Scientific Evidence

Transcription

Scientific Evidence

Stefan Launer, VP Science & Technology
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• Introduction
• The world we live in will change
–
Always on - connectivity
• Technologies for our products
–
Mechanical design: product design and style
–
Connectivity: Wireless technology
–
•
Functionality
•
Services
Borader range and different focus of application
•
Tinnitus, APD, telehealth
Hörgeräte im Jahre 2020, Akustika 2014, S. Launer
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• The environment we live in will be different
–
Technical and societal
• The technology we will be using will be different
• The future of hearing health care and it’s education will be different
• How people communicate will be different
• Change is needed: penetration of hearing instruments still very low
–
Different countries, different needs regarding hearing health care
provision process
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1910
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Robert Sloss, 1910 , Das Telephon in der Westentasche,
.. Will connect everyone with everyone ... just type the numberand call...
Receive messages ... Listen to music ... Watch movies ... Participate in
telephone or video conferences ... Join in any event or any catastophies in the
world live while happening...
The world will be a single place we live in...
–
Skype , e-vote, GPS und Navigation, e-newspaper
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Change in life style and social interaction
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Was macht das Digitale Dorf aus?
• Digital content & information
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Lokale Neuigkeiten
(Vereine, Veranstaltungen, BLOGs)
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Globale Inhalte
(News, Wikis, Publikationen,…)
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Information retrieval (Google)
• Digital community
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Soziale Netzwerke
(WhatsApp, Twitter, Facebook und Picasa)
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Verstärkung oder Ersatz von lokalen
Gemeinschaften (Vereine, Freundschaften, Stammtischen, …)
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Ergänzung um globale Gemeinschaften
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Was macht das Digitale Dorf aus?
• Digital communication
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Lokal und global
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Videokommunikation
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Soziales Spielen, Treffen, Fitness
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Notruf
• Digital coordination
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Lokaler Markt: z.B. Sharing Economy, Zeitbörsen, Tauschbörsen,
Sonderangebote, Coupons, Veranstaltungen
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Digitale Dienstleistung: online retail, services, ….
–
Lokale Intermediäre
–
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Kommunalverwaltung, Wohnungsgesellschaft, Krankenhaus, Vereine,
Kirchen
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Qype, Around-me, Google, Directories, …
Globale Coordination: Amazon, eBay, Google, airbnb, …
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Wearables: available examples: Infotainment, Gaming
Control – eye blink, eye tracking
Buhel Helmet Communication
System
Google Glasses
THUMP 2digial music
eyewear
Recon Alpne
Googles with GPS
O.R.B. headset capable
of hands-free calling
Vusix Smart
Glasses
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Amiigo Fitness Band
GOW Heart Rate Monitor
Jawbone tracks movement
Nike Fuelband: calories burned TmG moniot muscel fatique
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Wearables: available examples: Wellbeing & Health
First Warning Breast System
Philips Bilirubin Blanket
Preventice: remote
monitoring of non-lethal
cariac arrhytmias
WatchMinder: aid
children with with
Attention Deficit
Disorder by
vibrating
Whihings: Blood pressure
Everon: mobility and
security for 11elderly
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Interactive Homes, interactive Living
Convenience
Smart power management
Ambient assisted living
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Launched in Q4 2013 after a successful pilot in Ohio, HealthSpot
provides consumers with access to a doctor via its ‘telemedicine’
kiosks. Connecting doctors with patients via HD video-conferencing,
the walk-in kiosks are installed in locations such as retail spaces.
Each HealthSpot kiosk is equipped with basic medical instruments,
including a stethoscope and digital thermometer. A HealthSpot visit
costs USD 60-70.
HealthSpot
Kiosks offer video
conferencing with health
professionals 15
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Quantified self: getting
insight into one’s health
and lifestyle
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DRIVERS:
Personal Growth
Health awareness
Big Data
SOCIAL
Connecting and
sharing with
Others
DRIVERS:
Social media
From me to we
Shareconomy
SELF MONITORING
Having an extra
Layer of
experience
DRIVERS:
Wearable Tech
Internet of Things
Digital Lifestyle
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Always having
online Access
SMART LIFE
DRIVERS:
Digital natives
Mobile Technology
Busy lifestyles
ALWAYS ON
Being
empowered to
decide and do
things one-self
DRIVERS:
