DON'T Buy Hearing Aids Until You Watch This! | Premium vs. Advanced Hearing Aid Technology

[@timhammond691]

A couple of questions come to mind in the patients making the decision of which technology they preferred. 1) Were they given the choice before any pricing was mentioned? 2) Was the treatment/fitting the same for both levels, i.e. the amount of time taken for the programming and verification the same in order to assure that their wasn't any apparent difference in the device levels? 3) is there a cost difference in fitting/programming the different levels of technology? 4) What "features" are being eliminated by going to the lower tier of technology?

[@WarpFactor999]

This falls into the category of why true audiophiles subjectively prefer vinyl records vs. digital formats, even though the digital formats can capture higher effective data rates and never degrade. Vinyl records just sound warmer, smoother, and ethereal. This is most likely a similar issue with hearing aids. Several researchers have suggested that since the analog vinyl records produce sound that mimics the ear drum's response, it is more attuned to HOW we hear, not WHAT we hear. An interesting point...my dad was profoundly deaf in one ear and only had ~20% hearing in the other, and all of that was in the lower octaves. He got new premium hearing aids that were tuned for him. He couldn't hear hardly anything. Going back to the audiologist, I explained what I had evaluated the problem as. (I taught spectrum analysis for several years and had profiled my dad's hearing earlier.) He had zero hearing above 1KHz in both ears. He had about 20% below ~1 KHz in his left ear. His hearing in his right ear was at most 5% below ~800Hz. What had been done with his new hearing aids was an inverse profile of his hearing to "balance his hearing." This focused on the how and not the what. After much discussion and explanation, I had the audiologist cut everything off above 1KHz with a soft gain profile from 400 Hz (semilog) up to 1Khz. Suddenly he could hear far better than he had in years! Why? Because it focused on the WHAT he was hearing. What was happening was the gain on the frequencies above 1KHz was saturating his ear drums with high SPL's that prevented the lower frequencies (which required maximum ear drum compliance) from being transmitted across the ear drum tympanic membrane. Note, that this was way back in 1995. Things have obviously improved greatly since then.

[@Elephantine999]

Do you have a double-blind study that supports your claim? There is an awful lot of subjective BS in the audiophile realm (for example, that silver speaker wire works better than copper). You really need a reliable test to make a categorical statement like that. (Or at lest *I* need one.)

[@maxwood5938]

I am getting my hearing aids replaced very soon, great to hear the truth, all l want is to hear, a cell phone costs $600, why should hearing aids cost $6,000.00. Is it a money milking machine for deaf people. thank you for your video.

[@SubToTripleThreatRC]

I just got my first set of hearing aids after a (non work related) accident took much of my hearing. I got talked into the $6,000.00 set and am now wondering if I could have saved a couple thousand dollars???

[@mmarjisr]

that's just it if the hearing impaired wants to hear again than they gotta pay what a crock

[@neilfurby555]

Yes it surely is...

[@SaltNBattery]

Yes.

[@xiyangyang1974]

1. Smart phones are mass products, whereas hearing aids are niche products. 2. There is nearly no consulting effort for a smartphone, whereas users of hearing aids need a lot of consulting. Technology is not expensive, but the workforce is expensive.

[@olschool3740]

Attempting to educate myself to help my spouse address a hearing issue, and unfortunately the more I discover, the less I know. Lots of noise out here in the name of hearing clearly.

[@sykesc2]

What a fantastic example of a small-scale, well-designed clinical study presented in a balanced way that consumers can understand. I am a health care researcher and was extremely impressed by how you took the results of a single study and validated the findings in your own group of clients. You were very clear about the limitations of your study, but that does not take away from your findings. I would love to use this as an example of translating evidence into practice in the research class I am teaching this fall. Bravo!

[@DrCliffAuD]

Possibly the best comment I've ever received on my channel! 🏆

[@hephzivahisrael6974]

I don't understand why this gentleman spends the whole video saying or implying that there is no real benefit difference between premium and advanced technology, and then says he recommends the premium level to all his patients every time. What then, was the purpose of the video .. it makes no sense to me. Obviously his patients will follow the advice of a specialist .. yet he says he works ethically

[@SlackFX.channel]

​@@hephzivahisrael6974He literally directly addresses what you're saying you don't understand at 13:21 onward. Just because you aren't able to make sense of something does not in fact mean that it does not make sense. His stance is entirely reasonable as he's being entirely transparent (and therefore ethical) in how and why he's drawn the conclusions he's drawn, as well as acknowledging the issues with drawing these conclusions weighed against the positive outcomes patients feel they've had in having been recommended the premium products over advanced. Recommending them the premium option does not mean he does not make them aware of what options they have available to them/and why they consider should choosing one over another. Ultimately it is still the patients choice, and like any medical advice, people are always free to seek multiple opinions.

[@sarahdurantsmith1278]

@@hephzivahisrael6974 It's a bit hard for a lay person to follow, but I believe the standard he's using is called "informed consent". This basically means that he gives patients the information they need in a way they can understand so they can make the best decision for their health. He tells them that there isn't necessarily a drop in performance, but there are likely benefits the premium technology since he couldn't explain why all 4 patients in the study picked premium before knowing which was which. It doesn't sound like he's pressuring people to go out of a comfortable price range. He doesn't really get into this but the info is also helpful on the other end; the difference between advanced tech and premium is miniscule compared to the difference between no hearing aids and advanced tech

[@vasundhararatakonda9455]

Hi no

[@shaffar]

2 years ago I tried Costco KS9 120 days (I could have 180) ; It cost $1500 and adjusted by dispenser; then, i switch to $4000 Oticon S3, adjusted by experienced audi, for almost 40 days (out 45 days trail) In the last 5 days I switched from one to another. Both were the same; so, ended up with Costco. My A audiogram curve is down to approximately -75db at both ears. there may be situations that one rides bike so wind is a big factor or one works a warehouse and the 8 hours of noise is a factor. The S3 at 4000$ did not do the trick and S1 was $6500. for me noise usually occurs in restaurant (total of 8 hours a month) or football/basketball games (several times a year). So this $5000 more to S1 not worth the diff. At my home or at my car or walking in the nature with friend Costco was superb.

[@gonzo2.0]

Consumer Reports always finds Costco hearing aids to be the best product for the best price. I think you made a good choice.

