Will a phone app replace hearing aids? Blog editors discuss the changing outlook for hearing aid technology

As editor of the Hearing News Watch blog, I am constantly finding items online heralding some breakthrough in technology that will render traditional hearing aids obsolete. Typically, it is said that these new devices will cost a small fraction of what today’s hearing aids sell for. What’s more, they will not require users to get professional help to obtain and use this technology successfully.

In view of the constantly accelerating pace of technologic progress, it would be foolish to scoff at the idea that hearing aids as we know them may be replaced by something inexpensive that people with hearing loss can pick up at the drug store or order online.  There are people now making a living in hearing care who are plenty worried that this may occur before they’re ready to retire.

One recent technology promoted as being the future of hearing aids is BioAid, which was developed by researchers at the University of Essex in the UK. According to a press release from the university, BioAid is “a free mobile app [that] turns an iPhone or iPod into a hearing aid that could revolutionize the future for people with hearing loss.”

The release continues, “Unlike standard hearing aids that simply amplify all sounds, the BioAid app is inspired by biology and replicates the complexities of the human ear. It puts the user in control, is available to anyone, anywhere without the need for a hearing test, and potentially holds the key to a future where tiny, phone-based hearing aids can be dispensed and adjusted remotely…

“Unlike standard aids that have a single setting, BioAid has six fixed settings, each of which has four fine-tuning settings allowing the user to find the perfect match for their impairment.”

Now, if you know anything about “standard hearing aids,” you know that it’s been decades since they amplified “all sounds” or had “a single setting” for all users. Still, when a recognized university promotes a product, you tend to take notice. That’s especially true in this case, where the technology was developed as “part of a research project to influence the future of hearing aids” that received funding from the Engineering and Physical Sciences Research Council and from Phonak.

Probably that’s why stories about BioAid have cropped up all over the web and in print, including in the Times of India, the world’s most read English-language newspaper. 

Its article starts, “Move over, bionic ears and hearing devices, i-ears are here. A team from the University of Essex has developed a free mobile application that can turn the iPhone or iPod into a hearing aid.”

LET’S SEE WHAT MY COLLEAGUES THINK

While there’s some pretty obvious hype in the announcement from the University of Essex, I am not tech-savvy enough to know what potential BioAid really has to solve people’s hearing problems. That’s why I decided to solicit opinions on this matter from the other editors at HearingHealthMatters.org, all of whom have experience either fitting or wearing hearing aids.

My query elicited some very interesting responses and thoughtful, which I have drawn upon for this week’s and next week’s Hearing Views. 

David H. Kirkwood, Editor, Hearing Views

Marshall Chasin, AuD, was the first to reply. Marshall, who is editor of our Hearing and Music blog, wrote: “I’ve seen apps like this before and they do work well. I guess we can add that to one more ‘personal listening device’ that doesn’t have to go through FDA. The sampling rate, however, is only about 8-10 kHz so the effective bandwidth may only be 4-5 kHz.”

I agree with Marshall,” wrote Robert Traynor, EdD, whose Hearing International blog covers hearing-related topics all over the world and throughout history. “These are rather ‘low-tech’ devices and they are usually made by engineers who do not know much about hearing aid engineering. It is, however, news and an interesting discussion.”

Gael Hannan, editor of our Better Hearing Consumer blog, offered the perspective of a long-time hearing aid wearer. She wrote:

“My people (the peeps with hearing loss) are looking for affordable alternatives to hearing aids.

Gael Hannan

“Even more significantly – and what I’m hearing a lot more lately – is how can we use all this emerging electronic stuff to work with our hearing aids to give us optimal communication? Very few hearing care professionals are willing or able to talk about technology outside their manufacturers’ very expensive add-ons. Excuse me for appearing to whine, but even my own Audie couldn’t recommend any ALDs that weren’t made by the big guns, including simple neck loops that work with our telecoms. I had to show her.

“I applaud all this new emerging technology, but still want every HoH [hard-of-hearing person] to be working with qualified professionals.”

Wayne Staab, PhD, who blogs for us at Wayne’s World, prefaced his remarks by stating, “I have intentionally not read any of the other replies so that I would not be influenced by them. Thus, the following is a response to the original article that I asked my colleagues about—not to any of the other editors’ responses.”

