[HN Gopher] $1 hearing aid could treat millions with hearing loss
       ___________________________________________________________________
        
       $1 hearing aid could treat millions with hearing loss
        
       Author : gumby
       Score  : 500 points
       Date   : 2020-09-24 12:01 UTC (10 hours ago)
        
 (HTM) web link (www.sciencemag.org)
 (TXT) w3m dump (www.sciencemag.org)
        
       | jononor wrote:
       | Based on the MAX9814 chip, which costs 0.75 USD in 2.5K volume,
       | leaving 0.25 USD for everything else. The design is not
       | integrated much (many connectors), so assembly costs will be
       | high. It also requires 2xAA batteries as a consumable, which
       | consumer has to pay as well.
       | 
       | So this is not a 1 USD hearing aid in any way. And if current
       | units are 500 USD, then going down to 50 or 10 USD would already
       | be a huge improvement.
        
         | jlgaddis wrote:
         | I'm not surprised that someone who can fit two "AA" batteries
         | in their ear has trouble hearing!
        
         | tyingq wrote:
         | The pdf shows a MAX98306. Curious where you saw the MAX9814.
        
           | jononor wrote:
           | The HearingAid.sch PDF says MAX9814 on the JP1 connector on
           | the left side. So are they actually using both?
        
             | anamexis wrote:
             | The MAX9814 is the microphone.
             | 
             | Here's the BOM which shows the full breakdown coming in
             | under $1.
             | 
             | https://journals.plos.org/plosone/article?id=10.1371/journa
             | l... (Table 1)
        
               | tyingq wrote:
               | Just the BOM image so it's easier to read: https://journa
               | ls.plos.org/plosone/article/figure/image?size=...
               | 
               | Also, I'm not sure where he's getting the prices. Prices
               | for the MAX98306 and MAX9814 seem higher, even in high
               | quantities, than what he's showing.
        
               | kube-system wrote:
               | Interesting that they list the cost of raw PLA pellets
               | for the "mass production cost" of the 3d printed case.
               | 
               | This is starting to smell like an exercise in making an
               | incorrect BOM to justify the result they were looking
               | for. Nobody will 3d print you a case for $0.06. If what
               | they meant was that they'd 3d print the case themselves,
               | then it should be the filament or resin listed on the
               | BOM. You probably can get a plastic part pretty close to
               | that price, but not 3d printed, it would be injection
               | molded.
        
               | dekhn wrote:
               | If you read enough of Nature and Science you will realize
               | that skilled scientists are practiced in the art of
               | misrepresenting many details of their work to get
               | published.
               | 
               | Note that the pricing in there is organized around the
               | idea of a very massive custom purchase by a large
               | company.
        
               | kube-system wrote:
               | I don't think there's anything wrong with them citing
               | volume pricing per se. You'd expect something like a
               | hearing aid to be mass produced.
               | 
               | It's the incongruency of the materials listed with the
               | actual materials that would be used in a mass production
               | scenario that I find unscrupulous.
        
               | tyingq wrote:
               | You can find plenty of these "personal amplifier" devices
               | for $15 or so. I doubt they are making $14 on each one.
               | 
               | https://www.ebay.com/sch/i.html?_from=R40&_trksid=p238005
               | 7.m...
        
               | [deleted]
        
               | magicalhippo wrote:
               | > The MAX9814 is the microphone.
               | 
               | It's the microphone amplifier. This unit still needs an
               | external microphone, as well as headset/plugs.
        
         | Accujack wrote:
         | >assembly costs will be high
         | 
         | You read the article and know this is intended for DIY
         | assembly, correct? That it's not a commercial product?
        
       | emcq wrote:
       | The most accurate description is probably the authors built a
       | hearing aid from the 1960s with only $1 today [0]. Its worn
       | around the neck, doesn't have any fitting, doesn't appear to have
       | beamforming or feedback management, and low amplification.
       | 
       | It turns out these things are all important in clinical outcomes
       | for listening comfort and intelligibility. I've built a modern
       | hearing aid and done extensive patient testing - the details
       | matter and it's not just electrical or algorithm problems but
       | tough mechanical and UX challenges to get something more state of
       | the art.
       | 
       | While I haven't worn many neck mounted devices, the Bose
       | Headphones can get crazy feedback and the feedback path is
       | similar. This would cause squealing discomfort for patients and
       | everyone around them.
       | 
       | [0] https://en.wikipedia.org/wiki/History_of_hearing_aids
        
         | rexelhoff wrote:
         | This.
         | 
         | The other issue to contend with in his grandparents demographic
         | is the perception of being deaf and being seen wearing such a
         | big bulky item. Image consciousness is a large hurdle to
         | overcome these
         | 
         | Great ingenuity but commercially it's hard to see it take
         | traction
        
       | shae wrote:
       | I never wrote part 2 of this blog post, but there's a $300 open
       | source hearing aid that can do way more than most hearing aids:
       | https://shapr.github.io/posts/2019-08-03-tympan.html
       | 
       | Here's the organization building this thing:
       | https://shop.tympan.org/
       | 
       | I'm kinda excited about the four microphone board, where you can
       | subtract the ambient noise behind the listener from the noise in
       | the direction they're facing.
        
         | newyankee wrote:
         | Can i mail you ? Where are you based in ?
        
       | [deleted]
        
       | mothsonasloth wrote:
       | Hearing aids are useless for people with tinnitus like my
       | grandmother.
       | 
       | The most expensive or cheapest are all the same when you have a
       | medium high pitched buzz in your ear all day
        
       | ritchiea wrote:
       | Too bad we live in the kind of world where the biggest hearing
       | aid manufacturer will read this, raise additional capital, buy
       | the patent & rights to the $1 hearing aid and then sell hearing
       | aids for $5,000 each they'll bill to medicare and big health
       | insurance co.
        
         | pkaye wrote:
         | You can already buy cheap amplifiers like this on Amazon.
        
         | GuB-42 wrote:
         | Patent this? This is just a microphone, an amplifier and a
         | headphone jack. That's the most obvious thing.
         | 
         | There is no real innovation here. The work being done here is
         | closer to a market research: find the cheapest components that
         | do the job.
         | 
         | Cheap is also its only quality. $5000 hearing aids are better
         | in every other aspect. It makes no sense for big hearing aid
         | manufacturers to use anything about this design.
        
           | pomatic wrote:
           | It does seem like a bit of a missed opportunity - even
           | slipping in the most basic ots equaliser or dsp would add a
           | minimal amount to the BOM, whilst moving from a late 70s
           | format aid to late 80s, albeit in a dated form factor. (Chest
           | worn isn't too terrible IME, but expect to replace the
           | "wiring harness" to the earphones on a regular basis.)
        
       | tyingq wrote:
       | At first, it seemed like a laudable effort. I hate it, though,
       | when someone makes a github repo and sticks a single zip file in
       | it: https://github.com/bhamla-lab/LoCHAid-2020-PLOS-ONE
       | 
       | So I found the pdf in the zip file where you can see what it is.
       | It's a MAX 98306 amp. The only peripherals are the typical filter
       | capacitors, resistors, volume pot, microphone, etc. So, it's
       | basically this: https://www.adafruit.com/product/987
        
         | dcassett wrote:
         | I was surprised to see a git repo consisting of one zip file.
         | And that zip file itself contains a zip file.
        
