if it had 100 channels (and I know that is just a silly example) it could maybe cut down say 25 channels to improve the hearing, leaving 75 channels unaffected. So that’s 75% of your hearing though the aid unaffected by the reduction of that noise. Yet the two channel aid might have affected 50% of the sound thanks to that lack of flexibility.

My argument however was that beyond a certain point it is questionable as to the true benefits to the patient. Can a patient really notice the difference between a 8 channel aid and a 12 channel aid? It depends on a lot of factors.

It would seem that some companies keep striving to add more and more channels and bands to their hearing aid. I even saw some cheap crappy aid advertised online for $99 that had some absurd number of channels (so they claimed). Would it really sound better than a top of the line Starkey or Siemens aid with far fewer channels? I doubt it.

To give a car analogy. I drive a BMW 328i. It has six cylinders. If you buy the BMW 335i it still has six cylinders (yet the same engine size) and develops 70 more HP. You can buy a Mustang with a V8 in it, and I guarantee that in a race that included corners, the BMW 335i would spank the Mustang soundly every time. So is a V8 always better than a V6? Not really. Subaru make a really nice four cylinder turbo engine that will beat most V6 cars any day. Etc.

I’m just saying that there’s more to a hearing aid than the number of channels or bands. Just as there is more to a car than the number of cylinders. Or more to a camera than the number of megapixels it is capable of.

The book still lacks, Rexton, Widex

I am dropping my Audibel CIC’s and going to something else. I’ve read so much I’m in HA overload!! My number are as follows:
HZ RIGHT LEFT
250 10 5
500 20 10
750 30 20
1K 60 35
1.5K 65 55
2.0K 70 60
3.0K 80 70
4.0K 95 75
6.0K 100 95
8.0K - 100

I’m even considering a drive to Tennessee to see ZCT as he seems to have a lot of knowledge and experience. Could someone with high frew loss like mine recommend an aid they have used?? Thanks for the help!!

To return to the original post:

Why would having millions of adjustment options be useful … especially for an end-user?

Sure, if you have a portable NOAH self-programming system you could tinker with the settings all day, all week … but most users won’t do that!

As a scientifically/mathematically inclined dispenser I would indeed like to have at least one model available where I could adjust EVERYTHING … primarily so that I could test new algorithms from Moore, Dillon etc.

However does ANY dispenser … or end user in real life successfully tinker with compression times etc?

We certainly need advanced hearing aids … but the idea that we can personally fine tine each setting is maybe unwise. The ‘default’ settings for the majority of the parameters will probably be as good as any.

These default settings will have been generated by software which encapsulates the expertise of many audiologists, DSP engineers, HOH etc … so it could be difficult to improve on them via ‘tinkering’.

We seem to live in a world where technology is regarded as The Great Saviour. Sadly bits, bytes, bands & channels are only a part of the equation.