Comparing Hearing Aid Performance in Real-World Settings: The Role of Advanced Processing

Today we’re going to discuss an interesting development in hearing aid processing that has been studied by Hörzentrum Oldenburg in Germany with the Signia device. And it promises some higher understanding ability in background noise. So I’m Bob Traynor, your host for this episode, and with me is Sheena Oliver and Eric Branda from WS Audiology. Sheena is the Chief Clinical Officer for WS Audiology, and Eric is one of the researchers at WS Audiology. And so thank you guys for being with us today. Although we had a few connection issues, but here we are and we’re all together. So before we get going, can you give us a little bit of an idea of your journey into audiology? What got you here? And. And let’s maybe start with Sheena and if you just give us an idea of your journey in audiology to get you to the Chief Clinical Officer at WS Audiology, certainly. Well, first, great to see you again. Thank you for having us and giving us this opportunity. So I’ve been an audiologist for close to 30 years now. I’ve worked both on direct patient care as well as working within the industry in a number of different roles across sales and marketing. And I think probably like so many audiologists, I kind of stumbled into it. I started out in college as a broadcast journalism major and I was like, you know, this just isn’t for me. And just flipping through a course catalog, I found a communications disorders class and, you know, as they say, kind of the rest is history. So for me, this summer will be six years with WSA. And, you know, what attracted me to the company was just, you know, I saw a lot of opportunity because there were so many different companies under the WSA umbrella. And I was like, hey, this is an opportunity for me to be able to grow professionally within the same organization. And so, you know, I’ve worked in different roles, globally, regionally. I was the Chief Marketing Officer for five years, and now as the chief Clinical officer, I think it’s really just. It represents a culmination of all of my experience. And so I’m kind of that person in the organization that it’s constantly thinking about the patient, patient outcomes and also what’s in the best interest of our providers. And my responsibilities also include government services. So really kind of just going full circle. It’s quite a career. And we’ve had the experience of working together, although we didn’t know we were working together because you were in one side of Bernafon, I was in the other side of Bernafon so it’s really been a pleasure to get to know you again, Eric. Now we know each other somewhat from our interactions and meetings and can you give us an idea of your journey through the start to kind of where you are now with WS Audiology? Yeah. So I actually started out in a different field. I was in photojournalism. I was working for newspapers and such since high school and was very attached to the visual medium. And then again in college I started looking at what might be some other interesting opportunities and options and stumbled into hearing and speech sciences. And audiology became a really natural fit because there’s a side of me that loves technical things. I very much technical, analytical. But there is also, as I’ve felt in the visual medium and with auditory things, there’s an art side to it. So when we get to audiology and you’ve got frequency and pitch, which they’re the same, but they’re not, and then you’ve got that mix of art and science, it really had a natural fit. And that just took me right into audiology and working with hearing aids became just, I mean, just fun. I just find it interesting and like what we can do with it. And so I jumped right into the industry side on audiology support and then went into training for customers both us and internationally. Spent several years in product management and now I’m also spent some time in R&D and now I’m director of hearing technology and research and getting to try to translate the research we do to something that’s very consumable for our professionals and for the hearing aid wearers. Fabulous, Eric. And some of that I didn’t know and some of it I did know. But. Well, you, you know, maybe both you and Sheena can give us an idea of some of the key findings in this recent Hörzentrum Oldenburg study. So for the recent study at her Hörzentrum it’s with the Signia IX, its ‘Integrated Xperience’. And what we found with that was we were comparing to one of the leading, actually the leading AI co processor technology in the industry. We looked at how IX would compare with our ‘Real Time Conversation Enhancement’. So how we can look at multiple talkers for a group situation. And what we found in this is that we saw a 1.5 dB improvement which is around about 24% improvement in speech intelligibility with the IX processing over the other processing. Wow. So Sheena, how do you think that will work with some of your people that use these products in the VA? You know, it’s Interesting, because, you know, Eric talked a little bit about more of the clinical findings, but I think one of the big things that we saw was just really like how it impacts how people work, specifically the audiologists in the VA. I think over the years, we’ve kind of stepped away from audiology and really kind of just got down to, okay, well, look, what type of phone does the patient have, or the veteran in this case? And then based off of that, then see, okay, well, what’s the best hearing aid solution that we can choose for that patient? And quite frankly, that can be frustrating for an audiologist. Right, because you may feel like you’re compromising on what you actually want to put that patient in because it’s being driven by the phone. And so really, when we look at this study, it’s like, okay, one, we really put audiology first. Audiology matters, and that we can start there picking the device that’s going to be best for that patient. And Eric talked about the research and the evidence that we have. And once we’ve made that decision, then we can decide, okay, well, let’s