         | magicalhippo wrote:
         | Actually it uses two IC's and the more interesting one, in
         | relative terms, is the MAX9814[1] microphone amplifier with
         | automatic gain control.
         | 
         | I suspect there are cheaper class-D IC's that could be used
         | than the MAX98306, but for a prototype why not.
         | 
         | It also puts the volume control potentiometer on the amplifier
         | output which seems wasteful for a battery operated device.
         | 
         | [1]:
         | https://www.maximintegrated.com/en/products/analog/audio/MAX...
        
         | andai wrote:
         | Looks like that's it in the first photo in the article: he's
         | holding it in his hands and using earbuds. Presumably it would
         | go in a pocket or clip on to your belt.
        
       | vpribish wrote:
       | here's a more detailed write-up including pictures of the device:
       | 
       | https://journals.plos.org/plosone/article?id=10.1371/journal...
       | 
       | It's a crude, bulky, ugly, and fragile thing and the $1 price is
       | not realistic - but it would be less than $10. It seems like a
       | decent product for the poorest places - which is their goal.
       | 
       | The hearing aid biz in the US is glaringly inefficient and
       | obviously ripe for disruption - but this product will not do it
       | here. There's definitely a demand for hearing aids in the couple-
       | of-hundred dollar range that doesn't require audiologist visits
       | and insurance hassle - but the entrenched interests will not help
       | bring it about.
        
         | jiofih wrote:
         | This is basically using academic journals as a marketing
         | channel. As someone else linked above, there are tons of
         | similar devices available from China, probably even using the
         | same chips, at equally low prices.
        
       | pontus wrote:
       | With all the advances in tech, why does it seem that hearing aids
       | are still from the 80s?
       | 
       | I guess ultimately you're limited by your interface to the brain
       | (something maybe neuralink could address?), but even still
       | shouldn't there be some "magic" machine learning stuff going on
       | in this space? Not at all an expert in audio processing, but I
       | would imagine that we could do a decent job distinguishing voices
       | from background noise, automatically thresholding sound in
       | different environments, and possibly modulating sounds into
       | different frequency bands when there are e.g. multiple speakers.
       | 
       | For all I know, stuff like this is already going on.
        
         | red_hare wrote:
         | My mother, who's fully deaf in one year and mostly deaf in the
         | other, has heavily depended on strong and expensive hearing
         | aids her whole life.
         | 
         | Over the years her hearing aids have improved in battery life,
         | gotten smaller, and improved in things like filtering
         | background noise. Every new hearing aid would start by sounding
         | distorted and weird but her brain adapts to the new sounds
         | after a couple of weeks.
         | 
         | The single largest life improvement I've seen for her was about
         | 10 year ago when she could finally get a hearing aid with
         | bluetooth. Suddenly she didn't have to decide between the
         | "whistling" (feedback) or not hearing to talk on the phone. We
         | got her an iPad and she stopped watching TV almost entirely and
         | now watches YouTube and Netflix. And she can do her yoga over
         | Skype.
         | 
         | Her biggest challenge, at this point, isn't a hearing aid
         | problem but a bluetooh one. Her iPhone inconstantly switches
         | between her hearing aid and her Volkswagen (pre-CarPlay).
         | 
         | I agree hearing aids are stuck in the past, but I'm also
         | convinced most of the problems are lower hanging fruit than a
         | neuralink :).
        
           | jki275 wrote:
           | If she likes watching on a TV, the Apple TV can talk to
           | bluetooth audio devices. Have never tried it, but it would
           | probably be able to talk to the hearing aids directly.
        
         | skybrian wrote:
         | These days they are fairly sophisticated; my hearing aids will
         | automatically switch between several different programs
         | depending on the environment. (It doesn't work how I'd like it
         | to, though, so I have a program that I manually set for music.)
         | There is also a phone app for adjusting settings, though it's
         | limited and buggy.
         | 
         | It's difficult to evaluate hearing aids because they are
         | proprietary. Reading about the features in a brochure for a
         | hearing aid is like reading the features for a TV set or
         | stereo. Who knows what those trademarked terms really mean when
         | it comes to how the code works?
        
           | pontus wrote:
           | Would be cool to create an open standard and perhaps even
           | open source the development. If nothing else, I would imagine
           | that there are quite a few hearing impaired engineers and
           | scientists out there that would gladly work on something like
           | this if it meant that they themselves could benefit from the
           | improvements.
        
         | emcq wrote:
         | Both https://audatic.ai/ and https://whisper.ai/ are taking the
         | ML approach for speech enhancement, and the large companies are
         | starting to get on board. It's the future!
        
         | shariqm wrote:
         | I agree! We're working on this at AudioFocus (YC S19). You can
         | see an old demo here: https://www.audiofocus.io/demo
         | 
         | There are a lot of challenges with putting this in a hearing
         | aid: low latency inference (10ms), small power budget,
         | consistent performance, fault tolerance, etc. Still a fair
         | amount of R&D to be done, but change is coming.
        
           | pkaye wrote:
           | How many microphones do you need to do this filtering? I wear
           | hearing aids myself and if you can do it that that level on a
           | real hearing aid that would be amazing.
        
           | newyankee wrote:
           | Is it too difficult to ask for one that distributes the
           | processes between phone/external device, rims of glasses and
           | in the ear speaker. It will go a long way in addressing the
           | issue of stigma and enabling more people to use it early.
        
       | jononor wrote:
       | Looks like Chinese manufactures already sell hearing aid devices
       | in the 25-50 USD price range.
       | https://www.banggood.com/search/hearing-aid.html Unlike the
       | device from the article (which would cost more like 10 USD than
       | 1), these are rechargeable and fully integrated over-the-ear
       | units.
       | 
       | Would love to see a low-cost open/hackable hearingaid/hearable
       | though. For example BOM of 5-10 USD. But then it should use a
       | reprogrammable chip for the signal processing, so that one can
       | make improvements in software. Even the cheapest and simplest
       | hardware is harder / more expensive to improve than software.
        
         | newyankee wrote:
         | Honestly what is needed is a cheap secondary device like a
         | mobile phone which contains a custom designed chip to do
         | Machine learning fast on sound and transmit it to the ear. Even
         | if this costs 500 $ i would reckon the benefit would be worth
         | it. I guess battery technology has advanced to a level that the
         | said device can easily be recharged daily or probably swapped
         | with batteries if needed.
        
         | sputr wrote:
         | Damn that link made me happy. Was wondering if anyone has done
         | to hearing aids what they did for glasses.
         | 
         | We just brought my father progressive glasses for 100usd (would
         | be 400+usd here at a 'normal' store). Now he needs a hearing
         | aid and we're dreading the multi-hundred payment on top of what
         | is covered with insurance for a basic device.
         | 
         | So.. What's the catch with these cheap hearing aids? Why would
         | we not buy these?
        
           | bagacrap wrote:
           | quality? doesn't this question apply to every cheap Chinese
           | product? My mom has had poor hearing for decades and always
           | spent thousands on her hearing aids for marginal improvements
           | in quality (e.g. noise cancelling, size, noticeability). The
           | only thing that really made a big improvement was when she
           | finally got a cochlear implant.
        