[@MR-pr8tp]

thanks for sharing as I am going to go with Costco and stay within budget. I am convinced the profits and differences in the devices are simply lining someone's profit margins. After all, we are the only country that makes profits over care for the clients. I am simply convinced these devices could be made less expensive for the consumer.

[@petersuozzo1227]

Cliff, thank you for your videos. I’m the only person in my family that is using adaptive technology to help me. I was born hearing but have been deafened over time and these videos significantly helped guide me in my decisions and wished I could have gone to see you in your practice. Thank you for your very educational and informative videos.

[@2010securityful]

Thanks!

[@DrCliffAuD]

Thank you!

[@saraphillips15]

I recently got my ears checked at the audiologist. I'm a candidate for hearing aids. Mild to hearing high frequency, so I'm new to all this.

[@ТарасСтецько-н5щ]

In my country audiologists always start with the question: How much are you willing/able to spend on your hearing aids? Because most people here simply connot afford premium technology. I myself collected money for 2 years to buy me advanced level hearing aids (one per year).

[@johnwilson7809]

Used car dealers also lead with that question.

[@evereddie9984]

In my extensive personal layman’s research I feel that very basic core hearing benefits are equal across each level in various models. This is good for extremely mild hearing loss. However when you reach moderate severe or profound you definitely need the features of premium and advanced. At these levels the higher the level the better the fine tuning capabilities exist along with specialized features like noise cancelling and tinnitus masking. I have hearing loss similar to your patient #4 and I require the top tier to achieve the best quality of life possible. I could go with a lower tier and still obtain improved hearing but not at the level that I could with a step up. Also since hearing worsens rather than improves with age it makes sense to purchase the premium level which can later be programmed for hearing that worsens rather than needing to buy another pair prematurely. I am happy with my premium aides but as you stated go with the best you can afford.

[@ruthnovack144]

best hearing aid to purchase

[@ruthnovack144]

what is the best hearingaid to purchase

[@kaylasmusic]

Agreed! But it’s most likely you’ll be changing the device after a few years or so, because that’s generally the lifespan for the devices now,.. you could always start with advanced level and see if you need premium, because it’s usually a 1,000 difference

[@kaylasmusic]

@@ruthnovack144It depends on your lifestyle situation and hearing loss

[@rogerdodger8415]

As a pre-teen my father helped clear up these weighty issues with a small bit of advise.... he said.. Whenever a salesman sells you a turd, he most surely will have a gold plated turd for those that want "only the best".. There's always an up sell, and it seems to me that in most cases it comes with diminishing returns and less value for your dollar.

[@rogerdodger8415]

@@sanuehimen1415 I think that you have ringing in your ears!

[@sanuehimen1415]

@@rogerdodger8415 I have tinnitus before over 2yrs after my friend recommended me to this doctor I was cure completely

[@sanuehimen1415]

@@rogerdodger8415 he can help you send him a message on is WhatsApp

[@rogerdodger8415]

@@sanuehimen1415 Indeed, but I keep telling you something, and you can't hear me.

[@thecreativechamp]

@@sanuehimen1415 Is this real?

[@Ryarios]

I wear hearing aids. My audiologist sells 3 tiers of hearing aids @ about $1000/$2000/$3000 each. The cheaper ones are the basic models with the speakers in the hearing aid behind the ear and a tube running into the ear. The mid range covers all the models from behind the ear w/ the speaker in the ear, to the very tiny ones that are replaced every 3 months at the office and are otherwise worn 24 hours a day. The highest priced ones are the same as the mid range ones but are recommended for the profound hearing loss patients that need something like frequency compression. It also doesn’t matter which brand of hearing aid of the several they offer. The cost also includes 2 office visits a year for cleaning and servicing and 1 comprehensive hearing test a year - for 3 years. Also, at the end of the warranty period, they will send in your hearing aids to be rebuilt at no cost to you. So, yeah, I wear the mid ranged aids. Granted the prices I quoted were as of about 5 years ago, so I don’t know what they are now. On a side note, my hearing is pretty bad. On the day I got my hearing aids, as I left the dr’s office, I started my car and for the first time heard my car’s startup chimes. For a second I thought the car was broken until I realized what it was. All-in-all, they were worth every dime I paid for them.

[@DougYeager]

Personal anecdote: my premium gear is worth it. I am thankful for my ability to afford it. I experienced a substantial improvement to my quality of life. And since I have severe hearing loss in my left ear, streaming music through my hearings aids with L/R adjustment was like hearing the music all over again.

[@mstinamichele]

In February, I settled on the middle tier of the Octicon Opn S got the minirite R. I was already cringing at the almost $4,000 price tag but wouldn't go a tier lower and couldn't go a tier higher. My audiologist recommended a Starkey brand (the brand they favor) and a h.i.s. recommended the Oticon Ruby. Inheritance money I had at the time is the only reason I have these today. Had I not, I would have financed the Oticon Ruby or the Opn S3 (depending on the price) and left it at that. I did see there were differences between the three on the tech sheet, but not really enough to spend more money on the top tier offered imo. The audiologist didn't really explain thigs like this video did, but I wouldn't have been able to go up a tier anyways. I honestly wasn't looking for any bells an whistles, I just wanted to hear. In all honestly, my Apple Earbuds Pro are my go to when listening to youtube videos or fb lives or my usb headset. The hearing aids just don't sound as good for those things. Informative video Dr. Cliff.

[@sanuehimen1415]

Do you have tinnitus contact this doctor can cure you here is WhatsApp number [phone] if you are interested

[@FoussAHS]

I was watching this video as a potential hearing aid user, but I really enjoyed the description of the study. I'll be showing this video in my AP Statistics classes when we learn about experimental design!

[@johnwilson7809]

You'll probably find that n=4 is too small of a sample size.

[@janakpatel5690]

U r so honest and kind to people can't afford expensive hearing aid great thanks I learn lots from your vedeio

[@paulcostelow7713]

Thank you Doctor Cliff for making this high quality content! You are helping people like me make decisions we can live with.

[@DrCliffAuD]

My pleasure Paul!

[@Kulvinder1974]

As an audiologist, if I were one, I would also ask my patient, what their lifestyle tends to be and then make the judgement whether any extra features would make a difference to that persons lifestyle, in real terms. Just a thought.

[@jameseubanks1509]

Interesting information. I personally like the premium level too. There is usually one feature at that level that is worth the cost to me. One thing that neither study addressed is client satisfaction. If a premium level makes the client happy, then sell them the premium device. (If you make extra money on this, that's even better.) I know you would step down a tier or two if your client couldn't afford the top line - and we like that about you!

