This transcript was prepared by a transcription service. This version may not be in its final form and may be updated.
Charlotte Gartenberg: Hey, Future of Everything listeners. In today's episode, we're looking at how hearing aids can do way more than help you hear and how the hearing aids of tomorrow will even predict aspects of your physical and mental health. We want to hear from you. What's one thing you wish a hearing aid could do? Take a listen to the episode and send a note to foepodcast@wsj.com. Thanks for listening, and now onto the show. It was a cold day in West Fargo, North Dakota. David Kruse had just gotten home from work and changed his clothes to relax for the evening, but he couldn't stand seeing that clean filter alert light on the air purifier anymore, so he decided he cleaned it out really quickly using the vacuum in his garage, he went out to his driveway where he tripped and fell, alone.
David Kruse: It was 20 degrees outside, and I'm ashamed to say all I had on was a robe and T-shirt and shorts, and I stumbled and my foot caught and down I went. I skinned up my arm and I dislocated my left shoulder and I hit my head on the front bumper of my car.
Charlotte Gartenberg: David Kruse is 71. He's a hearing instrument specialist who sells hearing aids made by Starkey, one of the largest hearing aid companies in the world. He also wears one of their devices, which has fall detection. When he fell, it was set to notify his wife.
David Kruse: As far as I know, I might've been knocked out for a few moments, but within literally seemed like a long time, but maybe within two minutes I heard my wife come to the back door.
Charlotte Gartenberg: Kruse is one of more than 44 million Americans with mild to complete hearing loss, but less than 25% of Americans with hearing loss actually use a hearing aid. That's due in part to stigma. Kruse understands that, but he says he doesn't feel it himself.
David Kruse: Just never thought that wearing hearing aids was any kind of stigma. I mean, there was the old, "Well, you wear hearing aids, you're an old person."
Charlotte Gartenberg: Older people are the majority of hearing aid users. One in three Americans between the ages of 65 and 74 has hearing loss after 75. It's nearly half, but the hearing aids of today are not your grandfather's hearing aids. They've come a long way, not only in how they look, but in how they work and what they can do. Achin Bhowmik is the chief technology officer and executive vice president of engineering at Starkey, one of the world's biggest hearing aid companies. He says three questions guide his approach to developing hearing aids.
Achin Bhowmik: One, can we make hearing aids that people will be proud to show off and not wanting to hide?
Charlotte Gartenberg: When you picture a hearing aid, you might imagine a bulky peach-colored plastic thing that hugs the back of an ear, but today, they're sleek, discreet, or even effectively invisible.
Achin Bhowmik: Number two, can we use modern technology that's just changing the world in front of our eyes, artificial intelligence, to do intelligent amplification of the sound that matters to me?
Charlotte Gartenberg: Deep learning, a machine learning method, can help hearing aids filter sound in the most challenging acoustic environments.
Achin Bhowmik: Third question. Could we turn this device into a multifunctional multi-purpose device for me?
Charlotte Gartenberg: Today's hearing aids go beyond the ear. They connect to our phones through Bluetooth, even monitoring our steps and exercise, but the hearing aids of tomorrow aim to do even more. Like not only detect that you have fallen, but predict whether you're more likely to trip and fall.
Achin Bhowmik: I'm telling you, there'll be a time when everyone will have any devices with this magical technology that clarifies and amplifies the world of sound, lets you track your health, and then it'll be your in connection to the world that will connect to you and communicate with you. You'll not want to live without such a device.
Charlotte Gartenberg: From the Wall Street Journal, this is the Future of Everything. I'm Charlotte Gartenberg. Today we're looking at the cutting edge hearing aid tech that's aiming to make hearing aids not only an assistive device, but a vital accessory. The hearing aids of tomorrow will track and even predict aspects of both your physical and mental health, whether or not you're one of the 55 million Americans projected to have hearing loss by 2030. Stay with us. Achin Bhowmik is a hearing aid company executive at Starkey and a hearing aid user.
Achin Bhowmik: I take my device, take it out of my charger as soon as I'm up from my bed at 5:00 AM and then I put it on and I don't remove them until when I'm about to go to sleep midnight.
Charlotte Gartenberg: Bhowmik wears his company's latest hearing aid model, the Genesis AI. It comes in a range of styles. The invisible model is about the size of the end of a pinky finger and sits in the second bend in the ear canal. After that, there are a bunch of slightly larger in-ear varieties, and finally, the largest one which Bhowmik wears. It's got an in canal receiver that connects by a transparent conducting cable about a quarter of a millimeter thick to the hearing aid unit that rests discreetly behind the ear. During our Zoom call I didn't even notice it until he took it off to show me.
Achin Bhowmik: All day I can do phone calls and numerous meetings. I can listen to hours and hours of audio, books, lectures. It's always there. It's connected to the smartphone streaming when I have to stream.