In his 10-point analysis, Wayne said:

1)  “I think this is all entirely possible and probable. I have been told that most of the major hearing aid manufacturers are/have been working on something very similar. And, one can already find devices with similar features as apps for smart phones. The BioAid app is free, is a research tool at this time, allows for different responses (as do most current hearing aids, unlike what the article suggests), allows for a relative measurement of one’s hearing sensitivity, includes what appears to be WDRC compression, and allows for gain adjustment. It is suggested also for those who have difficulty accessing health care. As I see it, the primary limitations relate to cosmetics, portability, extended use, and the cost of the phone service, which is usually fairly expensive. So, cost may be six of one and half a dozen of the other.

2)  “For the past several years it has been evident to many that the smart phone is becoming the communication center/device for many of the things we do. What would keep anyone from putting a hearing aid chip (commercially made and available) into a smart phone? Wired, or wireless transmission can be transmitted to a device in the ear that uses the same speakers as hearing aids use. In fact, some of these may be more easily done in a phone that has a larger footprint than in a small device intended to fit in the ear.

3)  “If one wants to program the device to meet an audiogram measured by the phone, it can be done, as I reported on last year in one of my blogs. I doubt that the measured thresholds would vary much from the way we currently measure them audiometrically, and if they are off a bit, so what? We already generally measure hearing in 5-dB increments, meaning that at any frequency we can be off by 10 dB. Then apply that to a hearing aid fitting formula that might vary from another hearing aid fitting formula by 20 dB at 1000 Hz and you have something at least as close as government work, as the saying goes.

“Also, why is an audiogram needed? Relative measurements from a smart phone of one’s hearing can just as easily be fitted with relative gains, etc.

4) “My experience with patient results with the Songbird was that most people used amplification that fit within fairly general categories, and liked those instruments as much as, or even better in some cases, than more complicated hearing aids programmed by qualified audiologists.

“Also, the first requirement for a successful hearing aid fitting is to have the proper gain. Many people can’t detect differences in response unless they are extreme.

5) “Many hearing aids today, in my opinion, are a case of overkill for the average hearing aid user. Many wearers cannot manage the controls properly or don’t use them at all, preferring a single setting for all listening situations. And, is 1-dB really going to be a factor for most people with respect to their psychoacoustical perception?

6) “It is not uncommon for me to fit individuals successfully with hearing aids without having ever tested their hearing. In other words, I often have an idea as to what their needs are before I perform an audiogram.

7) “There are many magical features and good work done in premium hearing aids today. None of these should be discounted or diminished. Some features of traditional hearing aids would be difficult or impossible to duplicate in a smart phone application as proposed. Examples include: binaural hearing, directional microphone performance, localization, multi-day and long battery life, special fittings (CROS varieties, array processing), unusual hearing losses and special programming they might require, acoustic feedback management, etc. A caveat is that some of the measurement advantages obtained in an anechoic chamber may not translate to real life (i.e., adaptive directionality).

8) “The way most people are fitted with hearing aids today (manufacturer’s quick fit), I wonder if this fitting approach is as good as those 15-20 years ago when audiologists had to understand what to do to solve a fitting problem, rather than just using the programming device’s “wizard” to correct presented complaints.

9) “I believe that smart phones or other computerized devices that people use have the potential to do much of what current hearing aids do, at least relative to amplification, and for some people, acceptable for basic mobility as well. And, they have an advantage in that they are not limited to 1.28 volts for operation, a definite limitation of current hearing aids if additional processing is considered. Also, replacing zinc-air cells with the power provided by smart phones could be a blessing, provided that when functioning as a hearing aid the life expectancy could be improved.

10) “We know that not everyone needs premium-priced hearing aids or all the features currently available in these devices. Industry members have responded to this in different ways–from offering what are referred to as ‘entry-level’ hearing aids to PSAPs. Like it or not, marketing factors, not dispensers or training, are most likely to determine the direction consumers will embrace when it comes to purchasing hearing aids.”

Wayne concluded, “Now that I have made the above remarks, I will read what others have to say to find out if I have to moderate some of my comments, which I suspect I may have to do.”

Tune in to the April 24 issue of Hearing Views for more from my blog colleagues about this topic and Wayne’s comments. The second and concluding part of this series will feature a lively discussion on the price of hearing aids.