[@carlotta4308]

I think those guys went for the premium/better ones because the whole thing about hearing loss is that you are MISSING OUT on what you had before all your life and what everyone else seems to enjoy, especially if you are just on the cusp of being quite young for needing them, like i am at 59 years. So the thought of missing yet another funny throw-away remark which leaves others laughing or getting your spouse to repeat themselves one more time or seeing them try to conceal their annoyance with you makes it worth the extra money, even for a limited difference. So that's why your subjects chose the premium, I think. 😊 The question is then: is there any significant difference between the brands. I have already listened to the Starkey Livio Edge 2400 review - v helpful, thank you.

[@lschmidt2405]

I'm in New Zealand & each quality step increase costs an extra $2000, fyi Also l am a woman & l find your factual, straight talking approach very, very appealing. fyi

[@michelecaldwell3962]

I agree! He is so easy to listen to!

[@nand6181]

I wonder if asking them why they chose that level would have clarified the results. Perhaps it was primarily the extra automatic features that made the difference rather than the hearing benefit.

[@kemaldjakman]

Very impressed with the honesty in this study.

[@jamessherman7797]

Thank you for your informative video. I’ve just ordered my first pair of hearing aids so I’m trying to educate myself about the technology available.

[@pilotknob600]

I can purchase a 55" UHD 4K OLED smart TV for $700. The idea that hearing aids programmed to a person's unique hearing loss profile have to cost thousands per ear is highly suspect. Yes, they are smaller than a TV but they really do not have that much to fit into their footprint limitations, especially when you consider what's crammed into a smartphone, and of course the cost of the materials in a hearing aid is probably a thousand time less than that of a TV. I think someone somewhere around the world will break this artificial logjam and provide hearing aids with all the premium customization level features for well under $1000 for both ears.

[@neilfurby555]

Absolutely agree, from my perspective at least I suspect a very dubious relationship between performance and value, relying primarily on customer ignorance heavily influenced by great volumes of “professional opinion”.

[@1947froggy]

Costco almost there:)

[@ChangesOneTim]

Good analogy. Hearing aids today are essentially modular design with a range all based on the same 'platform'. Perhaps this can also be likened to the modular concept in car engine ranges: a certain German carmaker has a lovely 1995cc engine, the basic single turbo version gives cracking refined performance with 0-60 mph in 7.5sec, but they'll try to persuade you to go for the twin turbo spec with extra bells, whistles and 7.1sec 0-60 mph time. Better still, why not be bold and order the quad turbo with go-faster stripes, super-sporty suspension and 6.8sec 0-60 mph time? You'll have been persuaded to pay thousands more to 'go advanced' or 'go premium' even though you'd still enjoy 99% of the driving experience by sticking to basic.

[@attilaann9421]

Absolutely. Good to see someone talk about price. Maintenance and adjustment. Why can’t the individual be taught to adjust and maintain his own hearing aid? This ain’t astrophysics or heart surgery.

[@ChangesOneTim]

@@attilaann9421 For maintenance and replacement of mechanical bits, why not? To an extent I do that myself already eg domes and receivers and cleaning stuff. But sound is a technical thing and I for one would continue to entrust that side to a professional.

[@NickMoore56]

Dr. Cliff, Thank you very much for your videos. This is great information. For me the difference is between $1,400.00 for the Kirkland verses $7,400.00 for the Audibel Arc AI recommended by the audiologist. I am on trial with the Audibel for 2 weeks and will compare to the Kirkland as soon as I can get to Cosco. I can afford the Audibel but seriously doubt I will want to pay $6,000.00 for the premium features.

[@DrCliffAuD]

It has more to do with the professional care you receive. If you feel like the care provided at the Audibel clinic is substantially better than Costco, then I say stick with them.

[@kenvik-q5t]

Dr. Cliff is absolutely right, do not allow the chain-office HA services to robe you. Combine not so called “premium” tech, but advanced category, or basic and make sure the fitting, programming is used along with the “best audiologist practices”. This way one will save money and have the same premium outcome for their hearing loss addressed.

[@johnwilson7809]

If someone were to "robe you", does that mean buying you clothes?

[@MrJimmyJoe6000]

Love the knowledge you are providing me with my mile to moderate hearing loss. Male with upper range mile loss so I don't always hear or understand the wife (not a joke). Your videos give me a lot to think about from the $849 ($649 until May 15 ) Bose ones to the Costco ones to going to an audiologist to ensure the hearing aid is precisely fitted. I'd tell anyone who is shopping for a hearing aid to listen to a lot of your videos. Thank you so much for the education before I spend hard earned money on a pair.

[@123LetsGoEntertainment]

Hello May I ask one question? I have been having hearing problems during conversation. So thinking of having hearing aids and want a real comment from a person having similar condition like me. Can you have easy conversation with people especially in public noisy places with the help of hearing aids ? If you don’t mind please answer me. Thank you 🙏

[@MrJimmyJoe6000]

@@123LetsGoEntertainment I did try the older Bose ones but they did not work for me. However I called Bose a few times and they were very helpful and when I returned them within the warranty period I got my money back very quickly. Bose was very reputable and easy to talk with. to your question. If it is real noisy or lots of conversation I have to be very attentive and I know I am doing some lip reading. I have not tried another set of hearing aids and am waiting until next year money wise to try another pair. Yes, I know the longer you wait can be detrimental. In any case, I think this you tube channel is worth listening to quite a few of them, even the old ones. It's expensive.

[@123LetsGoEntertainment]

@@MrJimmyJoe6000 thank you very much. It’s quite informative hearing from your story. I have to do more research about it. Thanks again and I hope you have a lovely day.

[@bud1412]

I was tested at a hearing aid center as I have a pretty good loss of hearing at 75. When I was asked to go outside and see how they sounded with street noise and speaking with people, they were lousy, and 42

[@DriverGuy23]

So, what you’re saying is that it comes down to features. If you like one over the other due to design, color or features, get that one, because not only are you getting the same quality in hearing improvement, but you’re getting what you want in features as well.