Charlotte Gartenberg: But Bhowmik doesn't typically have trouble hearing.
Achin Bhowmik: Most times I don't even need to use the sound amplification function, because my hearing system works fine except when I am in a challenging lunch, I'm in a business meeting at Starbucks or at a restaurant. In the evening or during the coffee meeting or something. It's noisy environment I will turn my hearing aid on to listen to the person that's in front of me.
Charlotte Gartenberg: Hearing in noisy environments is actually hard for all of us. Picture this with your ears. You're at a party. There's music playing, glasses clinking, and the constant din of people chatting in the background. It's loud. You make an effort to hear your friend. You can pick their story out from the cacophony of voices, because that's the voice you're paying attention to.
Speaker 8: And I've only known him to have this jet black hair.
Charlotte Gartenberg: Your brain prioritizes their voice sort of dimming the others.
Speaker 8: Turns out he's a brindle poodle, so that means he has brown and black marble-
Charlotte Gartenberg: But it can still be a challenge to hear. For people with hearing loss, this can be even more difficult.
Lawrence Lustig: The more classic refrain is not that I can't hear, but I don't understand. I've got somebody coming in 65, 70 years old. They don't hear as much or they don't think they hear any differently, but the spouse is saying, "You don't hear as well. Go and get your hearing checked."
Charlotte Gartenberg: That's Dr. Lawrence Lustig. He's the chair of the Department of Otolaryngology head and neck surgery at Columbia University's College of Physicians and Surgeons. He sees 80 to a 100 patients per week. He says hearing loss is a combination of what's happening in the ear and in the brain. Prolonged unaddressed hearing loss means the parts of the brain that process sound, get less stimulation. They can weaken or even atrophy, but most age-related hearing loss has to do with frequency, which is a function of the ear, not the brain. A lot of Lustig's patients can still hear, but voices sound muffled.
Lawrence Lustig: And then they come in and the low frequencies are pretty good, but they're missing the high frequencies.
Charlotte Gartenberg: Before we get into the new tech that's transforming hearing aids that not only solves problems, but anticipates future health problems, we have to understand how hearing loss works, so stick with us here. Most of us lose the higher frequencies of our hearing range as we age. A typical hearing range for an adult in their 20s is from 20 hertz to 20,000 hertz. Don't worry if you didn't hear that second tone. Most of the sounds in our day-to-day lives are somewhere between 2,000 and 8,000 hertz. For example, the sound of a bird singing measures somewhere between 1,000 and 8,000 hertz. When your upper range dips below seven or 8,000 hertz, you start to have problems hearing.
Lawrence Lustig: Think about sort of the structure of the English language, right? We have vowels and consonants and think of vowels as sort of the architecture, the structure of the sound, whereas the consonants fill in some of the blanks. So if I say, rat, cat, bat, chat, mat, and you've got significant high frequency hearing loss, you're going to hear, "ah, ah, ah, ah, ah."
Charlotte Gartenberg: One way a hearing aid can help bring back some of those consonants is by turning up the volume on the high frequencies. Amplification of specific frequencies has been possible since the 1970s, but even with frequency adjustment, it's still difficult for a hearing aid to know what to suppress and what to amplify?
Lawrence Lustig: So if you go into a loud, noisy, crowded restaurant, you're going to be amplifying all of the background noise, and some people find that even more annoying than not having a hearing aid in at all.
Charlotte Gartenberg: With the addition of digital signal processing, this improved somewhat.
Ian Bruce: So it's basically a little computer program running on the computer chip in the hearing aid or the earbud that is analyzing that signal in a much more sophisticated way.
Charlotte Gartenberg: Ian Bruce is a professor of electrical and computer engineering at McMaster University in Ontario. He says, digital signal processing, or DSP, has been around since the 1980s, but chip technology had to catch up or rather shrink down. 1995 saw the first commercially successful fully digital hearing aid. Bruce says, this move to digital is the linchpin that allowed for the AI development we see or rather hear in hearing aids today.
Ian Bruce: More sophisticated signal processing, such as detecting if there's background noise and trying to reduce that background noise or detecting if there's speech and enhancing that speech is much easier to do with digital signal processing techniques.
Charlotte Gartenberg: Starkey's hearing aids are constantly analyzing the environment and adjusting. Here's Starkey CTO, Achin Bhowmik again.
Achin Bhowmik: The powerful processor we built into this device, 80 million times an hour, so 22,000 per second. It's amazing, mind-boggling. It's doing an analysis of the soundscape, doing fine adjustments to the sound without you knowing it or doing anything about it.