             | criddell wrote:
             | > doesn't this question apply to every cheap Chinese
             | product?
             | 
             | The question is always valid but the answer isn't always
             | the same.
             | 
             | I'm thinking specifically of cheap eyeglasses.I've had
             | nothing but good experiences buying glasses that cost
             | 10-20% of what I would pay from a local store.
        
               | NonEUCitizen wrote:
               | What's a good place for buying these cheap eyeglasses?
        
               | criddell wrote:
               | I've only used Zenni Optical. Their glasses start under
               | $10 but different frames and different lenses can change
               | the price.
               | 
               | My biggest complaint with Zenni is that shipping can
               | sometimes be slow. I've waited 4 weeks for glasses to
               | show up and other times it's only a week. I think it
               | depends if they come from China or their US facility.
        
           | coupdejarnac wrote:
           | These are hearing amplifiers, not hearing aids. The
           | difference being that hearing aids can boost certain
           | frequency bands to compensate for hearing loss at those
           | frequencies. The hearing amplifiers boost all the audio
           | frequencies in a one size fits all manner. There's no signal
           | processing going on. Maybe that is good enough for your
           | father, maybe not.
        
           | pkaye wrote:
           | I just got myself some Costco Signature hearing aids a month
           | ago. Its $1499/pair. Its made by a major manufacturer named
           | Phonak. The feature set is close to their top of the line
           | model. Half the cost of the hearing aids in the US is
           | actually the fitting by the audiologist and they have to pay
           | for their expenses. You have to spend considerable time with
           | the audiologist to measure, fit and calibrate the device to
           | your needs. Costco is able to minimize the cost overhead
           | since the office is inside a normal Costco store.
           | 
           | The hard part about hearing aids is making them work in
           | noise. You don't want to just amplify everything or you just
           | hear more noise. Also you need to tune it to your hearing
           | loss otherwise you may damage your hearing. They do things
           | like expanding the dynamics or compressing to prevent loud
           | noises. They suppress wind noise. They can focus on the voice
           | of someone in a group of people.
           | 
           | So the catch with the cheaper hearing aids is that may not
           | help help your dad with understand speech as well as a better
           | quality one.
           | 
           | I'd suggest you watch the videos of Dr Clif Aud on Youtube.
           | He is very informative.
        
             | colejohnson66 wrote:
             | Why are multiple audiologist visits necessary? Can't they
             | just take a 3d scan of your ear and have a computer decide
             | which shape will fit best? I recall when Apple introduced
             | the EarPods, they said they scanned thousands of ears and
             | derived a shape that would fit the most. So it is
             | possible...
        
               | volkadav wrote:
               | they have to tune the DSP settings to get the
               | amplification et al. profiles to match the patient's
               | individual hearing loss pattern. that takes custom
               | interface/programmer hardware the manufacturers generally
               | only (afaik) give to licensed audiologists as it takes
               | specialized education to do this work properly. the ear
               | dome/mold bits themselves are a minor component of the
               | overall fitting process. (src: been wearing hearing aids
               | for about thirty years)
        
               | pkaye wrote:
               | I went with standard domes but it took a second visit to
               | get the size right since they take time to conform to
               | your ears. Custom molds are another option but they told
               | it I would get a more plugged up feeling so I stay with a
               | more open dome unless really needed. Also there is some
               | time for adapting to any changes in settings. They also
               | bump up the gain with each visit to reach target levels.
               | A big jump might be too much.
               | 
               | I think there is room for optimizing the whole process
               | but anything medical related tends to move slowly. I
               | still find the phone app a little slow and cumbersome.
               | And switching between bluetooth devices is a pain. I wish
               | Apple and Google would put more effort in improving that
               | aspect.
        
       | [deleted]
        
       | brento wrote:
       | I was told I could benefit from hearing aids, but was told they
       | would cost $5K to $8K depending on which ones I wanted. I've
       | decided for now that I'll put up with the issues associated with
       | not having them for now. I was also told they blue tooth doesn't
       | work very well if you have an android phone, so I'm hoping that
       | there can be some real innovation and competition in this space
       | to drive the prices down and also improve the technology!
        
         | mgerdts wrote:
         | If you can find your way to Costco, make an appointment with
         | their audiologist. The test is free and hearing aids are less
         | than $900 each. Follow-up visits are free. You do not need a
         | Costco membership unless you decide to make a purchase. If you
         | are unhappy with your purchase you can get a refund on the
         | hearing aids and the membership.
         | 
         | I believe that most of their hearing aids support bluetooth,
         | but only when you get a pair. I only need one, so no bluetooth
         | for me.
         | 
         | I've had fittings by two people at Costco. One is an
         | audiologist and the other was less credentialed, but I forget
         | the title. I could hear better when fitted by the audiologist.
        
           | jki275 wrote:
           | This is so true! We were told 8k, Costco got us a top of the
           | line set with all of the features the other set had for less
           | than 2k for the set. Costco made a customer for life out of
           | that deal. They do glasses as well, though I haven't used
           | them for that and don't know if the discounts are as good or
           | not.
        
         | Hovertruck wrote:
         | I don't have any first-hand experience to share, but my wife
         | used to work at https://www.audicus.com/ which is a startup
         | focused on exactly this problem, in case you're interested in
         | further research.
        
         | dhosek wrote:
         | That seems really high. I have the fanciest hearing aids that
         | Costco sells (rechargeable, Bluetooth, optional external
         | microphone) and I spent under $5K on it.
        
         | gedy wrote:
         | If you have access to Costco their in house brand is much less
         | (~$1600 pair) and good. Also I really like Bose Hearphones
         | which work better for me and were $500, assuming you don't mind
         | looking like you are on a conference call all the time.
        
         | pkaye wrote:
         | I just started using hearing aids and went with the Costco
         | Signature. Half the cost of hearing aids is the office
         | overheads since hearing aids need significant tuning. Costco is
         | able to leverage its existing store overhead to minimize it.
         | The Costco ones re made by Phonak and based on the features on
         | the Phonak Marvel series.
        
       | netdur wrote:
       | Ok I will bit, I want to build this and redistribute in Africa, I
       | lack technical knowledge to do this, what is best approach?
        
         | janekm wrote:
         | Talk to a Chinese factory on what's the lowest price they'll
         | sell you the hearing aids for that they already make at near-
         | cost prices. The article is literally a "my first soldering
         | project" combining an OTS microphone amp module with an R-C
         | high pass filter. https://www.ebay.co.uk/itm/Rechargeable-
         | Digital-Hearing-Aid-...
        
           | person_of_color wrote:
           | Reminds of the clock boy who designed CPUs
        
           | janekm wrote:
           | The $1 figure in the headline is clickbait as it's only the
           | cost of components for the PCB. Add the PCB + mechanical
           | components + battery + plastic enclosure + assembly + testing
           | + factory margin + overhead and it would be a miracle to come
           | under the cost of existing low-cost hearing aids.
        
             | anamexis wrote:
             | That's not true, the $1 figure for all of the parts. Here's
             | the original, search for "Table 1" for the BOM
             | 
             | https://journals.plos.org/plosone/article?id=10.1371/journa
             | l...
        
               | tyingq wrote:
               | The BOM prices are just wrong. You can find the volume
               | pricing for the MAX9814 and MAX98306. Those two alone add
               | up to more than $1.
        
               | jononor wrote:
               | Good luck sourcing 3d-printed casings at 0.06 USD, or PCB
               | at 0.05 USD a piece, even in 10k or higher scale.
               | 
               | And of course in addition to the BOM comes production
               | costs.
        