[@kentspence4563]

I'm an audiologist in New Zealand and the cost difference between advanced premium is thousands of dollars. IMO its not worth the cost. I fit all my hearing aids with REM following best practice guidelines and extensively counsel my patients. I consistently have patients who trial basic vs premium or even compare new aids to their old ones and report having the same usual problems most commonly being hearing in BGN. My experience is that very few are afforded significant benefit from premium devices and that it is simply not worth the cost. At the company I work for we sell hearing aids from $450 for a pair up to $9000 and more often than not the patients who purchase the high technology levels continue to struggle hearing in noisy situations and are generally disappointed in their hearing aids. I also find that private audiology companies are primarily in the business of making as much profit as possible and often show a lot of disregard towards patients. Its extremely disheartening and I struggle with doing my job every day. I always prioritise my patients needs over the companies ambitions and it feels like a constant uphill struggle. Enough so that I'm ready to turn my back on the six years of university study I did and retrain and go into a different career.

[@DrCliffAuD]

In my experience, when an Audiologist thinks that the technology is responsible for people not hearing better in noise and responsible for determining satisfaction in their treatment, that the Audiologist really doesn't understand the fundamentals of Audiology. Perhaps it is a good idea for you to change professions my friend. I don't think audiology is the right profession for you.

[@kentspence4563]

@@DrCliffAuD I'm well aware that the technology is only part of the equation when it comes to helping our patients hear better. My gripes come from being constantly told that if I'm not selling the best technology I'm not giving my patients the best opportunities to hear better. I'm a big advocate of matching people's hearing needs to the technology best suited to what they want from their hearing aids but also being realistic about what can be achieved given someone's underlying hearing. For some people spending that extra money is going to make no difference for them and I refuse to be told that I've failed that patient by not upselling them to better technology.

[@HerbEdelstein]

Much as I liked this video (and will use it in my Intro Stats class) and your others, I think there are two other factors that you left out -- the different hearing loss profiles and the the tiers may differ across manufacturers. The real reason you need a larger sample is so that those variations will be much less of a factor in your results. Having no idea of what Dr Spence's practice is like or indeed how he works, I think your response is unnecessarily harsh and insulting. Addressing the substance of his comment would have been more appropriate than an ad hominem attack and is what I would have liked from a person of your expertise and stature.

[@Zealor365]

After 6 years of wearing a pair of high quality (Kirkland brand) ReSound hearing aids from Costco, I tried a tried on the Resound Omnia 7 hearing aid (Premium). I noticed a significant improvement in clarity and background noise (tinitus) reduction. Technology has moved forward in 6 years, but I am not sure I can justify the $1700 difference in cost (2 ears) and will most likely purchase the private in house brand "Relate" from my insurer.

[@PaulHtmnn]

My question is about the increase in price charged by the manufactures. If I am correct (please tell me otherwise), the aids have the same hardware installed regardless of the technology level with only difference is the software programming that allows what level of technology can be used. So why charge such a large difference between technology level?

[@oldblackstock2499]

My question exactly. I see you haven't been answered. The cost of hearing aids is outrageous ! And most of us must have it.

[@neilfurby555]

Great question. I also suspect that the internals of devices are identical, and the performance differences are created by adjusting the software controlling frequency response and other operating parameters. As a new user of hearing aids I am finding it pretty much impossible to obtain any specific information about device performance, all that seems to be made public is endless lists of features, none of which are ever quantified. Given the outrageous prices charged for these mass produced electronic devices, I can only assume that someone somewhere is banking very healthy profits based on a curious mix of customer naivety and blind faith in the hype? Someone tell me I am wrong please?

[@ChangesOneTim]

@@neilfurby555 On the basis that each person's hearing benefit is possibly just 50% from make/model of their aids with at least the other 50% benefit from the skill and experience of their fitting audiologist, it does make me wonder if the whole business model deliberately disincentivises the latter to do the best possible job for clients unless they choose to go premium!

[@MR-pr8tp]

@@oldblackstock2499 Amen! The cost and along with all American healthcare isn't about helping us but lining the pockets of someone in control. Of course these audiologists make money from selling and promoting the higher cost devices. . A real turnoff for me.

[@carolcooke7125]

@@neilfurby555 Check out bandwidth and channels for better hearing aids

[@derkradfahrer2207]

Very interesting video. During a testphase I was able to hear differences between premium and advanced level (Phonak Audeo P90 vs P70). P90 performed much better in (for me) rare situations with very high background noise. In (for me more) common hearing situations (group talk, video conference, phone call, single talk) the difference between P90 and P70 was noticeable but both levels performed not far from each other. Price difference per device in Germany was about 600$. It took me a while to come to a decision. At the end I decided for P70. And I am extremely satisfied. But if my hearing loss increases I tend to go and pay for premium because the difference in performance will most probably have higher benefits in common hearing situations.

[@asadwahidi8894]

Sq

[@johnwilson7809]

Interesting study for sure. A few observations: 1) Single to noise ratio is usually abbreviated as S/N, and not SIN. Maybe that was just a typo. 2) When you said "measurable difference", I don't think it was measurable as you had to use the user's opinion to determine better, worse, or the same. "Measurable" would mean it could be measured with a device that had a definite output, like a dB meter for example. 3) With only 4 people (n=4) the sample size is really too small to make any kind statistically significant analysis. But certainly a good starting point. 4) Many of us would like to know exactly what is the difference between the higher "technology" vs the lower "technology". Gain, frequencies, separation, S/N, filtering, distortion %, etc. In other words, what does each higher level of "technology" have over the lower levels.

[@RaffaeleMagaldi74]

Based on my own personal experience (as a hearing aid user for the past 36 years), premium technology becomes much more important if the hearing loss is more severe. And the features are also important because if you need hearing aids to be fully productive at work (and that is my case) you really want to have the maximum flexibility and options that premium products offer.

[@paulsheehan2998]

I live in the UK where healthcare is free and we're provided low to mid level devices on the NHS We are though able to pay privately for the best available. I'm under 40 and relatively wealthy so decided that an upgrade would be beneficial as I'd get many years use of the premium device. In my opinion, the money I spent gave a marginal increase in sound quality but no real improvement in volume.

[@paulsheehan2998]

Love the honesty too

[@rickbrosey9441]

Another important point in this discussion is whether the participants were concerned about the cost of the hearing aids. My assumptions are 1) They knew they were going to spend several thousand dollars for each device; 2) That they were going to pay those costs “out of pocket” anyway and; 3) That they had the financial means to do so. Therefore, paying an additional $200 per device was not a big deal. If these folks were of the “cost conscious” personality, would the results be the same?

[@i-see-desertbaldo2369]

OMG! I love science! This was just a fun video to watch. Thanks for making my morning filled with hypotheticals.