Autonomy
Distrust
Social media
Having things
Automatically
done for you
DRIVERS:
Big data
Internet of things
Busy lifestyles
EMPOWERED
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A CENTURY OF MINIATURIZATION
Electronics
Body worn
Transistor
Integrated circuit
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AFTER 1990: UNDERSTANDING OF PERCEPTUAL CONSEQUENCES OF COCHLEAR
HEARING LOSS – INTRODUCTION OF DIGITAL TECHNOLOGY
HEARING INSTRUMENTS TRANSFORMED FROM AMPLIFIERS TO SIGNAL PROCESSORS!
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• Digital signal processing (dsp) – generation I
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Digital signal processing (dsp) – generation II
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• Digital signal processing (dsP) – generation III
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Digital signal processing (dsp) – generation IV
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• Modern hearing systems are intelligent systems with ….
• … a portfolio of solutions for different listening and communication situations
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CURRENT TECHNOLOGY FOCUS: HEARING AND COMMUNICATION IN DAILY LIFE
• Speech intelligibility
• Language learning
• Speech production
Authentic &
natural
• Sound quality
• Authenticity
Sound
Recover
Feedback
Management
Multichannel
Compression
… Perception
Processing
Amplification
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SPEECH INTELLIGIBILITY IN DEMANDING LISTENING CONDITIONS
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PORTFOLIO OF SOLUTIONS FOR DIFFERENT LISTENING CONDITIONS
Adaptive and
Multichannel
directional
Microphone
Remote
Microphone
– Roger
Binaural Voice
Stream Technology
Noise
Reverberation
Wind Noise
Directional
Microphone
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• Objectives for a hearing instrument:
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Speech intelligibility improvement!!!!
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Ease of listening, listening effort, listening
comfort
• Techniques
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Multi-microphone
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Single microphone
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Different solutions for different
listening environments
• Variables:
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Environment
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Positioning on head
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Acoustic coupling
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• Usability Engineering becomes important!
1991
1999
2004
2006
2009
2013
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• ITE shrinking - 3D printing and design technologies
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MAIN APPLICATIONS FOR HEARING AIDS – TREND TOWARDS WIRELESS LINK
COMMUNICATION
CONNECTIVITY
Application:
Transmitting the voice of
a distant speaker or the
sound provided by a thirdparty device to the hearing
instrument
Application:
Transmitting a controlsignal and/or streaming
sound from a third-party
device to the hearing
instrument
Challenges:
 Background noise
 Ease of use
 Distance
 Interference
Challenges:
 Compatibility
 Power consumption
 Reliability
 Interference
Binaural
Application:
Transmitting a control-signal
and/or streaming sound between
two hearing instruments
Challenges:
 Power consumption
 Interference
FITTING
Application:
Adjusting hearing aid
settings to an individual’s
hearing loss
Challenges:
 Reliability
 Interference
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• Binaural VoiceStream Technology
•
•
Feature(s) making use of “Better Ear
effect”?
»
Listening to side  auto ZoomControl
Car, Restaurant, outdoors / wind
»
Binaural Telephone  DuoPhone
»
Feedback management
»
……
Feature(s) making use of “Binaural
directivity”?
»
Speech in noise in front  StereoZoom
»
….
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Why hearing aids are sometimes not enough
Loud bar
Quiet environment
Noise Noise Noise
Noisy restaurant
Noise
StereoZoom
Directional
Phonak
RemoteMic
Omni
microphone
Distance
Face to face
Distance
Up to 10 meters
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MICROELECTRONIC KEEPS SHRINKING: COMPUTATIONAL POWER KEEPS GROWING!
• Algorithms improving specific listening conditions
• Dynamic listening situations: Speaker identification
and tracking
• Binaural Voice Stream Technology
–
Reverberation
• Performance/robustness in various listening
environments
• SoundRecover: more hearing losses
• SoundFlow
• Whistle Block – Feedback Management
• Broader range of hearing losses
• Music perception
SYSTEM INNOVATION RATHER THAN SINGLE FEATURE INNOVATION!
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• A Broader perspective on Product innovation
DSP Feature
Innovation
New Product
Formats
RIC / Lyric /
CROS
Fitting
Personalization
Services
Product
Design and
Styles
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• New product formats help to overcome challenges in Usability
~50mm
New Product Formats
Different user needs:
- Invisible
- Hassle free
~16mm
~12mm
12.5
mm
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REHABILITATION OF SENSORINEUREAL HEARING LOSS
HEARING => COGNITION AND COMMUNICATION!
Cognitive aspects: listening effort, memory…
Auditory processing, language development
Sound quality and comfort, authenticity