Charlotte Gartenberg: DSP can use traditional statistical analysis, but machine learning can do so much more, so much faster. Starkey's hearing aids build on DSP by using artificial intelligence, especially deep neural networks to decide which voices to suppress and which to amplify? Basically, they train an algorithm with tons of data. Bhowmik says they train their deep neural network with over 10 billion sound instances, both speech and noise, which in this case can refer to anything from an AC to background chatter. In certain environments, the user can activate something called edge mode that's trained to enhance voices. Bhowmik says that's the difference between this.
Speaker 9: She slipped and sprained her ankle on the steep slope.
Charlotte Gartenberg: And this.
Speaker 9: She slipped and sprained her ankle on the steep slope.
Charlotte Gartenberg: Other companies also use AI to determine which sounds to dim and which to make louder, though not all use deep neural networks to do it. I asked Bhowmik about privacy concerns over user data, and he told me the hearing aids do not record speech. They take a snapshot of the acoustic patterns and features of the environment you're in to decide which mode works best for your environment. Enhancement and suppression are not the only ways to deal with understanding speech in noisy environments. The AI responsible for these processes is often paired with directional processing. Electrical and computer engineering professor, Ian Bruce again.
Ian Bruce: That requires multiple microphones on the hearing aid and then by comparing the signals that are received on the different microphones located different positions on a hearing aid, it can enhance sounds that are coming from a certain direction, say from in front of the hearing aid user.
Charlotte Gartenberg: Signia, another hearing aid company, has a new model, which came out in September, that uses bilateral beam forming. Its senior director of audiology, Brian Taylor says that their tech creates four acoustic snapshots around the wearer, three in the front and one behind, and then inside each acoustic snapshot AI analysis helps find speech inputs.
Brian Taylor: We use wireless signal sharing between the hearing aids to make the beam forming of both devices on the left and the right work together. When you do that, you can make the direction more sensitive.
Charlotte Gartenberg: Now their hearing aid can amplify more than one person at a time. This level of sophistication we've been talking about deep neural networks, several microphones, isn't in every hearing aid on the market, but many of these features are widely available in some form. Many audiologists and hearing advocates hope over the counter hearing aids approved by the FDA in August of 2022 can change the game, particularly since prescription hearing aids can cost upwards of $5,000 while over the counter options range from roughly $300 to $2,500. A quick note on price generally. Hearing aids can be pricey, especially the most cutting edge ones. Starkey's Genesis AI range from 2,500 to $7,500 per pair and Signia's most recent model can cost between 3000 and $7,000. Insurance coverage for hearing aids varies, but the basic Medicare plan does not cover them. We reached out to the Centers for Medicare and Medicaid services. A spokesperson said that although traditional Medicare does not cover hearing aids or exams for fitting hearing aids, Medicare does cover diagnostic hearing and balance exams if a doctor or other healthcare provider orders them to determine the need for medical treatment. Medicare Advantage plans can also offer coverage for things that aren't covered by traditional Medicare, including hearing as supplemental benefits. Whether they're over the counter or prescription, today's hearing aids can drastically change your soundscape and even look after your mental and physical health. More on what they can do beyond the ear, after the break. More and more hearing aids are becoming a whole health product. Like other wearable tech, some hearing aids can monitor your movements including activity and steps. David Kruse, who we met earlier, has hearing aids that alerted his wife when he fell. He also uses his hearing aids to count steps.
David Kruse: I set a new record for myself. I was able to walk almost 9,000 steps in one day. When I hooked my app to the hearing aids, it downloaded the fact that I'd walked over 9,188 steps, but I'm more conscious of walking now than I ever had before.
Charlotte Gartenberg: Kruse knew he was at risk for falling. He'd fallen a few times before.
David Kruse: Very first set of instruments that I had that had that feature, I downloaded it and activated it and had it ready and standing by.
Charlotte Gartenberg: Achin Bhowmik, CTO of Starkey, says that the head is a better place than say the wrist for that sort of tracking. Falls are the number one cause of injuries in people over 65 and often lead to an emergency room visit. This helps with health now, but in the future, hearing aids could get predictive, electrical and computer engineering. Professor Ian Bruce says companies are already looking for ways to help patients watch their steps.
Ian Bruce: Now, they're doing studies to see whether they can not just do full detection, but also do full prediction?
Charlotte Gartenberg: Using the same inertial sensors that help hearing aids track steps and other activities, hearing aids could monitor your gait to see if it's deteriorating. Starkey is one of the company's developing tech that aims to warn users before they might fall.
Ian Bruce: This is using deep learning to track the inertial sensor output to detect scenarios in which the person might be prone to falling and alert them that they're at risk of falling rather than waiting for the fall to happen and alerting a family member or caregiver that you've already fallen.
Charlotte Gartenberg: In the near future, hearing aids could also get predictive on another aspect of health, mental health. Dr. Frank Lin directs Johns Hopkins Cochlear Center for Hearing and Public Health. He looks at how hearing health affects cognitive and emotional health?