[@noormotani9719]

You noted price difference between levels at $200 or 500. I am in Canada and the difference is I thousands.

[@gregsettle9725]

A bigger study is needed. No-fault in recommending premium HA. The patient is free to choose.

[@genebean5477]

Hello doc my name is gene. I am 65 years old I have working still shops most of my life. Hunted most of my life. Been around a lot of noise shooting guns. Working in a steel shop beating on metals welding and grinding I'm sure you've heard this before . I wanted to commend you on your test that you have done. Because I can afford any hearing aids much less the good ones. Single father of two . One of them is 17 the other one is 19. I took an early retirement at 62 because I needed a steady income coming in. It wasn't because I could afford it. it was because I needed to do this it was because I needed to get a second job so I can afford to take care of my family by myself. I work for a farmer take care of his ranch for him. I guess what I'm getting at is every penny I save I spent on my kids.i wouldn't have it any other way. It's 1:00 in the morning somewhere around there I have to go to work in the morning but I was working on a pair of hearing aids that were given to me. And I went online to try to figure out how to fix them . Needless to say I pushed them side and said forget it. I mean I'm a fitter welder and a ranch hand LOL. I guess what I'm trying to say is thank you for being so honest and so sincere. I would like for you to know there is very few doctors out there like you. I wish you the best in your practice. It's pretty obvious you will go far. Bless you and your practice. Because there's nothing like hearing your children say good morning Dad have a good day dad. Most of all when they say I love you Dad. Thank you for the video. I will share it several times I'm sure.

[@leonidas6040]

Hi my name is Leon I've been wearing hearing aids for years now and my hearing just got worse over time it was very scary until I decided to get a cochlear implant in my right ear I'm glad I did because I had a very good surgeon and of course she is leaving for a new job soon we're going to miss her a lot I'm beginning to get used to my implant it's worth it I wish I had done it sooner it's so lonely and scary when you can't hear not any more

[@rosalindllk6454]

Is implant painful,l had profound hearing lost,need surgery.

[@citizenk812]

This past December I purchased my first hearing aids. I looked over the features and decided that the advanced level fit my life the best. While I've enjoyed a substantial improvement in my hearing, the next pair I will buy will be with premium technology....now that I've gained experience, I believe additional features would be worth it to me. As usual Dr. Cliff, you do a marvelous job of explaining everything and helping we users to make better informed decisions...keep up the good work.

[@123LetsGoEntertainment]

Hello May I ask one question? I have been having hearing problems during conversation. So thinking of having hearing aids and want a real comment from a person having similar condition like me. Can you have easy conversation with people especially in public noisy places with the help of hearing aids ? If you don’t mind please answer me. Thank you 🙏

[@williamgiglio3476]

I began wearing hearing aids 30 years ago. My choice buying a hearing aid was cost and expendable replacement due to my working environment. I worked in a power plant with extreme noise, heat and moisture. So I just bought a basic aid that I could turn on and off and replace with a additional pair at low cost. Now I’m retired and I bought a high tech model that I wear almost all the time unfortunately the high tech hearing aid batteries don’t last more than 14 hours. I still have to wear my old aids if I’m using them for a long period of time. Plus hearing aid stores come and go with changing economies.

[@susanc.7514]

I have a question about hearing aids in the pool. I take water aerobics ( no head in water) I don't even get my hair wet! I don't wear my hearing aids in pool but I can't hear our instructors comments either. Is there a hearing aid that is in the canal (less noticeable ) that I can get instead of the traditional one . I have a signa that's 3 yrs. old. But I can't hear with these very well. I have tinnitus too. I don't know if these were programmed right!! I just want to hear clear and not delayed sounds! Do I need these adjusted OR new ones ? I'm live in Fairfax VA. Help me please! Find a knowledgeable dr. Of audiologist. Thank you. Susan

[@mariogonzalez8517]

If you are an attorney and concerned about both hearing and people seeing your hearing aid, where you need to listen in a hard surface courtroom and constantly on the phone, what type of hearing aid and brand would you recommend?

[@flylady_project]

Invisible Hearing aids

[@Phil_Vernon]

What a great Video Cliff. Trying the best to justify why you reccomend Premium and analysing your potential personal bias in the process. A single blind is difficult, as all it takes is a slip like 'I think you'll like these' comment from you for the wearer to create an opinion. I have been using Costco hearing aids as they were the first in Australia to to sell at a relistic margin. Im 60 and on my 2nd pair in about 5 years now using KS 8.0 and tbh not really satisfied. So have started looking at Premium. But to digress, great video and you appear to have integrity and honesty. 👏well done.

[@melindapearl7629]

Thank you for this information. I was really confused on what was the difference in the two. I have to pay out of pocket for my hearing aids. Thanks for your amazing videos

[@jerrywiniarski1176]

Nice video Doc...now ita back to dreamin' of hearing sids for me...someday...😎👍

[@sct4040]

We spent $2,800 at Costco for a pair of Resound rechargeable hearing aids,3-4 years ago. It was money well spent for how it worked for hubby with the way it can be controlled on the iphone and how it be used with a mini-microphone ($179). The premium hearing aids are excellent, IF you can also afford a smartphone to use with it. For a low tech person, a basic device might be advised. Just my opinion. For reference, hubby is severely hearing impaired.

[@mostguitarswins]

Thanks for the thoughtful study. If I understood correctly there wasn't a hardware difference between the advanced and premium devices, only a software programming difference - is that correct? If so why does simply using a different program raise the cost of the aids $200-$500 each? Since you mentioned computers, the difference in cost between them is based on hardware sophistication not software; they all run the same operating systems and programs. It would also be interesting to hear you say more about the differences are between premium and advanced aids.

[@tictactoe325]

When I was looking at hearing aids the difference in price point was in the number of channels and availability of different programs/ apps. The bottom layer of hearing aids only had 4 channels, whereas the top range has 24 channels. I chose the top range because of the amount of channels that can accommodate my hearing spectrum and the ability of the hearing aids to do what I wanted. Yes, it’s cost me a small fortune, but it’s worth it for a quality of life.

