Cognitive Bias and Hearing Aid Provision

Don’t let cognitive bias interfere with hearing aid recommendation

I had the pleasure recently of making a short presentation to some Irish hearing aid audiologists on my experience with the latest Nx hearing aids from Signia. During the day and listening to some of the other presenters and the Dispensers present, it became obvious to me that many were thinking that these new hearing aids were for the tech aware, not necessarily for Mr. or Mrs Everyday who didn’t even know how to send a text on her mobile let alone use an app or stream some music. I thought to myself, that there is cognitive bias and I am going to mention it.

Signia Nx hearing aids

Thoughts about Recommendation

We all listen to the Patient, then make decisions on what hearing aid type, model and technology level that we are going to recommend. Generally enough, we probably only recommend Made For iPhone hearing aids to be people who have an iPhone, are relatively technically aware and who like the idea of more control. Generally, I would agree with that, but in some cases, that concept can get in the way of common sense, for instances, with the Signia Nx.

Closing the ear canal

It is a manufacturer’s wet dream to close the ear canal of all Patients. They have spent a huge amount of treasure and expensive R&D man hours to come up with strategies that are designed to help the user hear better. Then, those strategies and features are hobbled by leaving the ear canal open. If we could close the ear canal, well then all those features will work at their best. Why do you think some of your most successful hearing aid fittings have flattish moderate or severe hearing losses? Up to now, it hasn’t been possible.

Own Voice Processing

The new OVP system from Signia allows professionals to close more ear canals than ever. That means that more and more people will get the full benefit of the features and strategies of those aids. It won’t be suitable for everyone, for instance, I suffer some mid ear issues, not much, but it leaves me a bit sensitive to pressure changes.

I can use the Nx aids with closed tips most of the time, but there are times I have to change to open tips. This isn’t an auditory occlusion problem, it is a physical problem. During those times I don’t have any issue with my own voice, just the fact that my ear canals are closed off. I would imagine I am not unique, however, I would also imagine my experience will not be the same for every user, just the ones who like me, have nasal or sinus problems.

Close the canal, better result

So, if closing the canal is nearly always equal to a better technical result, well then why wouldn’t you recommend them? Yes, they connect to iPhones, but it isn’t a central part of their function. Don’t allow your cognitive bias get in the way, just because a hearing aid does a certain thing, or offers a certain ability, does not mean that is the sole focus of the device. It also doesn’t mean that it is not the right choice for the Patient in front of you.


About Geoffrey Cooling

my name is Geoffrey Cooling and I am the author here at Just Audiology Stuff. I have been involved in the Hearing Healthcare Profession for several years now. I initially worked as a Hearing Healthcare Professional for a large national retailer in Ireland. After several years in Practice I was approached to work for a manufacturer, where I was employed for five years. I am now the Co Founder of a business called Audiology Engine. We design websites, undertake content marketing and generally look after everything digital for audiological practices. I am also a contributor to many hearing profession periodicals and websites. I have written two commercially available books, The Little Book of Hearing Aids which is written for hearing aid consumers and Audiology Marketing in a Digital World which is written for Audiology Practice Owners. They are both available in Paperback and Kindle versions on Amazon. I also write for consumers on the website Hearing Aid Know, which is a website with the mission of demystifying hearing aids, their types and their technology. I have a great interest in commercial strategy as it applies to Healthcare in general and specifically to Hearing Healthcare. I also have a great interest in the psychology of sales and human interaction. I have been involved with social media for some time, both personally and professionally. I find the engagement and discourse on some social media channels fascinating. I instituted social media strategy for the company I worked for as an experiment. That experiment soon spread throughout the company and I am proud to say that the company is probably one of the most active in the industry. I would like to point out that all views, opinions and thoughts here are mine own. Unless of course they have been planted by the pod people, you just can’t take your eyes off the pod people. Those views do not necessarily reflect upon any views or opinions held by my employer, if I ever get another one. I think that our industry is in the middle of a time of huge change, I think that the change will be forced by both internal and external pressure. I think that private Independent Healthcare Practices will have to be smart and lithe of feet in order to meet these changes. I hope that some of my blatherings are of benefit to those Practices, Independent Hearing Healthcare Practices need to survive. I believe that if that occurs it will be of real benefit to Patients. I hope that I, and my writings will play a small part in their continued success.

Let me know what you think