Real Ear Measurement vs. Auto Hearing Aid Programming
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- Опубликовано: 30 окт 2018
- Real Ear Measurement vs. Auto Hearing Aid Programming. Dr. Cliff Olson, Audiologist and founder of Applied Hearing Solutions in Anthem Arizona, shows the difference between a customized hearing aid fitting using Real Ear Measurement versus a hearing aid fitting using the manufacturer's first fit settings (auto-programming).
REM Video: • The Most Important HEA...
Website: www.DrCliffAuD.com
Clinic Website: www.AppliedHearingAZ.com
Today's hearing aids have the capability of being Auto-Programmed otherwise known as the Manufacturers First-Fit settings. The problem is, these settings are not verifiable because you can only verify a validated hearing aid prescription like NAL or DSL.
What is a prescription? Different hearing losses require different levels of amplification at different frequency ranges. There are a variety of factors that impact this, including severity of hearing loss, age, gender, experience with amplification.
Based on years of research, we know that using Real Ear Measurement provides a superior fitting than the settings provided by the Auto-Program button. This was once again confirmed by a study at Washington University: ii. www.hearingreview.com/2018/09/...
There are several types of validated prescriptive methods.
1. NAL-R - Used for Linear Hearing Aid Programming
2. NAL-NL1 - Used for Non-Linear Hearing Aid Programming for Adults
3. Nal-NL2 - Updated version for Non-Linear Hearing Aid Programming for Adults
4. DSL - Prescriptive method for children which is now on its 5th version
Ensuring that one of these prescriptions are used and verified inside of hearing aids is critical for performance. These are verified by using a microphone probe tube inserted into the ear canal along with hearing aids to check the amount of amplification coming out of the hearing aid. The problem is, most hearing care professionals do not verify that the prescriptive targets are being met.
Hearing Aid Manufacturers aren't stupid. They know providers don't verify fittings. This is why they under-prescribe amplification, particularly in the high frequencies. This creates a situation where patients have improved perceived sound quality but sacrificing speech clarity.
Every time I check to see how close the manufacturer's First-Fit Auto-Settings come to the prescription, they are never close. Example after example in this video clearly indicate poor prescriptive estimates. Even though many people feel that hearing aids can auto-calibrate to a hearing loss, this theory is constantly disproven by verification.
Hopefully you now understand why verifying hearing aid programming using Real Ear Measurement is so critical to success with hearing aids. Do not settle for hearing aid fittings that rely on the Auto-Program settings using Manufacturer's First-Fit. This is ultimately setting you up for a sub-par fitting.
Finally got a hearing evaluation with real ear measurements: what a difference. Wish Imhad done this years ago. I was evaluated by Dr. Cristina Vallejo, audiologist here in Houston. I learned of her office by using your search recommendation for Best Hearing Practices. So, I did nit need to buy new hearing aides, can keep my Oticon Opn 1, which is now up to date. Very pleased. Bravo to you❤❤❤
Neil
As a provider, my patient satisfaction has sky rocketed since fitting the REM. I feel more confident in my practice as well. It’s absolutely crucial to good practice.
I’m an Audilogist and agree with you totally. I have verified more than 1000 hearing aids in my clinic , I use REM lately that make my fitting different .thank you for good information !
I just just walked out of a Costco blowing the mind of the attendant with the questions I had. She told me no one has ever asked these questions before. She was shocked.
I asked her if I would get all of the results and the printouts produced from their testing. Her answer, “I can’t see why not”. We’ve never been asked for that before.
Why would you not demand the most accurate “profile” to match your auditory needs?
After watching this video, I need to go back and ask more questions.
You sir are a gift to this with this impediment/handicap.
Please keep up the good work!! I only wish you were in Toronto Canada.
Thanks Noel. Best of luck on your journey to better hearing. I have a feeling you will do great.
Thank you for this video. I just had my fitting for my new ReSound hearing aids from the VA and they showed me the value of them doing REM. My VA is actually doing Best Practices. I was impressed.
Never stop your amazing work. We need to talk with our colleagues about this until 100% of them have joined the verification club.