[@grene1955]

I am a 67 year old hearing aid user. My experience was much different. I got the highest level Jabra device from Costco. Slightly over $2000. I wore them for over a month before returning them. The technology was so primitive, it was ridiculous. On the devices themselves I could either select to have the buttons control Volume OR Profiles...not both. To do that, and to provide Bluetooth connection to my phone, I had to have this third device hanging from my neck. I found this embarrassing and annoying. In addition, the phone app was useless. There was no way for me to access the EQ settings of each device...for that I had to make an appointment at Costco. As I said I returned them for a full refund. After doing a LOT of research, I now have Blaids X Pro hearing aids. The sound quality is MUCH better, and though I have to connect a small bluetooth adaptor when changing the programming, I do not have to use it for normal use. And the app allows me to access the exact EQ frequencies I want to adjust. The controls on the devices allow me to adjust either volume OR profile. The only downside is they are so small they do not have onboard BT, so no phone connectivity. But since I can now understand speech on my phone, not really a problem. And the kicker was they were less than half the price of the "Premium" Jabras at Costco.

[@chrisbisel2274]

Couldn’t agree more. I always say to get the best technology that you can personally afford. Good video.

[@sancoffsr]

I think it’s kind of scummy how these companies sell you the same hardware( hearing aids )and give you different levels of software instead of just selling you one great product .

[@edbouhl3100]

It’s also extremely misleading to use the term ‘Technology’ instead of ‘Software’. There is only one point in this video that hinted that the hardware is the same in all five levels, when he mentioned reprogramming the devices and fewer features as a result. The implication seems clear to me that you should be able to buy a ‘Basic’ hearing aid and later have the software upgraded. But I think most buyers would balk at paying that much purely for software - and per device at that. At the end of the day, it’s about marketing and profit. The hardware is the razor and the software is the blades. At $1000 per ear for a software upgrade, it’s a profitable business.

[@sancoffsr]

@@edbouhl3100 But it is software this is what they use to tune the device.

[@lucasjohnson5871]

I'm hard of hearing. I read lips. This combined with my limited hearing, I usually understand everyone. Now, with everyone wearing masks, I'm missing alot. I want to get hearing aids, but am not sure I can use them at my work because I work in a noisy manufacturing environment that requires ear plugs. Do they make a hearing aid for people like me?

[@caroletraynor6337]

I would definitely not wear hearing aids at work, do you want to be permanently deaf? I also have trouble with understanding people because of the face masks, it's really hard to have a conversation and listen at the same time. when I go to a concert I will remove my aids as it's too loud for my ears when wearing them, so to protect what little hearing I have left I remove the aids in any settings that are just to uncomfortable for my ears. So don't use your aids at work.

[@hazelnewshub6443]

Very hard to hear what face mask people saying even you have an hearing aids

[@sct4040]

It has been a real struggle the last 2 years with masks. 😔

[@shauncronin3961]

Very informative, what about the direct sell or OTC where the device is not fitted by anyone but the patient

[@DrCliffAuD]

What about it?

[@shauncronin3961]

@@DrCliffAuD you stated that the aids should be fitted and setup I’m asking how they would work if you got them on the I yet net and tried doing it yourself

[@DrCliffAuD]

@@shauncronin3961 could be okay, could be a complete disaster. Who knows if you'll actually hear your best.

[@RB-bg2xi]

I found premium just gives me less strain to hear in noisy places.

[@hwolfeaz1946]

I don’t mind paying an addition $200 or even $500 per hearing aid for premium technology, but not $1,000 per hearing aid or more. My ENT told me I could do better than the $2800 Resound Hearing aids I got from Costco; and his Audiologist recommended $5,200 and $6,200 hearing aids. I was unable to detect a significant different in the higher priced hearing aids so i didn’t select them.

[@RB-bg2xi]

@@hwolfeaz1946 go to Costco or Sams

[@krishysler1373]

Hi Dr. Cliff, do you have any videos on BTE vs RITE? I am looking into new hearing aids. I have Oticon OPN Mini-rites but I hated the domes (itching, feedback, movement, etc) and switched to a lite tip mold. It’s okay, but it still gets clogged and I clean it multiple times a day. My cerumen is very thin liquid. I have mild to moderately severe sensorineural hearing loss mostly in the high frequencies and constant very loud tinnitus. My AuD didn’t think I needed the mold in the first place, but I couldn’t hear myself and everyone always told me I was yelling. I wore a size 6 dome, so my canals are a little small and totally straight. I’m also a bartender (loud job), a singer (I know lol), and in nursing school (digital stethoscope), so I have a pretty varied list of needs. Like I need the ability to hear one person over many and protect my ears from noise damage. I also need to be able to hear myself. Who benefits from BTE vs RITE? How do I make an informed choice?

[@aziyzulabdi6713]

You got OPN or OPN S?

[@krishysler1373]

@@aziyzulabdi6713 OPN

[@aziyzulabdi6713]

@@krishysler1373 my case very similar to you, with tinnitus in both ears.

[@eaaa1977]

Hi. what do you think of lucid? would you recommend them

[@EclecticTastes]

I live in Australia, and I'm a pensioner. I have moderate hearing loss. Every 5 years I am eligible for a free pair if what you would call Level 5 hearing aids. As the level goes up, so does the cost: Level 4 - $AU690 for each hearing aid Level 3 - another $690 per hearing aid Level 2 - another $150 per hearing aid Level 1 - another $620 per hearing aid Level 1+ (AKA Performance Plus) - another $1,000 per hearing aid. These are all Siemens Signia range hearing aids In these circumstances, which pair would you recommend?

[@sanuehimen1415]

Do you have tinnitus contact this doctor can cure you here is WhatsApp number [phone] if you are interested

[@phillipmarsh7200]

I have a premium set of Phonak aids from Costco, but I also have a pair of "free" aids from unitron (sister co to Phonak). Although the Unitron aids don't have all the bells and whistles of the Phonak they work remarkably well. I am a department of Vet affairs client but I believe the free ones are the same for pensioners. (Also in Australia)

[@nettyd5350]

So premium aides are what tier? Advanced are what tier? I am confused…new to aids & currently trying one - tier 2

[@GTFour]

Very interesting, should definitely look to do this with a much larger sample size. Big as you can. And review the questions.

[@julianroberts698]

Thanks for this an enjoyable watch

[@Ingraomusic]

I'd be interested to see APHAB and SADL on these folks for each device. Also, a larger sample size would be preferred.

[@DrCliffAuD]

Hopefully this will encourage researchers to get federal grant money to conduct a larger scale experiment.

[@michelecaldwell3962]

@@DrCliffAuD Absolutely and I appreciate that you took the time to perform the study at all!

