London, May 15
Author: Nick Lesica, Professor of Neuroengineering, Ear Institute, University College London.
Let’s start with the bad news.
According to the recent WHO World Report on Hearing1, there are approximately 500 million people worldwide with disabling hearing loss, the vast majority of whom receive no treatment. The consequences of this unmet need are dire: hearing loss is a top-5 contributor to the global burden of disability; the leading modifiable risk factor for dementia; and costs nearly 1 trillion dollars per year.
The gap between the need for hearing healthcare and its current provision, which continues to grow, is already overwhelming. In fact, it is almost impossible to imagine that it could ever be closed with the current service model, which is heavily reliant on specialized staff and equipment that will inevitably be in short supply.
But now comes the good news.
Recent advances in artificial intelligence (AI) have made it possible to imagine an entirely new model of hearing healthcare in which basic services and assistive devices are widely accessible. In this AI-led model, most people would be able to receive the treatment they need without ever needing to visit a specialized clinic.
This is not science fiction. The technology needed to develop the AI-led model is already here. Neural network software trained using deep learning routinely solves problems that are much more difficult than those involved in providing basic hearing healthcare. Prototype applications for services like middle ear screening, audiogram measurement, and device fitting have already been developed.
So what are we waiting for?
The barriers to innovation associated with the current service model and market for devices have been well documented2,3. I’m no expert on economics or policy, so I will leave further exploration of those aspects to others. But what I can say from my experience as a hearing scientist is that we are also part of the problem. Since the flurry of innovation that led to cochlear implants and digital hearing aids, there have been decades of incremental progress. Hearing has folded back on itself, with seemingly little interest in the broad collaborative efforts required to achieve transformational impact.
An AI-led revolution in hearing is not inevitable, at least not in the short-term. Unless we act aggressively, there is a real risk that we will be left behind. Many applications that are closely related to hearing, such as automatic speech recognition and natural language processing, have already been transformed by AI with no input from or impact on hearing.
Instead of waiting for AI-based innovation to come to us, we should be leading it. Given the importance of hearing to many next-generation consumer and business technologies — wearable devices, augmented reality, virtual assistants — and the huge potential for societal impact related to healthcare and accessibility, hearing should be a magnet for AI talent and resources.
And we should not underestimate the value of our own expertise for the development of AI-based applications in hearing and beyond. Artificial neural networks have come a long way, but they are still no match for the auditory system in many respects. We can help translate the magic of hearing into more robust and flexible artificial systems.
The global battle against hearing loss will not be easily won. The entire hearing community — scientists, clinicians, and patients — will need to work together with a range of different partners, from medical device, consumer electronic and tech companies to public health organizations and policymakers. Of course, all of this is much easier said than done; the challenges involved are just as great as the opportunities. But if we fail, it should not be for lack of trying.
At the upcoming Virtual Conference on Computational Audiology, we will be having several interactive sessions about opportunities and challenges related to AI in hearing. Here you can find the program highlights including Nick Lesica’s talk. We encourage anyone with an interest in the future of hearing to join the discussion. Registration is free and will soon open.
- World Health Organization. World report on hearing. (2021).
- President’s Council of Advisors on Science and Technology, (PCAST). Aging America & Hearing Loss: Imperative of Improved Hearing Technologies. (2016).
- Committee on Accessible and Affordable Hearing Health Care for Adults, Board on Health Sciences Policy, Health and Medicine Division, & National Academies of Sciences, Engineering, and Medicine. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. (National Academies Press, 2016).