Definitely keep talking about this! Im a provider and other providers in my company have been begging for REM but due to the cost they wont pay for the equipment. The providers who actually care for patients want this. The others are not much more than salesmen.
Dr. Cliff, AuD., At my last fitting for Phonak Audeo B90 312 I asked my Audi if they could do a REM. I never knew it existed until I got hold of your video training RUclips series. Keep 'em coming! Anyway we did the REM and I witnessed the first fit didn't match the Rx and then watched to see my Audi make the adjustments to more closely match the Rx. The match fell away from the curve as the frequency went up over 8k and higher. Schweet! Thanks Doc!!
Love it!
I agree! Thanks for all the effort you put in to giving us details about, and pros and cons about so many hearing aid options!
great video! i used REM in Poland. In my country REM is not popular but i watch that so clever and smart. my pacjent’s are so happy when i used REM in first settings hearing aids. ( sorry my English...)
I have gone thru many of your videos. I think you are singularly contributing a lot on RUclips about ideal parameters for a really a good HA experience by users.
Thank you so much for sharing your knowledge with all of us. I have bilateral nerve damage hearing loss your vids help me through the process and help me understand. For this I am very grateful I appreciate you
Your videos are so informative to the consumer. This information from your videos is so valuable to have!
Thank you so much for this & your other videos. I have been wearing aids for nearly 20 years & have moved from Phonak cics to micro powers & currently bte super borderline ultra powers. For each set I have always expressed my frustration of no proper post fit testing capabilities - the only option was for me to try & describe what I thought was wrong. I work in tech & have always found this so frustrating. In the early days I even bought by own word recognition software to have some way of having repeatable testing. Not once have I been offered a REM option. I am currently trying a pair of Phonak M7-SP - I have profound loss at the highest frequency end & am currently at the stage of either know high frequency beeps of frequency shift which is currently causing sshh sound for s. With the help of your videos I will now push for REM or find another audiologist who will provide it. Once again many many thanks.
With my first pair of hearing aids, they helped a lot, but I knew they weren't like glasses, so for things I couldn't hear, I thought, "well, there will always be things I'm missing and it is what it is". Now that I know about this and believe my new audiologist does this, I feel excited to get my next pair of HAs because it might help me hear more! (Can't afford them right now though.)
This is gold! Thank you very much!!
Thank you so much for having a RUclips Channel. I live in Germany and I am testing hearing aids. Thanks to your videos, I am a much better informed patient. 😊
And yes, in my personal experience, real ear measurement is much better
Great information. Thanks. That's disappointing that so many people don't have their prescription verified and that manufacturers intentionally lower the high frequencies from ideal to help to ensure fewer returns.
Awesome! Thanks!
Thank you for this info. I’m about to have a fitting today and now I know what I want and need, Thanks so much.
You're welcome Judy!
Doctor Cliff, AuD I need to let you know that my Audiologists was quite impressed with my knowledge by asking heaps of questions. I told him about you. I’m please to report he seems well informed which put my mind at ease. Thank you for all your fabulous info, much appreciated.
Thanks for getting the word out
I have Beltone hearing aids and they used the same excuse for not REM that you spoke of in your video.If I don’t get better service I will return my aids.Keep the info. coming.
Thanks
I have come to the place where I need hearing aids. After watching your previous video on REM I decided that was a requirement for me. I called all the local audiologists and found only one 30 miles away that preformed REM. I had my fitting two days ago and the chart on the screen didn’t look like the one you show. Hopefully they did it right. I have been keeping them turned down because they seen too loud on high frequencies. It may just be part of the adjustment process. Anyway, thank you for making me an informed consumer.
There are a variety of verification equipment manufacturers. I like Otometrics because it allows me to precisely fit at all frequencies.
Thanks for this informative video. My audio provider does not do REM and for that (and other reasons), I will be looking elsewhere for my next hearing aid (or perhaps to better adjust the ones I currently own).