figure out how to connect to their phone, because that’s no longer a limiting factor. So I would say that’s really been kind of the big takeaway that we’ve seen for just the audiologist, but as well as the patient. So in particular, why is this simulated group conversation such a breakthrough in this, in this journey that we’ve all had for as long as I remember and as long as probably even she remembers. Eric probably remembers too, but not as long as we have journey on hearing speech in background noise. I think you. You touch right on. One of the big topics is speech understanding and noise. We know that that is a major issue, and technology for a while has really focused on how we can address that issue. And when we look at a lot of the research, we’re good at setting up a lot of background noise. Let’s make it difficult, and then we’ll put that single target speaker in front of the study participant. With this particular study, what we decided to do was let’s really focus on that group dynamic because we’re not only always just talking with one person. So let’s look at how we can make it easier. Easier in the group conversation scenario. So the real time conversation enhancement, instead of using one single beam facing forward, we use multiple beams. So we can pretty much put a directional beam on different talkers in the group dynamic and look at where they’re at, track them, and help the hearing aid wearer follow them. So in the study, what we did, instead of putting just a single target speaker in front of the wearer, we had that one speaker in front and then just off at the angle, just as you would if you were sitting at a table with two people. We put a second speaker there. So it would have to alternate and the hearing aid had to do the work because it’s not that we were waiting for the participant to look at one and then look over at the other speaker. And back to the front, the speech would come out and they had to follow it. And then behind them we had two speakers putting out some speech babble. So like a conversation behind you and then all around 360 staggered speakers with cafeteria noise. So we made it extremely difficult and made sure that their target speech, they had to follow and repeat back was alternating from different target speakers to simulate that group dynamic. So was that using some AI kinds of components in the inside the device? Eric so we’re actually using our, our algorithms built in there. We’re not including AI. We are using two processors because we do have processing from the front and we separate that from the back. And then so the hearing aid is separating those two pieces and then we’re looking with the directional components to find the different target speech that we’re looking for. So how is this going to meet the needs of veterans there? Sheena with this kind of a system? I know that a lot of these guys have, have, have significant difficulties, particularly in noise because they’ve been listening to noise most of their career. And so how do you think this is going to, going to be of assistance to maybe not only the patients but the audiologists as well? Yeah, I think it’s a great question because I think, you know, at just a kind of a fundamental or foundational level, the needs of veterans can be very similar to non veterans. You know, they want something that aesthetically looks good, they wanna be able to accept it, that visually it looks attractive. They wanna make sure that it’s easy to use. Right. So it’s like all day convenience. And then also I would say is they wanna be able to hear better. That’s the reason why they’re getting hearing aids. And so just at kind of that core level, IX checks all of those boxes. But I think where we start to say, well, what’s this added benefit for veterans as you mentioned, one, they’re disproportionately impacted by tinnitus because of the noise induced hearing loss. And so signia, when we look at Notch Therapy treatment that is really unmatched. The other thing that I would say is we have what’s called SCIF compatibility. So you probably know about SCIF, but this idea of, you know, there are a lot of veterans that have to work in secure government environments and so they have to disable some of that technology. And so fortunately, within our hearing aids, no matter what hearing aid actually not just IX, the audiologist has the ability to do that through the fitting software. It’s not hardware changes or things that have to be sent in. And we’re able to do that in our most recent technology platform which is IX. Those are two really big advantages that you get with BCT from an audiologist perspective. I think it goes back to, hey, I can be an audiologist first and fit what’s most appropriate for this patient. But I think the other thing that we see with VA audiologists is that they are just crunched for time. Like time is just not something that they have a lot of just due to the high patient volume that they see. And so some of the other things that we’ve added to this product, like an LED light so they don’t have to take time to see if the devices are actually on, they can just quickly see visibly if the devices are on. We’ve also made it really easy for them to locate the serial number. So those are things that typically have taken time in the past. So we’re making them, ensuring that they’re a lot more efficient in how they’re working with the products. And it’s not. So, yes, they’re getting it from the audiological and technology side, but also just ease of use. They can be much more efficient in how they work clinically. And then the last piece, I would say, is just overall battery life. I mean, that’s always going to be super important for the patient as well as the audiologist. And with this new device, we’re getting 36 hours of battery life, and that includes four, five hours of streaming, which is really important. Right. And, you know, some people say, well, you know, all we need is a day. 24 hours is enough. But the reality is it’s not just how the device or the battery is lasting today, but what’s it going to look like three years from now. And three years from now