Speech (sound) audibility … Speech intelligibility
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SENSORINEURAL HEARING LOSS – COMORBIDITIES
Tinnitus
Auditory
Processing
Disorders
Dizziness /
Fall
Sensorineural
Hearing Loss
Cardiovascular
Dementia
Diabetes
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WIRELESS COMMUNICATION TECHNOLOGY POTENTIALLY ALSO HELPFUL FOR
OTHER AUDIOLOGICAL DISORDERS
• Auditory Processing Disorders
• Dyslexia (Kraus et al)
• Autism (Rance et al)
FM SYSTEMS / ROGER SOLUTIONS AVAILABLE!
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DE-MYSTIFED: GOOD UNDERSTANDING OF TINNITUS
• Counseling
•
Audiologist
•
Patient
• Individually tailored sound therapy
Debilitating tinnitus
Population of
adults who
experience
chronic
tinnitus
(10-15% of
all adults)
Bothersome tinnitus –
seek clinical intervention
(~20% of all those who
experience tinnitus)
Non-bothersome tinnitus
(~80% of all those who
experience tinnitus)
Source: Dobie (2004)
APPROACHES
FOR PROVIDING RELIEF EXIST
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Counsel patient I:, patient assessment , determine
tinnitus level  triage
Vernon 1977
Jastreboff 1990
Counsel patient II: tinnitus basics, relaxation
techniques, …  take anxiety away
R. Tyler 2005
J. Henry 2009
Sweetow 2010
Norena 2012
Treat hearing loss, improve communication and
quality of life  reduce stress
A. Moller 2012
J. Eggermont 2012
Laperre
Amplification hear environmental sounds, draw
attention away from tinnitus
Sound enrichment: noise through HI, additional
soothing sounds  refocus attention away
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MOBILE DEVICES – CREATE ADDED VALUE!
• Information- & Service Center
• Connectivity
• Remote Control
• Training Center, interactive fitting
• Computation
• Telehealth / teleaudiology
Distant support
Diagnostics
STANDARDIZATION IS KEY!
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TODAY: MOST ACTIVITY DURING FITTING PROCESS IN THE OFFICE OF AUDIOLOGIST /
DISPENSER
Awareness
Counseling
Fit
Trial
Use
Today > 90 % of
activity happens during
fit and trial
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A LOT OF OPPORTUNITIES EXIST ALONG THE CUSTOMER JOURNEY
OTC /
self fitting
Tinnitus
Diagnostics
Awareness
Internet Sales
process
Counseling
Consumer
profiling
Remote
Contro Appl
Product
selection and
demonstration
Teleaudiology
Use
Distant
support
MobiVal
OFTEN CONNECTED TO E-BASED TECHNOLOGIES
Cuper
Trial
Fit
Smart disney
E-upgrades
Mobile
fitting device
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Expert
Support
eDiagnostic
Repair
eSupport
eRepair
eDiagnostic
AWARENESS
eProposal
COUNSEL
eAdjust
FITTING
eAdapt
& eSupport
TRIAL
USE
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• Diagnostics of various deseases incl
indication for a CI
• Video otoscopy
–
Using smartphone?
• Telesurgery-robotics (not for CI thus far)
• CI surgery preparation and planing, data
exchange, video conferencing for
consultation before and (?) during the
surgery
• CI surgery: remote monitoring and
mapping
• Success factors in telemedicine
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• Screening and diagnostics of various audiological conditions using pure tone
and speech audiometry, otoacoustic emissions as well as evoked potentials
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Adults and children
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Canada, South Africa, Australia
• Intervention:
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Counseling (Tinnitus), self assessment / questionnaires, re- training
(Sweden)
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Remote mapping and fitting of CIs (intraoperative and fine tuning the device),
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Remotely supported fitting of hearing instruments incl verification
• Telemonitoring, tele-information retrieval
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TELEAUDIOLOGY – MEET THE DEMAND OF GLOBAL HEARING HEALTH CARE
Central Office
Remote Site
Highly qualified
HCP
Patient
HCP / PERSON: WESTERN WORLD 1:20’000 – DEVELOPING COUNTRIES 1:500’000
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• Hearing – the social sense
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HEARING – THE SUBCONSCIOUS SENSE
• Information about environment
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Context information
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Monitoring and warning  localization
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HEARING – THE EMOTIONAL SENSE
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• Technology development: Performance, usability, design
–
Better solutions for specific conditions
–
Other product formats
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Connectivity
• Hearing, speech and language communication
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Audibility -> Intelligibility -> Auditory Cognition
• Hörgeräteakustiker  Hearing Health Care Provider
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Technician -> counselling and services
• Customers -> engaged and empowered
–
Different distribution channels especially for different target groups?
•
–
Different countries
Mild ... moderate .... severe
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The World is an EAR…
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Scientific Evidence

Transcription

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