Hi Dr. Cliff, I just received Phonak Audeo Marvel M-70 aids, in part because of your great review. I asked the audiologist about REM, which they had right on the counter, and she said they prefer to wait till 2-3 months after initial fitting to give the user time to adjust to the new aids. I have medium speakers and believe they are at about 90% of recommended volume. So far (1 day) they sound pretty good, way better than the Rexton and Resounds I have tried over the last 6 months via Costco, which were returned. Costco used REM on both types, but they were both too harsh and didn't work well enough for me after numerous adjustments. I have a return appt. on the Phonak's in one month then another in 3 months to do the REM, yet have a 45 day trial period. Based on your informative video, I'm thinking I should go back and have the REM done right away.. Your thoughts please? Thanks!
Did you ever get REM done? How did it go?
Spec Savers in the UK told me when fitting my Phonak P90's that Phonak recommend the first fit as the best way to program hearing aids! I've had to complain and insist on getting REM done... I'd not I'm going to ask for a refund. Great Info Dr C
Of course they said that. Much easier for them not to. Apparently ethics are not high on their priority list.
Amazing Video! I’m in the UK and struggling to fine audiologists offering REM... wish could see you. Keep shouting about it, things needs to change.
William Lawler, What region of the UK are you from?
Thanks Doc was considering audicus clara but since they are not a brick and mortar it would only be first fit programming. I have check my other option from Costo which does incorporate REm with the final in house fitment. I came this close to maybe making a regrettable mistake if not for your video.
Should REM be performed again after hearing aids are sent in for repair?
Hello Dr. Cliff, I bought pair of starkey muse IQ i2400 R which is wonderful, but although it's the most premium pairs I got but I still not comfortable with the fitting yet.
We can't perform these validation tests here in Egypt. So the question is from where can we ask about these validation devices to sell them to our audiologists here in Egypt so we can get these validation tests?
Where have you been all my life? Lol. Seriously I have worked with many audiologists over the years but have learned more from your videos in the past 3 months than in the past decades. I now sit in an office of an audiology clinic as a much more informed consumer. Thank you, thank you. Thank you. I am looking to get a new hearing aid now and am demoing one but it is clear that the HIS does not understand what I am talking about with REM. When is your clinic reopening?
Hey Patricia. People like you are why I spend all of my free time creating informational video content. We have been open for a while. Just taking extra precaution with Covid.
I am new to hearing aids. I did a trial with Starkey AI 2400s and they were fitted using the REM. I purchased the Starkey 2400s without the AI. However a new REM was not done to the new aids that I purchased.Since its basically the same software without the extra sensors am I good ? They sound pretty good to me. But like I said this is my first set and I am still getting used to all the new sounds.
I hope I can talk my hearing aid peddler to perform REM. They said they would when I first when in. Now that I have my hearing aids, he says "real ear measures are only to measure how well the devices are working". Fitting appointment included no adjustments at all.
Can you use REM in CIC's?
Roughly what proportion of REM output adjustments, especially at higher frequencies important for speech intelligibility, are to increase gain to match target as opposed to lowering gain?
A couple of things:
First, thanks for providing this information. I'm not tired at all about you talking REM's until you are blue in the face. You should be proud of the fact that this information and process needs to be best practices in your
industry. This is your military training coming through :)
What do your colleagues say when you tell them you insist on doing REM's for a proper fitting? Do you get a
lot of eye rolls?
Is there an industry association for clinicians like you (I'm sure there is), and if so, why isn't REM a standard of care via their recommendations and educational influence?
These auto-program algorithms are also something that the manufacturers use as a selling point to clinicians like you. "See, you don't have to take the time or have the equipment to do REMs. Just hit this button on the
software".
I have my first appointment with an audiologist that is supposed to be experienced in tinnitus management. If she recommends hearing aids as the first step, but does not offer REM's, I will have to find another provider.
Thanks for educating the consumer. Your efforts will not go unnoticed.
ATB,
Michael
I realized that it is worthless to try and encourage hearing care professionals to do REM. They don''t listen. That is why I make the videos to educate consumers to demand them. If the provider doesn't step up their game and offer them, then they will eventually go out of business.
The industry influence from the manufacturers works both ways. They want providers to do REMs, but also want to sell hearing aids. This requires them to create first-fit algorithms that patients will tolerate if a provider doesn't do REMs.
Obviously, I personally believe that REMs is a necessity, but even the new standards organization won't list REMs as the standard. They will probably require some sort of verification, but it won't be REMs because standards don't necessarily equal Best Practices.