we’re seeing that, yes, they’re still going to be able to get that full day of charge, which is going to be really important for any patient, not just our veterans. Well, if they’re listening to watching TV most of the day and then towards the evening, then they start having a conversation with somebody with some of the products out there these days, the device goes dead and it’s rechargeable. So they can’t just stick a new battery in it. So having that, that kind of battery life is really, really helpful. The other thing is that, you know, I would say one of the biggest issues that veterans have from. From my knowledge of, of the vets is that they, a great number of them have tinnitus. And you mentioned something about the device and how it works with the tinnitus patients as well with, with notch filtering and some of those kinds of things. Can you, can you go into that just a little bit more, Sheena? Sure. I’ll turn it over to Eric to handle this. Well, Eric. Yeah. You might as well contribute here a little bit. Right? Exactly. Yeah. Tinnitus. We know tinnitus is a very big concern for our veterans. And when we think about tinnitus and think of it as basically kind of the idea of a maladaptive cognitive reorganization, we’ve got some. They hear this tonal tinnitus in areas where they shouldn’t have a sound. So we’re looking at how can we address this. And many devices look at some habituation therapy with the masking approach, let them get used to hearing other sounds around it. We looked at some other therapy approaches with notch therapy, and with this, what we want to do is provide the amplification that they’re looking for. But at the area where the tinnitus is occurring, we actually create a notch in the amplification. So we kind of take some of the activity away from that area, which allows the hair cells operating on the outside of that, the lateral inhibition, to kind of desensitize that area and basically help the brain stop hearing the tone there, Softens the tone for them. So we’re kind of readjusting that cortical reorganization. Well, that’s a huge issue in the VA, but it’s also a huge issue just in general. And many clinics are now, quote, amplifying their. Their area of tinnitus treatment in the clinics around. Around the world, actually. So. So on the VA side, that’s one thing, but on the civilian side, it’s a. It’s a big issue also. So what has been the response to this, this new orientation to maybe noise reduction and some of these things both in the VA and maybe with the civilian community as well? Yeah, I think overall it’s been extremely well received, very positive. And I mean, I think it goes back to what I said earlier, where it just allows hearing care professionals to focus on what they do best. Right. And that’s audiology fitting here, Dealing with hearing loss and solving real listening needs and challenges, and then thinking about cell phone technologies and things that really aren’t our primary areas of responsibility or hasn’t been, that becomes a secondary issue for them. And so that’s been kind of the biggest thing and kind of the greatest type of feedback that we’ve received from hearing care professionals. I think the second thing is just how well people are performing. You know, we have someone on our team whose mother was wearing a non Signia device for a different reason, and she had tried to convert her over to IX last year, and her mother really rejected it just because the connectivity was too much of a challenge. It was too hard for her to learn how to use her cell phone with the new devices. This individual since refit her mother with the Signia BCT. And not only did she say, wow, it was really easy to kind of connect to all the different devices, but what she also said was that the sound product, the sound quality was significantly better than what she was used to. And so I think that’s the other thing that we’re starting to hear is that, yes, they’re hearing extremely well when they’re in these group conversations, but also when they’re actually streaming, which we know sometimes that can be compromised. They’re noticing and commenting on how much improvement they’re seeing in streaming. And so there’s really kind of a win, win all around. So, yeah, we’re really excited about that. And that’s whether it’s veterans or civilians. Eric, did you see some specific issues in your research that, that really showed some other than, other than the 1.5dB difference in directionality and those kinds of. Did you see some success stories on the patients themselves in your research project? It’s always funny when we look at some of these projects because the task we’re usually doing is looking for an SRT50 or an SRT80. So what signal to noise ratio are they going to get? 50 or 80% correct. So I always feel bad for them, especially when we’re doing an SRT50 because they’re never getting more than 50% correct. As soon as they do, we make it tougher on them. So I see them performing at these levels where I see their struggle because we’re looking to make it challenging. But I know the noise level that they’re listening in and I know the difficulty of the task. So watching them perform in these more difficult situations with the technology doing what it should be, it’s. I enjoy watching that. Not because they’re having a challenge to do what they’re doing, but I know how tough it is and how well they’re doing. That’s. Wow, that’s great. You know, this has been a great conversation, guys. The only thing we were missing is a couple of beers or a martini or something and we’ll have to do that another day, another time. So now the, the device then is getting a lot of feedback based on the research, but also based on patient interaction. And so that kind of underscores what is a perceived value here, at least from an audiological standpoint and something to really look at seriously for patients. I want to thank Eric Bfanda and Sheena Oliver for being my guests today as we discuss this interesting project that was done by Hörzentrum Oldenburg in, in the study of this signia. And thank all of you for being with us today at This Week in Hearing