               | anamexis wrote:
               | The casing is just a rectangular plastic box with some
               | holes in it, I'm sure you could get some made at that
               | price.
               | 
               | Even if the PCB costs 5x the quoted price, you're still
               | rounding down to $1.
               | 
               | That said, I have no idea what production costs are for
               | something like this.
        
               | jononor wrote:
               | The casing is about 2 hours 3d-printing a piece. That is
               | 20'000 printer hours for 10k units, giving a machine-time
               | cost of 0.025 USD (including plastic). That is off by a
               | factor of 10-100, at least.
               | 
               | For injection molding, one would need to make the molds.
               | That would cost probably more than 1000 USD, excluding
               | engineering costs (the design is not injection molding
               | ready). Amortizing the mold costs over 10k units alone
               | would be 0.1 USD per unit. Then comes actually making the
               | parts. Maybe 0.5 USD is doable.
               | 
               | I checked an off-the-shelf casing (no custom molds
               | needed) it was quoted at 0.20 USD at 1K units - but this
               | then needs to be CNC machined on 2 sides to add the
               | necessary openings. Probably 1 USD a piece, at the least.
               | 
               | The costs in the scientific article does make any sense.
               | It is really sad to see that it gets through peer review
               | so easily... I mean OK that the scientist does not really
               | know what things cost to produce, but then they need to
               | consult someone who does! Ask a manufacturing or even a
               | design house for a cost estimate. Quality check your
               | numbers at least a little bit.
        
               | jononor wrote:
               | I would estimate the PCB costs, excluding Assembly time,
               | to be 10x the quoted price.
        
               | janekm wrote:
               | I can understand how it may seem that way when a plastic
               | takeaway box costs $0.1, why should this cost any more...
               | 
               | The article's cost assumption is just based on the cost
               | of the raw plastic material, which is hilarious (3D
               | printer time doesn't really come free).
               | 
               | But in more realistic mass production you'd make a mold,
               | and the cost of the mold is dependent on how many "shots"
               | you want to get out of it. Making plastic parts at the
               | cost of takeaway boxes requires expensive high-volume
               | molds.
               | 
               | At 10k volume you'd be happy to get the box for $1
               | including amortised mold cost (though in reality the box
               | could be much smaller, reducing mold & material costs
               | some).
        
         | grenoire wrote:
         | Step one is to come in contact with an electrical/industrial
         | engineer who will be able to assist you in the manufacturing
         | aspects.
        
         | pkphilip wrote:
         | Talk to someone in Africa who works with repairing mobile
         | phones, laptops etc. They will have enough skills to assemble
         | such a device.
         | 
         | Recruit one of them or work with of them to make the devices in
         | bulk.
        
           | sokoloff wrote:
           | Repair and bulk assembly are substantially different
           | expertise. Almost no matter how cheap the local labor is,
           | doing automated assembly with manual finishing is probably
           | going to be way cheaper in China (especially since the supply
           | chain for components is well established there).
        
         | aaron695 wrote:
         | Say you want a order of 10 million made up for a name brand
         | company to a Chinese company.
         | 
         | Send in the plans for them to check. Put on an expensive
         | looking logo and paperwork.
         | 
         | Done.
        
       | Jaruzel wrote:
       | > _the scientists anticipate that LoCHAid's parts will wear out
       | after about a year and a half._
       | 
       | Why would that be, I wonder. Anyone know?
        
         | londons_explore wrote:
         | Perhaps the AA batteries need changing that frequently?
         | 
         | Or thats the average time till they get crushed/wet/stood on by
         | the user?
        
       | dpweb wrote:
       | Unfortunately that $1 aid will cost $1000 when it hits the public
       | market. It would be nice to see open source hardware in medical
       | devices. And a health/safety approval of the DESIGN. At least
       | devices that won't kill you if they fail. So I can build my own
       | like I build my own desktop computer.
       | 
       | Buying any Chinese electronics off Aliexpress doesn't excite me
       | too much. Generally, they suck.
        
       | ggrothendieck wrote:
       | Personal sound amplification devices already exist at
       | significantly less cost than conventional hearing aids.
       | https://jamanetwork.com/journals/jama/fullarticle/2635618
       | https://www.nytimes.com/wirecutter/reviews/best-personal-sou...
        
       | danjc wrote:
       | I get that this product is about super low cost but seems to me
       | that with a custom firmware, the AirPods Pro could do a brilliant
       | job of noise cancellation and amplification of specific frequency
       | bands. Ostensibly, you could even employ some ML to enhance
       | clarity of spoken words, etc - like Krisp
        
       | caymanjim wrote:
       | This is not a $1 hearing aid and never will be. The material cost
       | of almost any device is insignificant compared to the overall
       | cost of manufacturing, testing, and distributing it. The barrier
       | to low-cost hearing aids in most countries is medical regulation
       | and liability coverage, not expensive parts. Maybe India's
       | regulations are lax enough that someone could bulk-manufacture
       | cheap, poorly-tested medical devices to get the price down to a
       | few dollars, but there's no technological breakthrough in this
       | "new device" that would enable that; if there were a viable
       | market, it would already be manufactured. There's no profit to be
       | made, so why would anyone bother?
        
         | paulcarroty wrote:
         | > if there were a viable market, it would already be
         | manufactured. There's no profit to be made, so why would anyone
         | bother?
         | 
         | Big market, not super-complex tech, it's only matter of time
         | when cheap solution comes.
        
         | markc wrote:
         | >There's no profit to be made, so why would anyone bother?
         | 
         | Really dude?
        
         | jiofih wrote:
         | > if there were a viable market, it would already be
         | manufactured
         | 
         | Yup.
         | https://m.aliexpress.com/wholesale/hearing+aid.html?channel=...
        
       | joerango wrote:
       | I wonder how different it is from something like this:
       | https://www.ebay.com/itm/Pocket-Hearing-Aid-Sound-Voice-Ampl...
        
       | [deleted]
        
       | ajnin wrote:
       | So this is a very simple circuit. Basically a microphone
       | amplifier directly connected to some earphones with a volume
       | knob. No frequency control of any kind. I'm wondering why this
       | sort of device is not already available like loupe type glasses
       | that we can easily find. I'm thinking this has something to do
       | with legislation and maximum allowed earphone sound levels? Or
       | maybe it is too crude to be actually useful?
        
         | janekm wrote:
         | It is available, even as in-ear style "hearing aid", for <$10
         | from the usual factories. I gather it's a little problematic
         | selling them in the US due to medical device regulations...
        
           | pkaye wrote:
           | You can choose among hundreds of cheap "hearing aids" on
           | Amazon.
        
           | coupdejarnac wrote:
           | They can be sold here, but they can't be marketed as "hearing
           | aids" afaik.
        
       | subhashp wrote:
       | My mother has been wearing Hearing Aids for over 20 years. These
       | days she has trouble with hearing what is on TV even with a
       | powerful hearing aid. Most times she just sits quietly in front
       | of the TV watching moving pictures.
       | 
       | I have always wondered why it is so difficult to make hearing aid
       | which can be connected to a bluetooth enabled TV or Mobile phone,
       | so senior citizens can watch TV or talk to their loved one.
       | Whatever is available on the market is so expensive.
        