@@DrCliffAuD Thanks for the information. You would think there would be an opportunity here for the REM equipment manufacturers with the results of this study. If I was running one of those companies, I'd hit the ground hard trying to convince your colleagues that REM's are a requirement for a clinically proficient hearing professional.
@@DrCliffAuD I'm also grateful for the information I've found on your channel. I was beginning to feel crazy bc even after getting more powerful receivers & having my hearing aides adjusted I was still struggling to understand & lipreading everything & felt like I must be crazy bc my AuD said my hearing aids should be giving me what I need. After research & realizing that I've never had real ear measures done, I went to get a 2nd opinion from an AuD who does REM. We figured out that my hearing aides are only amplifying the certain frequencies, which is why things are louder but I'm still not understanding things! The new AuD also told me several new things that I'd never known about my hearing loss, even though I'm 26 now & have had it since birth. Thank you for educating us so that we can better understand how to advocate for our own needs!
Hello Micheal, if you don’t mind me asking how did it go with the tinnitus management? Did it help you?
Does the VA use real ear measures?
Great video. I've personally experienced the difference that REM can make vs. first fit and definitely agree that all HA fittings should include REM. Thanks for being an advocate and champion for this, Cliff!
Thanks Chris!
What is the difference between Oticon’s new Auto REM software and a Natus REM ??
DR. CLiff Olson audiologist i head all this don still no hearing aids ireland
Just doing a 'real ear measurement' (correctly) is only part of the issue. Next is making the necessary adjustments to correct the difference between Mfg estimated curve and "actual" real ear measurement. My current Resound GN (Costco) are just not quite adjusted right. Speech recognition is my main problem, and compression gain seems to be off. I use closed ear cups. 45 to 50 db down both sides, not quite the same L and R.
Some questions; In doing all these adjustments should the MAX gain and MIN gain be adjusted after all other adjustments are done? 2; When an incoming sound exceeds max gain setting, how does the HA reduce the sound? By "limiting, or clipping" ?? And then is feedback resetting. Should all HA centers have Nal-NL2 , and use it??
In the absence of REM at almost all providers in India, is Audiogram Direct closer enough to REM compared to Auto Fit algorithms?
Hey doctor cliff I have a cwick question How do you stream music with a hearing aid that doesn't have any bluetooth because I have a hearing aid that doesn't have bluetooth
Unfortunately, in my region (in Kazakhstan) we have only one REM-apparatus and it is currently in repair. Nobody knows, when it will be available.
If I find an audiologist or ENT who can perform a REM, will s/he be able to do this regardless of the HA make and model? I'm asking this because I might prefer one HA over another but the audiologist who happens to be the 'agent' of my preferred HA does not do REM but perhaps another audiologist (who represents a different HA make) is prepared to do REMs. Is this possible?
Would the bottom line be if my audiologist cannot do REM find another audiologist that can?
Do REMs have to be performed again after installing different shape/sized domes/moulds on RIC aids? Or would the gain levels still be the same for more occluded domes as they would for vented domes?
You definitely should at first, but you can also do a real ear to coupler measurement that applies the coupler changes to the software after changing the pieces apparently
brilliant. i'm asking all potential audiologists if they do Real Ear Measurement
Good call.
Hi Dr. Cliff,
I was wondering in your experiences, is it possible that patients prefer the sound of first fit because the gain of high frequency is less ?
Because many of my patients feel that the sound is unnatural when they first time wear the hearing aid and they say sounds very "microphone"
But after dropping the gain of high frequency they feel more acceptable with the sound.
Thank you very much ！
Of course. Everyone with a HF loss is used to the sound of NOT having high frequency hearing. It is our job to help them progress to the point where they can tolerate and eventually prefer the HF amplification. After all, this is where the return of clarity will come from. This process is progressive, and we should counsel our patients accordingly. It is no excuse to let our patients be chronically underfit in the HFs forever. Build them up to the prescriptive target gradually. They will thank you in the future.
Do you know any place that does real ear measurement in Pensacola fla
Great thanks. Should I receive real ear measures at the first fitting during a test?
