FDA Clears Path for Hearing Aids to Be Sold over the Counter | Hacker News Reader

FDA Clears Path for Hearing Aids to Be Sold over the Counter

nytimes.com

38 pointsxnx16 comments

Whatever you do, skip the digital hearing aids.

As a former musical savant, I’ve had to accept analog hearing aid (before digital was in vogue) and it was arguably better in form of being able to distinguish different tones (ajoining piano keys and chords).

Once you go digital aid, you WILL most assuredly go tone-deaf (smashed chord, no pitch. It’s the shits.

And furthermore, cochlear implant is weirdly better/worse. With CI, you hear further (and bionically so) but now you get at most 32 distinctive tones. CI remains more useful in terms of resuming General hearing but analog hearing aid is KING!

Hmm. That seems odd to me. There is no technical or physical reason for digital hearing aids to have this issue. It makes sense for the cochlear implants, but not for digital hearing aids - which are no different in principle to headphones on transparency mode.

Yea. That’s a common input that I get often.

BUT, a lot of my musically-inclined folks having gone hearing aid have to experienced and then commented on superiority of analog hearing aid over digital; and analog are continuous spread spectrum, and I concur.

I suspect the narrow channelization / narrow pass filter but multiple of them to blame in digital hearing aids. Analog however takes more power consumption to perform at same dB output.

Yes, bad filter configuration can cause these kinds of issues. However, this is a configuration issue. Any competent hearing aid is going to have configurable Q (narrowness) for the filter, so this is on whoever set up your hearing aid.

Hence digital will never be able to recreate the same continuous spread spectrum of auditorial frequency band and outcompete the analog in power consumption.

The trade off made by digital hearing aid manufacturers is you will only get “passable” hearing experience instead of par excellence … all this so that your battery life is merely 1.8x longer.

I’d take quality over battery life: makes a difference in distinguishing between V, P, Z, D, E, T, G, and C. But I’ve had to elect to take the one-way to CI because of total loss.

In short, all digital hearing models choke on high frequency range.

I'll be interested to see if this changes with hearing aids being able to be sold over the counter (More people buying them -> more interest in creating good products -> better digital options). Something tells me the existing hearing aid companies are stodgy and slow when it comes to new tech.

That seems odd to me. Modern digital hearing aids have a great many features that are far more costly in terms of processing power than a simple parametric EQ or minimum phase convolution. You should definitely be able to do so with less power consumption than for an analog one.

I can't see how hearing aid manufacturers are implementing Bluetooth, multiple speaker arrays with sound source detection, etc..., but can't make these fairly basic features available.

I would be be surprised if it wasn't simply misconfiguration.

Features like automatic gain control (AGC), frequency range compression (for those with a specific range loss, or amplitude compression (for those with advance dB loss) do not mean much if it doesn’t help you to discriminate bird calls.

Bluetooth is just a transport carrier of whatever audio processor can do.

All advance high-power digital hearing aids have failed high frequency range response time.

Keyword, response time.

I understand what you are saying. I'm saying that doing this properly is a solved problem, and that power consumption isn't an issue because many of the features they do have (not AGC or frequency/amplitude compression, those are quite simple) would consume far more power than it would take to do this properly.

Modern low-power DSPs can achieve latencies in the microseconds, especially for such a simple task as EQ. That's going to be far beyond human hearing to notice.

Tell the el cheapo hearing aid manufacturers to step up and deliver on their overpriced value.

What is the benefit to this?

Good in-ear monitors are almost exactly the same prices as hearing aids. So, while there might be some medical markup, it's remarkably less in hearing aids than in other areas.

I don't understand the difference between in-ear monitors and hearing aids well enough to give a reasoned counter-argument to that.

However, Costco does sell hearing aids for 400-1000 USD while audiologists sell mostly comparable equipment for 3000-10000 USD. So there is definitely pricing power in the current setup.

Most people in the industry also expect lower price devices to come to the market when the bar to entry becomes lower and manufacturers can start experimenting with new size/form factor/battery/functionality combinations. For example Bose Hearphones were selling at 500 USD as a low-volume product without much competition.

Glasses and contacts too please.

Glasses are already de facto over the counter. Virtually every online source of glasses (including large, domestic businesses) will openly sell glasses with requested specifications to anyone without asking for a copy of (or even affirmation of the existence of) any kind of official document.

While the word "prescription" is often still used when the specifications of the glasses are what is really meant, this situation is clearly a stark contrast to the prescription-as-approval practiced for medication. No legitimate domestic company will sell FDA-approved medication without asking for proof that the customer first paid a doctor for a signed document giving them permission to buy it. This step may still be prevalent for contact lenses, but in practice it's not applied to glasses.

I don't know if glasses and contacts have the same accessibility problems.

I know people like to rage against the machine and reveal the ancient forbidden knowledge they have "discovered" about the Luxottica monopoly but you can get a vision test at any of the ten thousand or so optometrists in the US for $50.

Then you can order a pair of perfectly serviceable and stylish prescription glasses online for $20.

In the 30 years I've been buying glasses, I've never paid more than $100 except for the last time when I opted for the fancy blue-blocking and ultra-scratch-resistant coating and my glasses were $105.

Hearing aids cost thousands and thousands of dollars.

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