         | jaclaz wrote:
         | Well, my mom has one of those.
         | 
         | They are actually two pieces, one is a match-box sized thingy
         | that can connect to Bluetooth devices and that she wears around
         | her neck that transmits to the devices in her ears and also has
         | a microphone, it is very handy as she can easily answer the
         | phone by pressing a button on it (leaving the telephone in the
         | bag, it works as hand-free) and it also has two buttons that
         | can regulate the volume of the hearing aids (the volume of her
         | hearing aids can be regulated also through a teeny-tiny button
         | on the back of the hearing aid, right hand one up, left hand
         | down, but she simply cannot find/push them properly).
         | 
         | We got the above first to better adjust volume and for the
         | telephone use, then she started getting issue with the TV and
         | we bought the following.
         | 
         | Then there is a small transmitter connected to the TV that can
         | link to the matchbox-like device (that has a fourth button to
         | connect/disconnect to the TV device), it has both RCA plug and
         | an optical input.
         | 
         | She is very, very happy of this setup for the TV, much more
         | than what she had before (wireless headphones).
         | 
         | Prices are steep, to give you an idea, if I recall correctly:
         | 
         | hearing aids EUR 2,500
         | 
         | neck matchbox-like thingy EUR 250
         | 
         | TV transmitter EUR 300
        
           | pomatic wrote:
           | They do come up on ebay - I got the tv link for my cochlear
           | implant for PS30. Yes, I was lucky. I assume it was a
           | deceased estate sale, and I'm grateful for their
           | consideration. A charity shop specialising in recycling of
           | this kind of tech would fill a definite gap in the market.
        
         | pkaye wrote:
         | There are bluetooth enabled hearing aids. Also you can get
         | normal headphones with bluetooth capability. I have 60dB
         | hearing loss and use the bluetooth headphones from time to time
         | both with and without my hearing aids.
        
       | patorjk wrote:
       | As an aside, there's a lot of exciting regenerative work going on
       | related to hearing at the moment. Sometime soon we may no longer
       | need hearing aids. There are some neat drugs either in clinical
       | trials or about to begin clinical trials that will re-grow hair
       | cells and broken synapses in the cochlea (ex: FX-322, OTO-413,
       | OTO-6XX).
        
         | volkadav wrote:
         | wow! ah, other than naive googling on those drug candidate
         | identifiers, are there any sources you'd recommend to read more
         | about this?
         | 
         | (I have a genetic condition that tl;dr impacts hair cell
         | substrate material leading to hearing loss by early teens.
         | Being able to hear natively again would be ... words fail me.)
        
         | snegu wrote:
         | Are any of these supposed to work on congenital hearing loss,
         | or only when hearing loss is caused by damage/age?
        
           | newyankee wrote:
           | In theory i believe if regeneration of cells is involved it
           | should work with congenital but i guess there might be other
           | complexities that might be involved (not a medical
           | professional).
        
           | ygjb wrote:
           | It depends on the nature of the hearing loss, for example,
           | FX-322 and OTO-6XX appear to work by triggering regeneration
           | of hair cells, while OTO-413 appears to work by triggering
           | regeneration of synaptic connections (both of which are
           | probably egregious oversimplifications because I am a
           | security nerd, not a medical researcher :P)
        
         | xtracto wrote:
         | I am closely following FX-322, but mostly for tinnitus. I do
         | have hearing loss, but it is that disrupting so far. But the
         | tinnitus is something I could definitely live without.
        
           | newyankee wrote:
           | Any other clinical trials that you can recommend ? Has the
           | path from clinical trials to commercial launch shortened ?
        
         | newyankee wrote:
         | Stefan Heller from Stanford's lab had set a goal somewhere
         | around in 2010 to cure hearing loss by 2020 by trying to
         | convert stem cells to hair cells. I have never heard of any
         | breakthrough. I hope this happens in 10 more years at least.
        
           | patorjk wrote:
           | This is similar to how Frequency's FX-322 drug works. It
           | stimulates progenitor cells [1] within the cochlea to divide
           | and form new hair cells. From what I've read, progenitor
           | cells are basically one step away from a stem cell.
           | 
           | [1] https://en.wikipedia.org/wiki/Progenitor_cell
        
             | newyankee wrote:
             | thanks, looks interesting. I hope these are only first
             | steps to more interesting developments.
        
       | biggieshellz wrote:
       | A few notes here:
       | 
       | * This is intended to treat presbycusis, or old-age hearing loss,
       | where the highest frequencies are lost first. It would not be
       | effective for noise-induced hearing loss, where the frequencies
       | around 4 KHz are lost first (the "s" and "f" sounds in speech).
       | This matters in the low-income countries it's targeted for,
       | because occupational health is not as strict and PPE is not as
       | widely utilized, so people are more often exposed to damaging
       | levels of noise at work.
       | 
       | * It does not handle loudness recruitment, a common effect of
       | damage to the outer hairs in the cochlea which causes loudness
       | perception to become non-linear. Someone with a moderate hearing
       | loss would hear an 80 dB sound as just a few dB softer than
       | someone with normal hearing, but a 40 dB sound as many dB softer
       | than someone with normal hearing, and a 20 dB sound as not
       | audible at all. So if you do what this hearing aid does and boost
       | it all by 15 dB, the 20 dB sound becomes barely audible, the 40
       | dB sound is perceived as "about right", but the 80 dB sound is
       | perceived as nearly 95 dB (really freaking loud). You have to
       | have some non-linear compression in there to adjust for this, and
       | not just overall -- it needs to be per frequency band
       | (https://en.wikipedia.org/wiki/Bark_scale) to match the way the
       | ear works.
       | 
       | * Another commenter mentioned that the "bandwidth to the brain"
       | is not available. That's only true in the case of damage to the
       | inner hairs of the cochlea. What's more common is damage to the
       | outer hairs, which amplify the sounds, and that can be
       | compensated for with a hearing aid.
       | 
       | What we really need is a common way to program a hearing aid, so
       | we can have apples-to-apples competition. Right now, when you go
       | to the audiologist, you get an audiogram, which tells you the
       | minimum threshold of sound that you can perceive at each
       | frequency band. But beyond that, there are proprietary
       | adjustments for compression, noise reduction, profiles for
       | different types of loss, and so forth. It's not like getting
       | glasses, where your prescription fully defines the lens, and you
       | can take it to any vendor and have them make it for you.
       | 
       | Edit: If you're really into this stuff from a technical
       | perspective, http://refined-audiometrics.com/wordpress1/ is worth
       | a read -- it's a project by an engineer who experienced a hearing
       | loss later in life who has built a software system to make music
       | sound right for him again, basically building a "super hearing
       | aid" running on a desktop CPU to do more fine-grained processing
       | than what is possible within the power budget and form factor of
       | a regular hearing aid.
        
       | jerome-jh wrote:
       | 15dB amplification is very little. A 15dB hearing loss can really
       | go unnoticed. It may help a few people, however this will never
       | be a medical device mainly because it has no medical use.
        
       | HashingtheCode wrote:
       | $1 hearing aid costs about $20...... what?? Clickbait.
        