Real Ear Measures can be done at different appointments. I prefer to do them at the very first fitting appointment when I actually fit my patients with a hearing aid.
Enthused by your videos, I asked my audiologist to apply REM (which was available ) to the very recent
fitting of Phonak Audeo Marvel M90 RIC aids which he had strongly recommended. He stated, categorically, that REM 'CAN NOT' be used with this product and that if I wanted REM, I would have to switch to another make, say Siemens. Is he correct?
Please advise.
E. Giblin
No, he is not correct. In fact, the Audeo Marvel programming software even has the capability to do Automatic REMs with the Otometrics Probe Microphone Measurement system. There isn't a single hearing aid in existence that you "CAN NOT" use REMs on. NOT A SINGLE ONE. I suggest you call his bluff and switch to a different brand to see if he ever performs REMs. Either your provider is Lying to you, or they don't know what they are talking about. Both reasons are enough to warrant finding a different provider.
How are you doing the hearing test?
Do you take the UCL ? Or only the hearing threshold?
UCL and MCLs included.
Dr. Cliff, can REM be done on virto b titanium intra canal? I have been told that it cannot be performed on IIC.
I perform them on IICs all the time.
What is the difference between Real Ear Measurement and an Audiometric Test? The audiologists in your provider list in my area don't have REM tests listed. Thought REM test was the gold standard? Thanks
Can a real ear measurement be completed in an audio box and not done while in the ear of the wearer. This is what my audiologist informed me today in a follow up appointment
THANKS for this video! Is there a listing of which audiologists offer REM? Telephoning them all is pretty tedious, and it is likely that the receptionists won't have a clue what you're talking about. Thanks! - Johnny
Hi John, I am starting a network of providers in October who will provide REMs. Until then, go to HearingTracker.com and use the provider search while filtering for REMs.
Just completed my second day wearing Resound LinX Quattro 61 9 with tulip domes. Great clarity and reliable bluetooth integrations but awful clashes with impact noises in kitchen had to turn them down to half way. The sound of your good self on video and people speaking on any TV program sounds way too harsh/sharp...as if emitted from a very cheap 1970s radio! I conclude there must be a need for a REM sesson with the audiologist though when i mentioned the idea to her (even before trying new hearing aids) I forget her exact opinion but it was ultimately a little on the wary side if i remember correctly...I'm hesitant to ask her again. But shall do. I've already placed my $1000 deposit and will lose some of that should I opt out and go for another brand. Previously a Moxi, then Phonak user and happy with both, natural sounds, nothing like the 'sound as if i'm in a bathroom' thing, having to get used to with the tulip domes and Resound, rechargeable, bluetooth etc. One more thing, am feeling tied to my App and phone to make adjustments, as many are needed in different situations at the moment. It's early days, am hoping all will be resolved.
Hi Alif, I tried the earlier Resound model 2-3 years ago and it was programmed including REMs by a very competent Audiologist, however I returned them due to excessive background noise eg traffic and tap water. I also still experienced some speech clarity issues but I did seem to hear quite well in noisy restaurants!
@@timsmith5980 thanks, helpful info. To share, I ended up opting for Oticon. Managed to secure an REM session (usually reserved for children), which was great...it 'showed' where frequencies needed tweaking, and made a great improvement. It is always a challenge to try to convey what i am hearing and what i want to hear in terms of tone and clarity. Regardless, over the year i ended up experiencing everything you have described. Am now looking at Phonak again. the Audiologist here (very competent) recommended stick to one brand because the differences in brand-circuitry can possibly be detrimental. My past experience with Phonak is great - clear, natural, warm - no issues. I'm told Phonak bluetooth is reliable also. Awaiting delivery and trial.
Alif Onatree Thanks for your reply! When I tried the Phonak Marvel last year I found that the. bluetooth was unreliable! The Oticon bluetooth has been very good, the only slight quirk is that very occasionally the Bluetooth will stutter but reconnecting fixes it! It is my belief that most Audi’s prefer a particular brand. Oticon gives a good music sound while streaming but I have yet to have any aid that gives me truly natural sound! What I really want is good speech discrimination but probably my residual HF Hearing is so low that no hearing aid will ever give me this so I will always mishear a number of words! Good luck with your quest! My Phonak Auto Sps were adjusted using Medrx REMs and they still do not give truly natural sound!
