I am curious, what is the formula determination that the CI centers use, and as well as the one that you have devised? In other words, how do you perform your calculations? I'm sure that there's a lot of variables and considerations held in your formula. Perhaps, it would be helpful for us to understand how you generate your statistics. For example, would success rate correlate to one's success with hearing aids prior to additional loss of hearing relative to one's current success? Putting numbers on this can be difficult.
My current formula just takes a person's unaided audiogram, ignoring cochlear dead regions and calculates the odds of hearing better with CI vs. the best HA. I define hearing "better" as not just speech but sounds as well. If someone hears 15db with HAs and hears 25db with CI, he hears worse in some aspects and possibly even when it comes to speech.
I have seen audiograms that some CI centers use but someone can have a reverse sloping audiogram with alot of hearing at 8000Hz that's useless anyway for HAs and no residual hearing in the lows and mids and score less than 10% on speech. The low frequencies account for 60% of speech information. I have verified this many times and seen people with no high frequency hearing still be able to hear the "S" and "F" without transpositional HAs. Ive read articles that state the benefits of residual low frequency hearing, even with left corner audiograms.
I will need to add more variables and considerations to my formula including best aided audiogram and also take quality into account. A person with 100db HL aided to 30db will hear way worse than someone who hears 30db unaided, 30db with CI or even with less than 100db HL unaided but aided only to 30db(less than max gains) but I only take max gains into account and I see no reason why more amplification can't only help. My speech went up 20% with more gains in the lows. Not only that, I hear so many more sounds, including faint sounds.
What does "better" or "an improvement" mean in relation to CI versus the old HA? Unfortunately, I don't think there's a simple answer to that. Certainly, with a CI, one could hear a noise that one could not hear before, but how well does one have the ability to distinguish?
Can one differentiate the keys on the piano (ones next to each other) clearly with a CI?
I am trying to get the most objective results, because subjective results can't be verified and differs for every person. Some say I am too focused on numbers, but after all that's the best way to compare results. Just saying "wow I hear better" does not tell the full story, I need the facts!
Ive noticed many people hear low frequencies worse with CI than HA. It's one of my concerns. I can hear deep bass sounds with my HAs and I still hear decent up to 500Hz. How many people get down to 15db or better with CI and how many people can hear 125Hz and below with CI?
Personally, I'd just rather have a straightforward assessment on whether CI is better or not, without anyone having a vested pocketbook interest saying, "yes, you need this $50k surgery." And also, what "better" or "an improvement" means. I just found out that my brother has a friend who's an audiologist who is more familiar with CI's capabilities than my current one. So I'll be chatting with him in the near future. And hopefully, to get that straightforward assessment as well.
Ive learned that speech appears to be the main draw for CI being better. That's great if you can't read lips but not so important when you are already understanding 80% to 90% speechreading. Then youd want to focus on hearing new sounds and yet at the same time, not hear any sounds worse than with HAs.
I think they should factor in your ability to read lips into the CI criteria. Someone(like me) who's a great speechreader won't struggle much compared to someone who simply is unable to master speechreading. Although I don't calculate speechreading into the odds, it's an important consideration regarding how much youd truly benefit and how much it would truly improve your quality of life(yes I said that)
I say anecdotally from others with a CI there is no question that a CI is much better than a HA. I say this from hearing sounds in general. They are hearing things that no HA could provide them. Speech perception is a whole different ballgame. I know at least 6 others with a CI. Two probably will never be able to listen to speech without some serious lip-reading and still rely on sign to assist them. The other four will do pretty well with speech but in various degrees of ability.
As for myself, I took off like a rocket and never looked back. I totally depending on hearing to listen to speech and have reduced lipreading skills, use the phone all day long, enjoy music, carry on conversations in noisy environments and etc.
And I have seen anecdotes on stem cells being used today and people claiming a huge improvement in their hearing. They have no facts, no numbers, no figures, no audiograms, just their claims. For all I know, they could be making it up. :roll: I will believe stem cells is around the corner when I see it all over the news about the first person who has hard proof of benefit.
I have no idea to the degree of their hearing loss or how much effort they put into trying the best HAs with max gains. I know that the worse your hearing is and the less effort you try with HAs and the more effort you put into CIs, the higher the odds of CIs being better. You did say 2 still don't understand speech even with CI.