       | rini17 wrote:
       | Hearing aids (nor cochlear implants, for that matter) do not
       | "restore hearing", except for light hearing loss. They are only
       | like crutches (not even wheelchair). For example, to follow
       | conversations or phone/skype with multiple people is very
       | exhausting even with fancy device, because in most cases the
       | "bandwidth" to the brain just isn't available.
       | 
       | That said, the hearing aids vendor lock-in is really atrocious
       | and can use a disruption. They don't like users configuring the
       | aids themselves, you are expected to make appointments with
       | audiologist - in fact several of them because every hearing loss
       | is different and it's hard to exactly measure, so usually the
       | aids won't fit on first or second try. The algorithms are
       | strictly proprietary - when there's 40dB difference between
       | responses to different frequencies such as I have, usual
       | equalizer won't do. To enable bluetooth the rule is to buy
       | expensive add-on streamer.
        
         | darkmoney007 wrote:
         | DIY Hearing Aids is on the rise because of this.
         | 
         | It's more accessible now than before.
        
         | ampdepolymerase wrote:
         | For a few dollars more it is possible to put a FPGA with
         | perhaps a neural accelerator on it. It may tremendously
         | simplify some of the DSP stack. More importantly, there should
         | be a full-proof app or UI to allow the user to tune the hearing
         | aid appropriately (or coupled with a training course for
         | audiologists in the targeted regions to do so).
        
           | KSteffensen wrote:
           | Hearing aids are tremendously constrained with regards to
           | power and mechanics. There is no way you will be able to get
           | an FPGA in a hearing aid. An FPGA runnning complex DSP
           | algorithms will:
           | 
           | 1. Get hot. I don't want a +60C FPGA in my ear.
           | 
           | 2. Eat up the battery. The batteries are small and fiddly to
           | replace for an 85 year old with bad eyes and arthritis in the
           | fingers. They should last for at least a week before needing
           | replacing. No they are generally not rechargeable in the
           | device. That would require a connector, which takes up
           | precious volume. Wireless recharging requires a coil with the
           | same problem.
           | 
           | 3. Take up way too much PCB real estate. They are just too
           | big to fit in your ear. Sure, you can run a wire to a box
           | outside the ear, but that messes with the fashion statement.
           | Most hearing aid users want small and discrete, so the world
           | isn't reminded they have a disability.
           | 
           | Besides, why would you put an FPGA in there? Hearing aids
           | already feature some of the most high-grade low-power DSP
           | ASICs available, custom made for that companys DSP
           | algorithms.
        
             | boogies wrote:
             | > a connector, which take up precious volume. Wireless
             | recharging requires a coil with the same problem.
             | 
             | Couldn't a "connector" just be a tiny gold contact to meet
             | another in a charging cradle/case like a smart watch or
             | wireless earbuds? Would that be too big?
        
               | etskinner wrote:
               | More than just a connector, it also needs a charging
               | circuit, which would also take up space.
        
               | boogies wrote:
               | Does that charging circuit need to be inside the hearing
               | aid, and not in the charging cradle/case/dock thing?
        
               | ygjb wrote:
               | Generally, yes. The circuitry for power does more than
               | charge the battery, it provides power regulation to
               | prevent over discharge and reduce the likelihood of short
               | circuits (among other things)
        
             | loa_in_ wrote:
             | About the precious volume and heat - the technology still
             | seems very unimpressive given we have wireless earbuds in
             | stores. Mounting something behind the ear doesn't seem very
             | extravagant these days and vendors only profit from this
             | forced conservative approach because it smothers any
             | potential competition that thinks it has to be this way.
        
               | magnetic wrote:
               | There are trade-offs.
               | 
               | Behind the ear is great when you still have reasonable
               | hearing in a good chunk of the spectrum, so the dome from
               | the BTE provides the boost that is additive to the
               | natural signal.
               | 
               | Wireless earbuds' counterparts in the hearing aid world
               | are called "in ear" or "in canal" or "completely in
               | canal" or "hidden", and they provide some benefits, but
               | do have a couple of drawbacks: they can often give the
               | impression of a plugged ear because they keep the natural
               | signal out (exacerbating tinnitus, which is common with
               | hearing loss), and they can irritate the ear canal from
               | all the friction (that part of our body is very
               | sensitive). They can also prevent the natural outflow of
               | cerumen (wax) and cause its accumulation.
        
               | DanBC wrote:
               | Yes. Plenty of people prefer behind the ear devices
               | because they are either rechargable, or brightly
               | coloured. Young people in particular benefit from being
               | able to chose an aid that's brightly coloured, and you
               | see some YP modify their aids with skins or stickers.
               | 
               | Here's the colour range for one modern aid:
               | https://www.fmhearingsystems.co.uk/PDF/FocusColours.jpg
               | 
               | Rechargable: https://www.phonak.com/uk/en/about-
               | us/rechargeable-technolog...
        
               | mdw wrote:
               | Having a brightly coloured hearing aid as an adult
               | doesn't look professional. Are these marketed towards
               | younger people?
        
               | ygjb wrote:
               | This is your opinion. In many parts of the world,
               | criticizing a piece of accessibility equipment as
               | unprofessional is likely an HR violation, and probably
               | grounds for termination.
        
               | lostlogin wrote:
               | It is and you are correct. It's not unreasonable for
               | someone to want a more neutral colour if that is their
               | preference though. Some HA users are self conscious and
               | hide that they are wearing them.
        
               | dhosek wrote:
               | As an adult, I want a brightly colored hearing aid. I
               | don't care about hiding my disability--in fact I'd rather
               | it be difficult for others to ignore--and I want it to be
               | easy to find if my kids knock one out of my ears which
               | happens less now that they're six but still happens.
        
               | libraryofbabel wrote:
               | Why not? People wear brightly colored jewelry or
               | "statement" eyewear in a professional context all the
               | time.
               | 
               | Are you saying that it's "professional" to hide your
               | disability if you have hearing loss? If so, then I
               | strongly disagree. It's a personal choice.
        
               | nicoburns wrote:
               | Indeed, to make an even more direct comparison: brightly
               | coloured glasses are very common these days. They seem to
               | be treated like neckties: it's acceptable for them to
               | standout even in very formal situations.
        
             | csunbird wrote:
             | is it possible to use the users phone for those
             | calculations ?
             | 
             | Think about a dumb hearing aid, with a microphone and
             | bluetooth connection, which is able to connect to any
             | compatible phone and phone does the processing.
        
               | coupdejarnac wrote:
               | Easier said than done. I developed a hearing aid app for
               | iOS.
        
               | ampdepolymerase wrote:
               | Realtime audio is tricky without hardware acceleration.
        
               | Someone wrote:
               | A recent smartphone has enough hardware for that, I would
               | think, and if it hasn't, but the idea made sense, it
               | would be added. If the hardware can power a GPU and a
               | million-pixel display, it can power quite a beefy DSP,
               | too.
               | 
               | I would worry about the latency of a round-trip over
               | Bluetooth. Google search tells me it's, optimistically,
               | 100ms single-trip, so 200ms round trip
               | (https://www.headphonesty.com/2020/07/fix-sound-delay-
               | bluetoo...)
        
               | pmayrgundter wrote:
               | See madspindel's comment above ^^^ about Bluetooth 5.2 LE
               | Audio and this:
               | 
               | LE Audio: Announced in January 2020 at CES by the
               | Bluetooth SIG, LE Audio will run on the Bluetooth Low
               | Energy radio lowering battery consumption, and allow the
               | protocol to carry sound and add features such as one set
               | of headphones connecting to multiple audio sources or
               | multiple headphones connecting to one source It uses a
               | new LC3 codec. BLE Audio will also add support for
               | hearing aids.
        
