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Unread 10-14-2009, 11:37 PM   #1
Phi4Sius
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Wow! AB's Harmony vs. Cochlear's Nucleus 5!

IMO, very interesting! A complete technical comparison of AB's Harmony vs. Cochlear's Nucleus 5 processor!

Compare: Harmony vs Nucleus 5
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Unread 10-15-2009, 09:23 AM   #2
jklai
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Nice find. But sometimes you have to be careful about specs found on the company's website...I mean of course they're only going to list the details where Advanced Bionics's product is better than Cochlear's.

But at least AB uses real numbers here, which kind of eases the bias.
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Unread 12-31-2009, 07:38 PM   #3
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These details are only useful if you know what they mean.

1. The temporal resolution numbers really aren't important, as it has already been shown that most CI users are unable to discriminate pitch differences for rates above 300 pulses per second per channel. The total stimulation rates as listed there for both devices are more than capable of delivering this.

2. The spectral resolution numbers are also overexaggerated. Even for systems with as many as 22 electrode pairs/channels most users are incapable of utilising more than 4 - 8 channels for speech recognition. Yes more channels in theory allows for better pitch perception, but in practice this is relevant only to puretones and does not translate to complex sounds because of current interactions between electrodes.

3. An expanded input dynamic range is useful for quiet situations, but in noise it just means you hear more noise, so this could be a positive or a negative depending upon the situation you're in. Current studies suggest an input dynamic range of 40 is better than one of 30, but there is no evidence ot suggest an IDR of > 45 offers any further benefit.

4. Potential pitch percepts - the emphasis being very much on potential. Pitch perception research suggests that CI users are unable to reliably rank the direction of a pitch change for a pair of notes 1/4 of an octave apart. Current speech processing strategies are very poor at providing pitch information, as they must work within the limitations of electrical stimulation in fluid-filled environment, the emphasis naturally being on speech as that is their main purpose.

5. Sound coding strategies are generally proprietary and largely device-specific. I haven't seen any evidence to suggest the advanced bionics strategies are superior to anything else on the market.
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Unread 12-31-2009, 08:36 PM   #4
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These details are only useful if you know what they mean.

1. The temporal resolution numbers really aren't important, as it has already been shown that most CI users are unable to discriminate pitch differences for rates above 300 pulses per second per channel. The total stimulation rates as listed there for both devices are more than capable of delivering this.

2. The spectral resolution numbers are also overexaggerated. Even for systems with as many as 22 electrode pairs/channels most users are incapable of utilising more than 4 - 8 channels for speech recognition. Yes more channels in theory allows for better pitch perception, but in practice this is relevant only to puretones and does not translate to complex sounds because of current interactions between electrodes.

3. An expanded input dynamic range is useful for quiet situations, but in noise it just means you hear more noise, so this could be a positive or a negative depending upon the situation you're in. Current studies suggest an input dynamic range of 40 is better than one of 30, but there is no evidence ot suggest an IDR of > 45 offers any further benefit.

4. Potential pitch percepts - the emphasis being very much on potential. Pitch perception research suggests that CI users are unable to reliably rank the direction of a pitch change for a pair of notes 1/4 of an octave apart. Current speech processing strategies are very poor at providing pitch information, as they must work within the limitations of electrical stimulation in fluid-filled environment, the emphasis naturally being on speech as that is their main purpose.

5. Sound coding strategies are generally proprietary and largely device-specific. I haven't seen any evidence to suggest the advanced bionics strategies are superior to anything else on the market.
Are you a CI user?

There has been a "independent" studies done in Germany, at the largest implant center. AB came out on top.

Bevilacqua et al. Auditory and Language Abilities in Children: Comparison of Two Different Cochlear Implant Systems. Presentation at the 10th International Conference on Cochlear Implants and Other Implantable Auditory Technologies, San Diego, CA, April 10-12, 2008.

Wolfe J, Mears A. Effect of Input Dynamic Range on Speech Recognition and Music Enjoyment. Poster presentation at the 10th International Conference on Cochlear Implants and Other Implantable Auditory Technologies, San Diego, CA, April 10–12, 2008.

Quick A, Koch DB, Osberger MJ. HiResolution with Fidelity 120 Sound Processing: Listening Benefits in CII and HiRes 90K Implant Users. Poster Presentation at the Conference on Implantable Auditory Prostheses, Lake Tahoe, CA, July 15–20, 2007.
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Unread 12-31-2009, 09:16 PM   #5
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FJ, the reason alot of people picked Cochlear because they trust it more. It's hard to trust something that is "new" in the market. Choosing a cochlear implant is scary as it is for alot of people so they look for something they know they can depend on.