[@geofru]

Agree generally. Unfortunately, you'd need 50 or more subjects for a reasonable sample size, plus randomly assigned, and double blind. I doubt that anyone would fund that sized study to prove that the lower cost and lower profit model is just as good.

[@Ingraomusic]

@@geofru and that exactly explains how we audiologists allowed the hearing aid industry to define and shape our "profession. " All rhetoric, no results.

[@bobprice6274]

I am wanting not just the heating improvements but premium features like streaming music at a high quality. That to me makes premium hearing aids a better choice on the surface.

[@carolcooke7125]

In my experience with Oticon More 1s, it's better to use your headphones for a good music listening experience ... none of these expensive hearing aids stream music well via Bluetooth even with the option to change the bass and treble.

[@davidpotter2968]

b Potter here. Ironically I studied asl and see II for 2 years in college? Did I have a subconscious premonition ID someday need to communicate to others within the deaf community? I'm trying to teach my Sheltie puppy how to be a hearing dog but my husband can't take her incessant barking tho. Is there an organization that will help me financially w the car of my 2nd assistance dog? She's 12 months old and trainable but I can't afford a trainer.

[@rubymckinney9126]

HELP!!!What do you know about Audien Hearing Aids??? Can not find a phone # to contact and having a problem With mine?

[@alfredotello1334]

Hello Dr. Great videos . I am a old time hearing aids user I have been using hearing aid for the pas almost 20 years...im 66 years old now, and it seem that my hearing loss is progressing. Am at around 88% loss. Everytime I take a Hearing test it comes back worts that the previous one, used to be 75 and now is 86 88% which is considered to be severe correct ?. My hearing problem seem to be concentrated on clarity. During the audiology test I can sometime hear the minor beeps, but when i am in real settings using hearing devices I cannot hear these minor beeps or sounds I should say, and experience lots of problems understanding speech however loud the hearing devices may be....so..what would be a good solution to these types of problems..I am in the market for a new set and im looking to purchase OTC devices..but I cannot find them for severe hearing loss.. I live on a tight budget so try to find a reasonable set of hearing aid that could fill my needs. any sugestion to my problem will greatly appreciated.. Thanks in advance...

[@cyndipierce9641]

I had Eargo for 7 years. a few weeks ago my left ear hearing dropped significantly so I went to new sound heating in Houston /. $6000 for these. Thrive app with my IPhone I am extremely frustrated with them. I have worked via telehelp to utilize application... I am a. very active individual I work as a mortgage lender and now have difficulty making sales calls due to various environments- I need advice . I don't feel like these are working.

[@Joeybz1]

I wanted to respond to Costco Kirkland heading aids. I have those. I do not think it is the hearing aid. I think it is the charger. However, I have had them just stop. Then I use the charger. So ?

[@Karicat6]

I like that this is exactly the video I was looking for this week and it’s here now !!

[@user-wq7hw2ow9l]

For my mom, the difference in price between advanced and premium is $800. That is an acceptable difference in price for here. However, the difference in the basic was almost $3000. Is the difference in quality between basic, standard and premium justified? She has moderate to severe hearing loss overall, and severe loss with background noise. The cost for her hearing aides is $6100.

[@rusnsc7622]

This scenario is very similar to mine. Same sort of hearing loss and pricing…basic level is $4200 with Premium being $7700. While I am blessed in that the premium devices are not out of reach financially they are from a willingness to spend it. I am now deciding between the advanced level devices at $5200 and $6200 respectively. After all, having the devices will provide significant improvement over current state with out them. Trial periods are available but at the end of the day I am leaning towards striking a balance and reluctantly going with upper level advanced at $6200.

[@josiahmay4933]

I wish: 1) there was a way to "test drive" hearing aids; this is the only industry that literally ask you to spend thousands of dollars without being able to try working aids to compare different model to see what you like better 2) there was a better way to compare hearing aids from different manufacturers. more info that allowed for comparing options between different manufactures. standardized terms so you know if you are comparing apples to apples or apples to oranges. trying to compare different aids (without being inside the industries) is like trying to teach a college class Japanese using an English to Japaneses dictionary; you could do it, but the results wouldn't be very good.3) more open pricing; this is one of the most secretive pricing industries there is 4) better ways to compare your hearing aid provider. the layman doesn't even understand what the hearing aid provider should be doing (I have only learned about best practices, since watching some of your videos). so many belittle their competitors but don't help you understand what they are providing. patients often don't understand what is available, what are the advantages vs price.

[@michelecaldwell3962]

Thank you so much. I am so happy to have found your videos! I need to get a new set of hearing aids. They will be my 2nd set ever. I purchased my first set about 4 years ago at age 54. Sadly, three weeks ago my covid mask knocked one out of my ear on vacation. I had no idea until it was long gone. So I now find myself needing to start over. I am actually glad because I was not happy with my first set. $4000 for the pair!!! Initially I think I was, but over time they seemed to help less. SO NOW where to start? I am trying to decide if going to Costco is a good place to start or if it is better to find a new audiologist. I WISH you were in the Atlanta area because I would Love to visit you. Thank you so much for your highly informative videos! They are really helping me figure this out.

[@sanuehimen1415]

Do you have tinnitus contact this doctor can cure you here is WhatsApp number [phone] if you are interested

[@ruthnovack144]

? .

[@sct4040]

My hubby sees his ENT, with an in-house audiology exam, then we take the test result to Costco. Costco prices are very reasonable, at whole sale and with a wide price range. Hubby liked the $2,800 Resound.

[@Elephantine999]

Man, that was some serious audiologist wonkyness! I wonder how many people stuck it out to the end. (I did.) It would be interesting to see this done double-blind with more people.

[@alexribas122]

Great video, did you memorize or teleprompter? In any case, amazing!

[@DrCliffAuD]

Memorize

[@bbstacker70]

@@DrCliffAuD Damn, I can't even remember my SS number half the time. Splendid videos.

[@carlotta4308]

@@DrCliffAuD 😲

[@dethray1000]

i have had 8 pairs of expensive aid--just recently bought a $100.00 pair-- they work as good as the expensive ones--33 percent hearing loss--i do not wear them all the time because the increase noise bothers me--only want them for speech--the 100 bucks ones are good enough

[@1734245]

Hi. I gave this a lot of thought. I conclude there is a sure-fire way to convince your critics. Say you make a net profit on the advanced of X dollars. You could price the premium to yield a net profit of no more than X. That will stifle your professional critics. What say you on this?