               | TheRealSteel wrote:
               | Can anyone who knows about Bluetooth comment on why I can
               | ping google in 50ms (wirelessly, even), but a Bluetooth
               | round trip over a few centimetres takes 2 - 3X that?
        
               | callalex wrote:
               | Please don't think of me as an expert, because the sum of
               | my knowledge comes from browsing Wikipedia articles. But
               | the summary of the issue is that Bluetooth gets all its
               | energy efficiency and robustness by constantly scanning
               | the spectrum it is to live in, and hopping around
               | extremely fast to different slices of channels,
               | essentially taking advantage of the tiny "gaps" in other
               | signaling protocols that share the same free spectrum. In
               | other words it operates on sloppy seconds/scraps like a
               | vulture, which means it's timing is very loose and cannot
               | provide any guarantees. But it's very low power as a
               | result because it almost never has to shout over anyone
               | else.
        
               | EricE wrote:
               | And wireless introduces significant latency! You don't
               | want wireless anything if you can at all avoid it with
               | real time audio.
        
           | chrisweekly wrote:
           | full-proof -> fool-proof
           | 
           | NOT being pedantic, just trying to be helpful / educational
           | (esp given the large % of non-native English speakers on HN)
        
             | ampdepolymerase wrote:
             | Sorry the auto correct changed the spelling. I meant fool-
             | proof. I am a native speaker.
        
         | SeasonalEnnui wrote:
         | Multiple-decades of hearing aid wearing here. I agree with most
         | of that. I ended up buying the programmer for my aids to do
         | small tweaks (not the prescription/audiogram, just the program
         | configuration where you can edit the level of DSP in various
         | situations).
         | 
         | I would say that this latest generation of hearing aids (Phonak
         | Marvel) is the first generation where I've felt like they've
         | got it right. Direct bluetooth connection that _just works_ ,
         | and with a very wide range of volume adjustment (older models
         | that used add-on streamer would not go loud enough). People
         | receiving my voice over bluetooth, using the hearing aid's
         | onboard microphones, report good sound quality. Magic.
        
           | tobtoh wrote:
           | I'm about to trial a replacement for my current HA (about 5
           | years old) for the Phonak Paradise (the just released
           | successor to the Marvel). The bluetooth connectivity has been
           | a big reason why I want to upgrade - the work from home
           | situation this year with constant phone calls and Zoom
           | meeting requiring headsets has been a constant annoyance.
           | 
           | I use an Airpod in my right ear and leave one HA in my left
           | for those situations - but its fiddly and annoying to keep
           | switching things in and out. The new IOS14 feature where I
           | can tailor the Airpod audio response to my hearing frequency
           | loss is simply amazing! However, being able to connect/stream
           | audio directly to my HA will be even better.
           | 
           | They are seriously pricey though - cheapest model is Aus$2700
           | (US$2000) and the top line model is Aus$8400 (US$5900).
           | However, given I feel I got made redundant from a previous
           | job five years ago due to my hearing loss (1), I'll basically
           | spend 'whatever' to ensure I can hear as easily as possible.
           | 
           | (1) In that job, I was wondering why as the years went on, I
           | felt like I was struggling to pickup new concepts or get a
           | handle on projects as fast as I used to. I seriously felt
           | like I was getting stupider. After I got my hearing aids, I
           | realised how much speech I was missing - I was heavily
           | relying on lip reading and also using the context of
           | conversation to fill in the gaps of words I couldn't hear.
           | Which is passable in general conversation - but when managing
           | new projects or new technology concepts, you don't have the
           | experience to generate the context that fills in the gaps. It
           | was literally life-changing when I got my HA. Go an get your
           | hearing tested if you ever feel you are even remotely
           | struggling with your hearing!
        
             | rajandatta wrote:
             | Whats your view of the Phonak aids? As a user, would you
             | say they are worth the money?
        
             | jiofih wrote:
             | > The new IOS14 feature where I can tailor the Airpod audio
             | response to my hearing frequency loss is simply amazing!
             | 
             | What feature is it? Can't the same be achieved with EQ?
        
               | tobtoh wrote:
               | https://support.apple.com/en-in/HT211218
               | 
               | I'm not sure ... i was under the understanding the that
               | EQ function on iOS only applied to music. I guess the
               | other advantage is that audiogram function makes it a
               | one-click accurate configuration of the 'EQ' based on a
               | hearing test.
        
               | ChuckMcM wrote:
               | Wow, I wrote Apple and suggested they do exactly that.
               | That this feature isn't part of the "introduction to your
               | airpods" stuff is wrong. It should be!
        
           | otoburb wrote:
           | And the Phonak Marvel's retail price is north of $1,000 USD.
           | Can some of the cost to the individual be defrayed through
           | medical insurance in the US?
        
             | snegu wrote:
             | My insurance covers hearing aids, but it definitely varies.
        
               | dhosek wrote:
               | I've never had insurance cover hearing aids. It's
               | criminal that something so essential isn't covered.
        
         | [deleted]
        
         | m0zg wrote:
         | I think skype is exhausting not for this reason but because
         | algorithms cut speakers out when someone else starts speaking
         | for echo and feedback suppression. I wish there was true full-
         | duplex mode that assumes everyone is wearing headphones, so
         | there aren't any reverberation concerns.
        
         | madspindel wrote:
         | It's because it's a medical device. The OTC Hearing Aid Act
         | will change that so Bose (and I would guess Samsung and Apple
         | in the future) can sell hearing aids directly to consumers.
         | 
         | Bluetooth 5.2 LE Audio will solve the vendor lock-in. So the
         | future looks bright for us with hearing loss.
         | 
         | Edit: And with iOS 14 you can use AirPods Pro as hearings aids
         | by adding an audiogram to the Apple Health app. Works really
         | well.
        
           | [deleted]
        
           | inetsee wrote:
           | There is a hearing aid app called Fennex that seems to be
           | very highly rated. It works with any IPhone running iOS 11 or
           | later (thus less expensive IPhones) and works with any
           | Bluetooth earbuds, not necessarily the AirPods Pro (thus less
           | expensive earbuds). I have never owned an IPhone, but this
           | app seriously tempts me to buy one.
        
             | WrtCdEvrydy wrote:
             | iPhone SE locked down to a specific carrier used in A-rate
             | (best quality) goes for $50 on ebay. iOS14 is guaranteed to
             | work on it for at least one year.
             | 
             | Edit: I am not an Apple guy but needed some cheap AF
             | development hardware.
        
             | coupdejarnac wrote:
             | I developed a hearing aid app for iOS in the past. You
             | might not be happy with the delay that wireless earphones
             | introduce.
        