I'm sure as AB gain more popularity, people will choose that too, but right now Cochlear been around for a quite a while so it is somewhat like a security blanket. I know the processor is old technology, but they know that the implant is safe because it been done on many people.
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Unread 12-31-2009, 09:16 PM   #6
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I am not a CI user, but know many people who use CIs and have a good understanding of auditory prostheses and how they work.

None of the articles you refer to are in peer-review journals yet, but based upon the evidence available:

RE: Bevilacqua et al. - This study focused solely on results from infants, and although children using the advanced bionics devices performed significantly better than the nucleus users at 3 and 6 months after implantation, at twelve months there was no difference in the performance of the two groups. Given that infants vary greatly in terms of their developmental timetable for speech development (often by as much as six months), this particular publication in effect has found no real difference in the performance of users of each device in the long-term, which I would argue is what matters.

RE: Wolfe & Mears - I was unable to find a copy of this presentation in the little time I have available, but the benefits quoted on the advanced bionics websites are perfectly reasonable - a wider dynamic range may very well be preferred for listening to music. This is perfectly reasonable. It does not however indicate that music recognition or pitch perception scores would be any better with advanced bionics devices than those from other manufacturers.

RE: Quick et al., This study does not compare the performance of different manufacturers devices, rather different advanced bionics processing strategies and from my brief reading of it, is not relevant to your argument.

I would recommend that you stick to peer-reviewed journals when looking for accurate comparisons (at least in the case of hearing research). Yes they can be expensive, but good ones are well worth the money. Of late I would recommend "Wilson, B. S., & Dorman, M. F. (2008). Cochlear implants: A remarkable future and a brilliant past. Hearing Research, 242, 3-21." for a good review of the literature overall. Manufacturers will quote whichever research is best for their financial interests. It's best to look at long-term outcomes from all devices when making choices.

At this point in time I wouldn't argue heavily in favour of one device over another, except to ensure that the device met your needs, was reliable and had good long-term support. After that, performance largely comes down to biological factors inherant to the implantee and proper programming and management by an audiologist and the support of your family, peers and habilitationists.
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Unread 12-31-2009, 09:20 PM   #7
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I'm curious as to why you seem to know so much, so quickly, but then in another post you said that an implant was connected to a child's brain....

Odd...

Also, you seem to post biased toward one brand, but you haven't told us anything about yourself.

Do you work for a CI company?
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Unread 12-31-2009, 09:41 PM   #8
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Also, you seem to post biased toward one brand, but you haven't told us anything about yourself.

Do you work for a CI company?
I'm not biased towards any brand, indeed although I feel that CIs are the right option for many people, I also feel that all CI users would be wise to learn sign language and become involved in the deaf community as we never know the course the future may take. I have learned done courses in sign language myself, and find it very useful.

I do not work for any CI manufacturers, rather I am an independent researcher of sorts. What I am against marketing people using the results of studies in an attempt to place themselves above the competition, when really the science doesn't stack up. Feel free to bring any claims, and I'll do my best to see whether they're justified.
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Unread 12-31-2009, 09:43 PM   #9
faire_jour
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1. Are you Deaf?
2. Who do you work for?
3. What is your connection to cochlear implants?
4. How do you have experience with children and ci's?
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Unread 12-31-2009, 10:24 PM   #10
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How about you tell me a bit about yourself first faire_jour

If I prefer to remain annoymous then let that be my business, as if it were otherwise I may choose to be elsewhere. All you need know is that I have some experience in such matters, but do not claim to be an expert, nor be the final word on any matter in this world. As I said above "Feel free to bring any claims, and I'll do my best to see whether they're justified." You may believe what you want. That is your prerogative
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Unread 12-31-2009, 11:11 PM   #11
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How about you tell me a bit about yourself first faire_jour