Dr. Frank Lin: As over hearing goes down a little bit, you might be less likely to be as socially engaged. You might not go out as much. Even if you go out, you might not be as engaged in the conversation you used to be and that social inclusion, that social stimulation is incredibly important for maintaining all of our cognitive activities and abilities as we get older.
Charlotte Gartenberg: Loneliness and isolation are a particular concern for people with hearing loss. US Surgeon General, Vivek Murthy released an advisory in May of this year on the epidemic of loneliness and social isolation. Lin says that can manifest in our physical bodies in a number of ways.
Dr. Frank Lin: Literally, if you look at loneliness and how it impacts our physiologic health over time, and when you're lonely, you're less likely to adhere to medical therapies, for instance, and it puts more stress in the body.
Charlotte Gartenberg: As companies like Signia and Starkey think about making hearing aids a whole health product, loneliness is one of the areas that remains front of mind. Brian Taylor says Signia's My Wellbeing tool helps users track how much they're engaging with the world. Users must agree to a privacy policy before opting in to use this feature. Taylor says, any data collected through my wellbeing is used explicitly for this tool and not sold to third parties.
Brian Taylor: We have a feature that tracks how much you talk when you wear your hearing aids, it doesn't track what you're saying, it's not recording it, but we can see if you're actually vocalizing when you're wearing your hearing aids. So the cool thing about that in theory is if a person could come into the clinic for a follow-up and you could say, "Oh, look how much more social you've been now that you hear better."
Charlotte Gartenberg: Starkey's hearing aids have a similar capability, but they plan to take it a step further. In the future they say they'd like to head off things like depression and isolation by putting out hearing aids that can track your mood.
Achin Bhowmik: You could train a neural litterer to detect not after they become depressed, but on the way there.
Charlotte Gartenberg: Users would need to sign a privacy agreement to use this feature. Bhowmik says, Starkey does not sell users' data. He says, this mood tracking is a natural progression of what AI and deep neural networks can already do, recognize patterns in the tenor and tone of human voices and interpret them.
Achin Bhowmik: Remember those days when you were a baby, a kid, and your mom might have said, "You sound sick." How did mom know that? Because mom's neural network was trained with what is your normal voice? How do you sound when you get sick, when you get a cold, right? So there's a lot of nuances and meaningful information that is encoded in our voice. AI might be able to decipher that in ways that's helpful. Just like your digital mom.
Charlotte Gartenberg: Linn from Johns Hopkins is optimistic about what this holistic approach might mean for the development of tech from both the consumer side, things like earbuds, and from hearing aid companies. Lin sees a lot of benefit to features like activity tracking and fall detection.
Dr. Frank Lin: It's going to come from both directions, and that's where you're seeing this again, this convergence, right? Let's say Apple, they always had these various features and now they're including the hearing augmentation per se. At the same time, now you have hearing aid companies now trying to also add on the other features, what the consumer tech companies are going to do.
Charlotte Gartenberg: For Lin, as hearing aids and earbuds become more versatile, each will gain a wider range of users who are wearing the devices for a wider range of tasks. He says the fact that more people are wearing earbuds is already doing a lot to battle the stigma around hearing aids and other hearing assistive devices.
Dr. Frank Lin: These are all these wireless earbuds that are all out there right now, right? That people use ubiquitously, right? My daughter uses hers all the time. In the future, as those companies begin integrating in a hearing aid feature, tracing means you can just customize the audio output based on your hearing. That changes the game in terms of how useful that device becomes. That's what's going to begin to happen. That changes the whole perception then around stigma, utility, price, everything. So that's the biggest game changer.
Charlotte Gartenberg: The Future of Everything is a production of the Wall Street Journal. Stefanie Ilgenfritz is the editorial director of the Future of Everything. This episode was produced by me, Charlotte Gartenberg. Our fact-checker is Aparna Nathan. Michael LaValle and Jessica Fenton are our sound designers and wrote our theme music. Katherine Milsop is our supervising producer, Aisha al-Muslim is our development producer. Scott Saloway and Chris Zinsli are the deputy editors, and Philana Patterson is the head of News Audio for the Wall Street Journal. Like the show? Tell your friends and leave us a five star review on your favorite platform. Thanks for listening.
"hear" - Google News
November 10, 2023 at 06:00PM
https://ift.tt/w1pQ8D3
Hearing Aid Tech Isn't Just for Listening Anymore - WSJ's The Future of Everything - WSJ Podcasts - The Wall Street Journal
"hear" - Google News
https://ift.tt/3xFbnlT
https://ift.tt/KzFSvge
Bagikan Berita Ini
0 Response to "Hearing Aid Tech Isn't Just for Listening Anymore - WSJ's The Future of Everything - WSJ Podcasts - The Wall Street Journal"
Post a Comment