[@393rocket]

Which technology was the last one used for each client? I suspect a strong correlation to recency.

[@TheRealLaughingGravy]

As he said, two clients started with the premium and the other two started with the advanced, then halfway through they switched. All four picked the premium. Since this test group was so small, we can't infer any correlation (positive or negative) to recency.

[@mdenizot2]

Dr. Cliff, I'm very impressed by the intelligence behind your reasoning. Now, if you could only be in Tennessee 🙂

[@DrCliffAuD]

Thanks Michael, I do know a GREAT audiologist in Nashville if you're interested.

[@1969russian]

@@DrCliffAuD Hey Dr. Cliff, you know of any great audiologist in Columbus Ohio? I need a really good 1 because mine that I had went to over the last 25 years has passed away 😔.. I trusted her so much about my hearing as I had bought 4 pairs from her in the last 25 years… Now I feel lost. It’s almost like she was my best friend. She totally helped me so much with all of my hearing needs. I really feel lost now that she’s gone.

[@boasecuritytechnologies2153]

Excellent video. Thank you. Wish you were in the NYC / LI area.

[@billrogers9230]

interesting look at individual preferences. Well thought out with tiny sample size.

[@artsagy]

Which devices were included in your test please?

[@daytonreuter3159]

Unfortunately there's another important attribute that's been totally overlooked - something fundamental to uncontrolled capitalism. The product tiers to which you refer are also ensconced in a product packaging pyramid intended to influence a users perception of which product they wish to be seen as choosing. Each purchase becomes a chance to cultivate a preferred personal image. I guarantee that if tier 1 tech is placed inside the physical housing (product shell) of a tier 3 product, and if the tier 3 tech is placed inside the product shell of the tier 1 product, that the results of this study would be considerably different. This is subliminal biasing done by product makers all the time, and it's done specifically to be able to increase profit margins by selling products that may cost the same (or minimally more) to produce, but can be sold for a much larger profit margin. In digital tech, this concept can easily be extended to include a clunkier menu logic or less appealing appearance to the software interface in general. This is done because we know it works - maybe not on all people all the time, but certainly on enough people to make it the default practice for any business where ethics are not aggressively policed. (In theory, licensed "professions" are regulated to enforce ethical practice - this being a founding principle behind the original definition of a licensed profession - but here to, not so much in the US where we pride ourselves on being home to a more wild west notion of "buyer be ware" capitalism.) Anyway, the net result is that the findings of this study are without merit because highly influential confounding variables were not controlled. Oh, and yes, I wear hearing aids. I initially got them so I could hear student questions more clearly in the university lecture halls where I taught research methods. And yes, I knew I was paying too much for the tier 2 products I use, but my design preferences, and ego, simply would not allow me to settle for a lesser product - guilty. Many things about human behavior may be predictable, but if the underlying logic is not understood, our assumptions about cause and effect relationships may be incorrect.

[@jameskearney4100]

My mother is on social security 83 years old. I am in no position to help her now either. Costco at 1400 dollars is a massive amount for the cheapest hearing aids. Is there any alternative or help?

[@christophermueller3370]

Hi Dr. Cliff, have you fitted many of the Phonak Paradise UP model hearing aids yet? I’m using the calm setting vs using autosense. However I’m seeing fluctuations in volume with the Bluetooth when listening to KZbin or music . It will start out loud and clear for the 1st 10 seconds or so then decrease to 1/4 or 1/2 then volume.it’s frustrating and I have tried 2 different devices and they both produce the same results. Any insight is greatly appreciate. Perhaps I have a bad hearing aid and need to replace before my trial expires?

[@jscutester]

Great channel. Any contacts in northern nj? Especially tinnitus.

[@natashak3387]

My friend who is a hearing aid user told me exactly what you said in regards to premium and advanced. There's many price ranges out there, but typically they do the same thing is what she was saying. She also said to be careful because some places will try to upsell you. I'll be going to another Audiologist that works at my ENT's office for my hearing aid consult, but then also go to Costco for another consultation before I make my budget decision.

[@johnwilson7809]

The kickback is usually more with the high-end products, thus the up sell.

[@theywright9960]

It depends on the patients life style... If they are home bodies and don't go anywhere then the basic is sufficient. If that person goes bowling and to church once a week that's a different story.

[@garyaanderson214]

I have bi lateral hearing loss.Costco couldnt help me

[@cornellsmith2205]

I am one eared; and wear a Benefon Z-9 from Costco. Would I benefit with a premium instrument?

[@Boemel]

im 31 and left ear is near complete deaf and heavy thundering tinnitus, work in steel plant so extreme loud noise, hot sweaty and dusty. i have no idea what hearing aid to get.

[@dr.emadboshi]

İ have a question please İs it dangerous to use hearing aid in just one side Like if i use it in the right side (%40 damage) without the left And i already have 20% damage in the leftt side

[@myrtlefitzgerald5657]

I was diagnosed with sudden sensory neural hearing loss in my right ear. I am really struggling with background and distorted sounds. I have a hood hearing aid but I am still not satisfied. I tried a bone conduction ear phone and I could hear perfectly. Of course it was through Bluetooth and my IPhone so there was no background noise. Could you explain about the difference in bone conduction hearing aides and who would benefit from this type and why most audiologist do not talk about this type of hearing aide?

[@mrbottomfeeder]

Dr. Cliff Olson What tier level are the hearing Aid at costco?? Thank you. Thank you. 👍👍👍👍

[@f143744]

Using a Case Study from 7-years ago, without the advancements of current technology is basically a mute point. My suggestion after wearing hearing aids for over 30-years, purchase what you feel helps your the most, within your budget. At the end of the day, hearing aids you don’t like, you don’t wear…

[@cb8591]

New to your channel, and wondering if you have done a comparison between what is available, both in devices and service, at Costco and typical local audiologists?

[@007rgb]

Cost of inputs vs price to clients: What is the cost difference to program for “premium” vs “basic” technology? Does the cost difference justify the price difference? …..or is it merely economic opportunism in the guise of professionalism?? Why doesn’t the ethics discussion consider this? Kudos to you for creating this small scale experiment and publishing 👍 …i do however wonder if you considered other explanations for subjects choosing the higher cost option. Eg, premium tech might have been chosen because of actual but subtle aural benefits however it might also have been chosen because of preconceived but unjustified perception of “quality linked with price”, or because of a “fear of missing out” on suggested tech benefits even when no aural benefits were apparent.