If I prefer to remain annoymous then let that be my business, as if it were otherwise I may choose to be elsewhere. All you need know is that I have some experience in such matters, but do not claim to be an expert, nor be the final word on any matter in this world. As I said above "Feel free to bring any claims, and I'll do my best to see whether they're justified." You may believe what you want. That is your prerogative
i am the hearing parent of a deaf child with an ab implant. but everyone here knows that. i dont trust you.
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Unread 12-31-2009, 11:35 PM   #12
Resolution
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i am the hearing parent of a deaf child with an ab implant. but everyone here knows that. i dont trust you.
So long as you question marketing claims without reliable proof of evidence, then I'm fine with that You will however find that most of what I commented on above is in the Wilson & Dorman (2008) article cited. It really is a good read, although perhaps a bit difficult.
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Unread 12-31-2009, 11:41 PM   #13
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So long as you question marketing claims without reliable proof of evidence, then I'm fine with that You will however find that most of what I commented on above is in the Wilson & Dorman (2008) article cited. It really is a good read, although perhaps a bit difficult.
you should explain your motives for being here. your presence feels suspect.
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Unread 01-01-2010, 12:16 AM   #14
Resolution
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you should explain your motives for being here. your presence feels suspect.
I have already done so. If you wish to confirm whether what I have written is true, you might read this article. I'm sure if you email Blake Wilson, he will be happy to send you a copy for free.

You know, have you even considered that I might have good reasons, rational and reasonable reasons to want to remain annoymous? Stupid American liability laws. Farewell then.

Last edited by Resolution; 01-01-2010 at 12:48 AM.
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Unread 01-06-2010, 01:01 PM   #15
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Resolution, You're not CI user. Why you're here for? Are you against CI?



I rather to get Nucleus 5 over AB.
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Unread 01-06-2010, 05:10 PM   #16
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Let me compare my device to my competitors device and I'm going to let my competitors device look better. Common. You take the comparison for what it's worth. A commercial.
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Unread 01-08-2010, 08:54 PM   #17
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When I did some research for my CI, I used third party research to get technical specs not the manufacturers and reviewed tons of reviews by the users themselves and talked to serveral users personally.

Every manufacturer is going to claim they're the best. All three manufacturers are good and the only time when one is better than other is because of the personal priorities of the features the individual wants in their CIs. For some people is the technology, others it's the batteries, and still others it may be the looks of the processor or even how old the manufacturer is.

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Unread 01-08-2010, 09:20 PM   #18
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Resolution I agree with the other users here. I've read your other posts and you seem to be here simply to be picking debates with people.

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Unread 02-12-2010, 04:30 PM   #19
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I use the AB and I have nothing but positive things to say about this implant.
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Unread 02-19-2010, 04:42 PM   #20
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I didn't know other CI technology existed besides the Nucleus 5.

There is a lot to think about.
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Unread 02-19-2010, 08:18 PM   #21
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Quote:
These details are only useful if you know what they mean.
ve
Quote:
read your other posts and you seem to be here simply to be picking debates with people.
On the OTHER hand, I do think Resolution may have a good point. He doesn't sound anti CI. Rather he's bringing up the point that the specifics that the CI company brings up may not be all that important for performance. In other words, the specifics may be "audiophile important." Audiophiles are notorious for being " Oh this feature/equiptment/etc lets you hear SO much more!" And then independent tests show either no real difference or the difference that the stuff makes is too subtle for the human ear to hear.
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Unread 02-20-2010, 01:02 AM   #22
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I didn't know other CI technology existed besides the Nucleus 5.

There is a lot to think about.

Heath, there are 3 cochlear implant manufacturers. Cochlear (Nucleus 5), Advanced Bionics (Harmony) and Med-El (Opus). Definitely do some research, see what each implant offers and when you get ready to decide which implant you want to get for yourself, consider the pros/cons, etc. Also speak with the CI audiologist and surgeon too about the implants.
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Unread 02-20-2010, 06:45 AM   #23
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Heath, there are 3 cochlear implant manufacturers. Cochlear (Nucleus 5), Advanced Bionics (Harmony) and Med-El (Opus). Definitely do some research, see what each implant offers and when you get ready to decide which implant you want to get for yourself, consider the pros/cons, etc. Also speak with the CI audiologist and surgeon too about the implants.

Speak with other CI user's too as CI audiologist/surgeons do not tell you everything. Here's a great amount of a post by a woman who did all her research for cochlear implants.

Cochlear implants I look so I can hear….
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Unread 08-16-2010, 02:00 PM   #24
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I actually have an Advanced Bionics Harmony Atria. It was picked for me by Sunnybrook Cochlear Implant section. That was 3 years ago. Still highly satisfied as I mentioned before -not capable of determining which of the 3 systems to get: Advanced Bionics. Cochlear Corp or Med El. They pick one which appears to be best for you. They do use all 3 here in Toronto.
Ironical: actually had a Cochlear Corporation booklet on their products and never heard of the other 2--before I became deaf in Dec/06.
I had an idea what was going to happen thanks to Cochlear Corp-- if accepted for an Implant.