           | Someone wrote:
           | Apple already sells a hearing aid that they can't legally
           | call 'hearing aid'. https://support.apple.com/en-us/HT209082:
           | 
           |  _"With Live Listen, your iPhone, iPad, or iPod touch can act
           | like a microphone that sends sound to your AirPods or
           | Powerbeats Pro. Live Listen can help you hear a conversation
           | in a noisy area or even hear someone speaking across the
           | room."_
           | 
           | It even supports hearing aids (a few? Some? Many? The most
           | popular? I wouldn't know). See https://support.apple.com/en-
           | us/HT210386
        
             | emcq wrote:
             | Unfortunately live listen is more like a replacement for
             | remote microphones, not the hearing aids themselves. It
             | adds around 70ms latency with a bluetooth headset. This is
             | enough to be very uncomfortable. For comparison, most
             | hearing aids on the market today have around 8ms of end to
             | end latency.
             | 
             | Source: I've built a hearing aid and done extensive latency
             | tests :)
        
               | eyesee wrote:
               | I have a major hearing impairment in one ear. Using one
               | AirPod with Live Listen was completely unusable to me
               | because of this latency.
        
               | TaylorAlexander wrote:
               | Hmm and I also heard John Carmack talking about problems
               | with audio latency in conversations. 70ms is a lot!
        
               | coupdejarnac wrote:
               | I had a hearing aid app on the iOS app store for a few
               | years, and all I got was whinging about my app not fully
               | supporting Airpods/bluetooth headphones. I had in the app
               | description and on the website recommending using wired
               | headphones so there was no delay, but people don't
               | understand how things work even when they are told point
               | blank. The reason why people don't notice the delay with
               | bluetooth devices during media playback is that media is
               | delayed to sync with the bluetooth audio. When Apple
               | deprecated wired headphones, I called it a day.
        
           | pmayrgundter wrote:
           | My gosh, thanks for posting this! It's been very frustrating
           | watching hearing loss affect my older family members and
           | seeing how bad the hearing aid situation is. The OTC Act +
           | the updated Audio spec looks like the right solution!
        
         | tootie wrote:
         | Eargo lets you calibrate yourself, but the devices themselves
         | are still fairly expensive.
        
         | etse wrote:
         | > That said, the hearing aids vendor lock-in is really
         | atrocious and can use a disruption
         | 
         | Agreed about the disruption in this space.
         | 
         | > They don't like users configuring the aids themselves
         | 
         | I get the feeling most users don't want to configure the aids
         | themselves, and even if they did, wouldn't feel comfortable
         | doing it or don't have the ability or audiology knowledge
         | needed.
         | 
         | Later on you mention how helping with hearing loss is not quick
         | or straightforward, which seems to support that the default of
         | encouraging sessions with an expert is right approach, at least
         | to start.
        
         | wefarrell wrote:
         | Cochlear implants do not "restore hearing" but they do allow
         | people who are completely deaf to sense sound well enough to
         | understand speech.
         | 
         | That's a huge change in a deaf person's life.
        
           | canada_dry wrote:
           | > to sense sound well enough
           | 
           | My understanding is that it's like a low-sighted person being
           | able to see _contrasts and outlines_ of things. It 's enough
           | to differentiate things, but significantly less than the
           | detail of regular ability.
        
             | jonathanlb wrote:
             | That could be for Deaf people. I'm a cochlear implant user,
             | having been hearing impaired most of my life. Because I
             | know what things sound like, I have an advantage over Deaf
             | users of CIs. Thus, for me, hearing is like the difference
             | between a RAW image or the same image in JPEG with heavy
             | artifacting, or like seeing something in 60fps- you know
             | what you're sensing, but it's just off a little, but still
             | much better than sensing nothing or very little at all.
        
             | noisem4ker wrote:
             | There are several simulators on the Internet, so you can
             | hear what it sounds like.
        
         | jbarham wrote:
         | > Hearing aids (nor cochlear implants, for that matter) do not
         | "restore hearing", except for light hearing loss
         | 
         | This claim is totally false for cochlear implants. I am a
         | cochlear implant recipient and before the implant I had
         | essentially no hearing in my right ear ("profoundly deaf").
         | With the implant in my right ear my hearing has been restored
         | to 90%+ of normal hearing.
        
         | mgh2 wrote:
         | I work on ecommerce, so I often see trendy products being
         | marketed: usually sourced from China and hyped to sell at
         | 20-50x its price.
         | 
         | I am trying to see how different this device is compared to
         | sound amplifiers marketed as 'miracle hearing aids' found in
         | any ecommerce site. The last thing HN wants is to fall victim
         | to an advertorial disguised as a scientific discovery.
         | 
         | Note: I worked for a company that wrote 'scientific' articles
         | like this as landing pages.
        
           | TaylorAlexander wrote:
           | Yep. I have a pair of fully functional Bluetooth earbuds that
           | cost $8 including shipping. It is already possible to make
           | cheap amplifying earbuds. The problems are largely
           | regulatory. I'm glad someone said the US passed or will pass
           | a law that allows earbud manufacturers to sell their devices
           | as hearing aids. I found a broken/crushed AirPod on the
           | ground and my goodness they pack serious engineering into
           | those tiny things.
        
         | Waterluvian wrote:
         | This all sounds similar to my experience with CPAP machines.
        
       | Snitch-Thursday wrote:
       | TL;DR: someone could make bank selling < 150USD a pop receiver-
       | in-canal wireless bluetooth headphones.
       | 
       | This is semi OT. I use a hearing aid every day. the hearing aid
       | features are turned off, i just use it for bluetooth streaming
       | and phone conversations. it is a receiver in canal hearing aid,
       | and I've put a non-occluding ear dome on it so I can hear
       | normally with it in, but when I play music, the music just
       | arrives in my ear. its also very discrete, people dont notice it
       | unless i tell them its there.
       | 
       | Why someone doesn't take a cheap android/iphone bluetooth-
       | compatible receiver in canal hearing aid and sell it not as a
       | certified hearing device (heck, disable the hearing aid part in
       | sw) but as a discrete wireless headphone set is a mystery to me.
       | 
       | Wireless headphones give me earaches with pressure on my ear
       | canal, over the ear headphones give me headaches with pressure on
       | my ears, then glasses, then skull. Custom in-ear monitors conform
       | to my ears just fine but block out most other sound and have
       | wires to deal with.
       | 
       | These? I put them in, forget about them for a long time, and have
       | sound just floating into my ears when I turn on music.
       | 
       | It's my go-to startup idea.
        
       | DenisM wrote:
       | Related to hearing problems there is also a thing called"Auditory
       | processing disorder":
       | 
       |  _Individuals with APD usually have normal structure and function
       | of the outer, middle, and inner ear (peripheral hearing).
       | However, they cannot process the information they hear in the
       | same way as others do, which leads to difficulties in recognizing
       | and interpreting sounds, especially the sounds composing speech.
       | It is thought that these difficulties arise from dysfunction in
       | the central nervous system_
       | 
       | https://en.wikipedia.org/wiki/Auditory_processing_disorder
        
       | artonge wrote:
       | The blueprints are hosted on github: https://github.com/bhamla-
       | lab/LoCHAid-2020-PLOS-ONE
       | 
       | Edit: there is also a video showing the building process:
       | https://www.youtube.com/watch?v=e0gnbOJ3nDo
        
         | anamexis wrote:
         | And the original scholarly article:
         | 
         | https://journals.plos.org/plosone/article?id=10.1371/journal...
        
       | Abishek_Muthian wrote:
       | This is nice, I was looking at this problem a while back and was
       | wondering whether implementing sound amplification features on
       | cheap TWS earphones can solve that[1], of course it wouldn't be
       | $1 and I wonder whether the latency of BLE would defeat its
       | purpose.
       | 
       | [1] https://needgap.com/problems/22-enabling-hearing-aid-
       | feature...
        
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