Were you ever good at lipreading? For those of us who are, they can understand as much speech reading lips as you can listening thru your CI. Do you have a CI blog or any audiograms of before and after? I also have no idea how much effort you put into trying to make HAs work.
I hear better with CI than when I had moderate loss (50 across board) and aided up high that I can hear leaf rustling (less than 20 db)
why? because I can hear speech more clearly and more pronounced/stand out in evirnoment, hear subtle tone difference, have full high frequencies hearing. for me its like comparing diamond to piece of dirt
speech used to blend in with evironment, machine noise sound all same static-like hiss women voices sound similar tone-wise male voice interfere the clarity of speech (gruff voice) and with ci the speech stand out so much its like sunlight shining through dark foggy swamp.
This article may explain why you hear "better" with CI than moderate hearing loss.
Hearing Aids: new hearing loss diagnosis, Hearing Aids, audiologist
What type of HAs did you have when you had only 50db HL? You can't compare old HA technology to today's HAs. I hear way better with my Phonak Naidas than any HA before. One should compare the best HA vs. CI, not some old HA vs. CI then it's not fair.
I can also hear leaf rustling and most sounds. What was your speech score back with a moderate HL? Phi4sius was able to understand 100% speech clearly with a moderate-profound loss once he got the right HAs. His hearing worsened to severe-profound but still scores 70% speech and he isn't getting CI since hes afraid of hearing worse. As for your full high frequency hearing, what range of frequencies do you hear with CI vs. HAs with moderate loss?
Deafdude, what makes you think that you made up some magical formula that will show how much benefit someone will get from a CI, and now you know better than every professional in the world? You are not a surgeon, you are not an audiologist, you don't have access to all the studies and research about the outcomes of thosands of CI users. You have your life experience and your EXTREME bias against CI's.
That is a very limited perspective.
Nothing is made up, everything is learned from the net. I suggest you look at
this:
Hearing Review
Case 1 hears 80% speech including "S" despite a 90-100db HL and 35-40db aided. Not everyone gets to 80% speech with CI. Many people can get to 35-40db with CI which is basically what this person already hears with HAs.
This person(on another forum) got 35db aided with CI and her audiologist actually said that was great and she was surprised! If 35db is "normal" or "average" why was she surprised?
I do not claim to know better than professionals but I know there's alot of hype on marketing CI to as many people as possible. I know a lady who scored 60% speech with the wrong HAs(figure an easy 70% to 80% with the right HAs and hearing 0-20db) and her audiologist omitted this information when submitting the paperwork to insurance. Her audiologist actually pressured her into CI so she could collect a fat comission. :roll: I wish I had her residual hearing, it's almost as good as what Phi4sius had when he scored 100% speech before losing more hearing.
If you have access to the studies of 1000+ CI users, please provide links. The studies I have seen, most of those people were profoundly deaf to begin with, many with worse hearing than me and some with no residual hearing(although they may show a tiny left corner audiogram of vibrotactile responses up to 500Hz)
I have read your blog and learned some interesting facts. So you were able to give Miss Kat more gains that she hears as high as CI in several frequencies. How much did this improve her speech? I am wondering because I want to learn. When I got my own HAs reprogrammed, my speech went up 20% with more gains and this is my experience. You also mention cochlear dead zones. Try reducing the gains way back on Miss Kat's high frequencies and see if this improves her speech. Amplifying into the dead zones can actually create more distortion. I will be getting tested myself for cochlear dead zones with the TEN and/or PTC test.
I may appear to be biased against CI but if this means helping people
first try the best HAs then so be it. I have seen lots of proof of audiometric configurations that would "qualify" for CI be able to achieve equal or higher speech scores than many with CI. Not only that, but with full amplification, they can hear higher up than with CI! Why hear 25db with CI if you can hear 15db with HAs? :roll:
AMEN!!!!! You really can't do that. It's impossible. Even testing booth conditions don't accurately translate to the real world!
Please explain more.
It is exactly why I am asking deafdude what his exact formula is. I am still waiting on his reply.
I have partially explained the formula in my above replies. When I have all the variables figured out, ill post it in a new thread.
I understand at my center (UNC) they typically set patients at 900 as the majority of them prefer it.
Thank you for taking the time to help clarify it for me.