Advanced Bionics-Harmony Atria-activated Aug/07
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Unread 08-16-2010, 03:19 PM   #25
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I was given teh option between AB and cochlear when I was evaluated. I chose Cochlear for the asthetic look and feel of the processor on my ear/ also the longevity of cochlear corp. Also My surgeon Is the CMO of cochlear corp so I felt he had more experience with implanting Coclehear than anything else. The sound quality is pretty good for having a device giving hearing, I dunno if I wouldbe doing as well with AB or not so I cannot comment on that.

Dr. Phil That had to of been scary to have them put that inside you without you having a choice in what to have done. Mad props man and I am glad your doing well with it. Cheers
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Unread 09-16-2010, 03:48 PM   #26
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This has been an interesting thread.

By reading some of the posts, I would agree that there does seem to some bias in Resolutions comments. I believe the bias is covert instead of blatant in-your-face bias.

That said, the general advice to look at sources and the quality of the source is standard in the academic world. Generally only peer reviewed publications are considered credible, especially in the Academic world. One thing that you must remember, in all these papers, is the doctors want to look good. They will likely not publish a paper saying "I implanted 30 devices and only 3 worked".

That said, faire, your articles also have credibility. Just because they are not peer reviewed does not mean that the data is not valid. You simply don't have the comfort of knowing that someone reviewed them to ensure statics and conclusion were agreed upon by a few other experts in the field. I would be very curious to know your source of the “largest implant center” [in Germany]. Which center was that and who was the author?

To make another thing clear, as cdm pointed out earlier in this thread, there are basically 3 cochlear implant manufacturers. Realistically, if he posted “I work for company X”, his employer may not like that or worse, if he were to say something (or imply) that is against the labeled functionality of the device, then his company could be held liable under US law. US law on medical devices is quite stringent.

As an example, lets say that Resolutions said he work for Cochlear Implant Manufacturer Y. Now, someone with Brand Y implanted in them tells him that the device is experiencing what they believe to be an improper functioning device. As a representative of the company, he is required by law to inform the employer of a customer complaint and it must be followed up on.

Now, let us extrapolate this a little further and imagine that someone from the FDA may actually look at this forum (which is not out of the realm of possibilities). If they are able to determine that Mr. Resolution knew of a complaint they may decide to ask to see that complaint file during their monitoring visit. When that complaint file doesn’t exist, Mr. FDA inspector will not be so happy.

I do think it is fair to ask his information, but people must realize that there may be reasons he doesn’t want to give it out. The industry is a very small one.

All of this said, I do not see any false information in what resolution has posted.

C1
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Unread 09-16-2010, 04:47 PM   #27
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I think resolution has given some very good points.I also see no false information and also wonder why one has to TRUST some posts here. They are here for your reading and digesting. There are pros and cons to most everything. I think resolution's comments have been informative and I don't see that he/she has recommended any one or said they were the authority. So as the saying goes " whats the beef "? Good discussion and also remember that most of the studies were several months old and some of the products have come out new and improved since then. Things change all the time and some on the top may be on the bottom now and other way around as well.
Yes I have a CI and yes I am biased to the one I picked which I think is natural. No one likes to say " I goofed" on something of that magnitude.
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Unread 09-16-2010, 09:54 PM   #28
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These details are only useful if you know what they mean.

...

3. An expanded input dynamic range is useful for quiet situations, but in noise it just means you hear more noise, so this could be a positive or a negative depending upon the situation you're in. Current studies suggest an input dynamic range of 40 is better than one of 30, but there is no evidence to suggest an IDR of > 45 offers any further benefit.

...
I have a IDR of ~50. I'm working on increasing that. The highest I heard of is one individual with 60.

Yeah, there is some trade offs of a high IDR. In a quiet environment, it has been fantastic. It's not too bad for me with lots of noise but there are drawbacks. It just simply means I have to pay attention more.

Interesting subject...
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Unread 09-16-2010, 10:29 PM   #29
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I have a IDR of ~50. I'm working on increasing that. The highest I heard of is one individual with 60.

Yeah, there is some trade offs of a high IDR. In a quiet environment, it has been fantastic. It's not too bad for me with lots of noise but there are drawbacks. It just simply means I have to pay attention more.

Interesting subject...
My daughter's IDR is 70.
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Unread 09-16-2010, 10:50 PM   #30
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My daughter's IDR is 70.
That is great!

I do know there aren't many that high!

Hopefully, in the next couple of years I will be close to that.

That being said, having a CI implies there is some upper limit and I suppose that depends on several factors.
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