Hearing Loss and Healthy Aging Workshop Summary (2014) / Chapter Skim
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5 Hearing Technologies
5 Hearing Technologies
Pages 43-58
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From page 43... ...
A TECHNOLOGY OVERVIEW Cynthia Compton-Conley Compton-Conley Consulting As Cynthia Compton-Conley, chief executive officer of ComptonConley Consulting, described in an overview of hearing technologies, a wide variety of hearing instruments and hearing assistance technologies are available for people with mild to profound hearing loss (see Figure 5-1)
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From page 44... ...
WIRELESS HEARING AIDS WITH ACCESSORIES FOR CONNECTIVITY AUDITORY TELECOMMUNICATION DEVICES VISUAL TECHNOLOGY FOR FACE-TO-FACE, MEDIA, TELECOMMUNICATION ALERTING TECHNOLOGY FIGURE 5-1 Range of types of hearing instruments and hearing-assistance tech nologies available for people with normal hearing to profound hearing losses. NOTE: FM = frequency modulation; HFHL = high frequency hearing loss; IR = Figure 5-1 infrared.
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From page 45... ...
Such systems can also be used in the workplace, though things can become complicated if more than one employee has a hearing loss and each uses a different wireless hearing aid system, Compton-Conley noted. In some settings where it is important that a signal not leave the room, infrared or encrypted FM transmission can be used.
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From page 46... ...
Specialty professional devices such as amplified or visual stethoscopes are also available. Finally, Compton-Conley covered alerting devices for homes, offices, and public areas, including alarm clocks, doorbells, phones, crying babies, appliance alerts, weather alerts, motion detectors, smoke alarms, and security alarms.
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From page 47... ...
Research is under way on self-fitting hearing aids that measure hearing thresholds, create an on-the-fly prescription, and fine-tune a device over time to meet a person's listening needs. And smartphones could eventually be used as hardwired universal hearing enhancement devices.
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From page 48... ...
He had brain stem injuries due to repeated strokes, and hearing aids were not an option. He was also in a wheelchair and had visual problems, so captioning was not an option for him.
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From page 49... ...
The FDA recently updated a guidance document in draft form to clarify the types of claims that would be associated with hearing aids and with PSAPs. Because a huge range of devices fall under its purview, from tongue depressors to pacemakers, the FDA applies a risk-based classification in which the regulatory requirements are matched to the risk posed by the device.
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From page 50... ...
Senate hearings that were held in the mid-1970s to look into the suboptimal diagnosis and treatment of hearing disorders prior to dispensing a hearing aid, as well as the marketing of hearing aids to vulnerable individuals who did not need them. The regulations are based not on safety issues with the hearing aid but on recognizing medically and surgically treatable causes of hearing loss and providing optimal hearing health care for patients, said Mann.
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From page 51... ...
There certainly is a process -- kind of a cumbersome one -- to change regulations, but it exists." Still, he also noted that hearing aids are different from reading glasses, where it is much easier for individuals to self-diagnose their conditions and to decide whether magnifying eyeglasses are an appropriate solution for their particular health situation. Hearing loss can result from a large variety of serious health conditions that could potentially be detected by a medical evaluation, Mann said.
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From page 52... ...
Multiparty Contracts As an example of a multiparty contract, Berger cited the ANSI C63.19 standard governing the compatibility of hearing aids with mobile phones. The standard, on which work started in 1996, is mandated by the Federal Communications Commission and recognized by the FDA.
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From page 53... ...
That is happening today in the hearing aid industry as the move to digital technologies shifts attention from simply raising the volume of sounds to issues of signal quality. Similarly, the standard for radio frequency interference is now based on the amount of interference created in the hearing aid rather than just the amount of potential interference from radio frequency sources.
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From page 54... ...
Miller University of Toronto Health technology assessment (HTA) is a field of applied policy analysis designed to support decisions about payment for health technologies, including drugs, devices, diagnostics, procedures, and even different ways of organizing health care.
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From page 55... ...
To the extent that hearing technologies can support healthy aging and avoid the need for highercost technologies, they can be an important part of the health assessment conversation. The Development of the HTA Field HTA emerged in the United States in the 1970s but is now well developed internationally.
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From page 56... ...
HTA Experiments Historically, HTA has focused "downstream" on the implications of novel technologies for health and health care, assessing whether health technologies warrant adoption; accordingly, HTA has often been seen as a barrier to innovation. Increasingly, however, HTA is looking "upstream" at innovation processes, seeking to support decisions about the design and development of emerging technologies; from this perspective, HTA has a role as a facilitator within productive health innovation systems.
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From page 57... ...
It can provide both a guide and an incentive for supporting technological innovations that will improve health, including technologies relevant to hearing loss. In response to a question about whether the demands of regulators and HTA agencies for evidence of safety, efficacy, and effectiveness might stifle innovation, Miller pointed out that this is "the classic countervailing powers question." Perhaps a small mom-and-pop shop will not be successful, she said, but the question is, do we want the small mom-and-pop shop to be successful if that means items that did not pass any meaningful regulatory hurdle are on the market?
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