Hi Dr. Cliff. I was wondering if you could assist me in the issue of loud noises being too loud. Say you've adjusted the amplification to meet target through REM, and a patient on a follow up visit is complaining about loud noises; what is your method of dealing with this issue?
I've heard things like simply lowering the overall amplification, lowering the high frequencies, but I would like to know you take on this. Maybe finding the true LDL and adjusting MPO to these values? Or is there some magic tricks with REM and MPO settings?
Thanks!
Hi baclash. You need to have frequency specific UCLs completed and use this data to restrict the MPO at those particular frequencies. MPO can also be measured with REM to ensure that it is contained.
@@DrCliffAuD Thanks for your reply! Do you follow a certain method to obtain the UCLs, like the "Cox Contour test"? I've found when using simple instructions and no scale of sort, the UCLs tend to be unrealistically low. And then setting the MPO to these values, I fear it will do no good.
I'm a long time hearing aids user. I was recently fitted with Phonak Virtro 90 hearing aids. They seem very good. My Audi. used the REM to set them up. I've used Starkey hearing aids for years. Recently tried the Oticon's which seemed ok. The two prior aids seemed ok too. These Phonaks feel good and the sounds they produce are very good. However, a new version of the Resound Lynx Quatro in the ear version was mentioned. Any thoughts on trying this first gen Resounds vs. my current Phonaks? Thanks
Might be worth a shot if you want connectivity with a Google Pixel phone. Otherwise, I'm not a big fan of Resound ITEs.
@@DrCliffAuD thank you very much. And thank you for what you do for those of us with hearing issues.
I reside in Sydney Australia and I have tried to find someone who may do R.E.M. Without success.
Dr are you able to recommend someone as I do believe R.E.M. Will make a difference and establish the correct prescription values to my hearing devices.
Thank you. Joe
Joe, I'm about to get first fit from a SpecSavers audiologist, who WILL be doing REM's. After having a trial hearing aid with a different so-called professional who never mentioned REM's, I was super impressed with the expertise and prices at SS.
Hey Dr. Cliff! What’s a good online resource to learn about all the latest hearing aid technology and current research going on in the field of hearing healthcare?
Hi Ryan. I really like HearingHealthMatters.org, The Hearing Journal (journals.lww.com/thehearingjournal/pages/default.aspx), HearingReview.com, and HearingTracker.com
Thanks! I will check those out
If the customer feels the sound is too loud/sharp/harsh when programmed to the real ear measurement, do you lower the volume or inform the patient that they simply 'need to get use to the amplification level?'
Yes, the goal of the initial fitting REM is to identify if targets can be met and how cleanly. 90% of the time gain is reduced to some level of comfort. In the following 2-3 visits, the gain is restored gradually until full target is met by the end of the fitting period. Easy Peasy Lemon Squeezy
As a disabled Veteran I will be examined for possible hearing aids by the VA. If they do not use Best Practices during this process, can any provided hearing aid be programmed by a different Audiologist willing to use Best Practices.
Why do audiologists NOT do rear ear measurement? Is it time consuming or is the equipment expensive?
please make a review of the new Starkey Livio AI, i try this hearing aids for few days and there were amazing!!
I'm in the middle of my review now.
@@DrCliffAuD Great!!
I have the same question asked by Brad Wood. Also, I purchased Oticon OPN1 aids, which I can tell are great compared to what I tried before, but my provider only does first fit (budget was a factor). My loss is cookie bite and I’m highly annoyed by amplified higher frequencies. If I were to pay another provider for real ear measurements, what would be a reasonable fee range? Thanks for what you do, and for your response.
Thanks CATalley. It's hard to determine what another clinics fee ranges are. I would suspect anywhere between $200-$500 depending on how much time they spend and how detailed they are with the measurements.
Your reply was much appreciated. Since I had no idea what might be reasonable, it helped me confirm my suspicion that the fee of $1,000 from one clinic was out of line. I did get REM and programming with another provider who spent lots of time with me, within the price range you estimated. @@DrCliffAuD
Hello Doctor Cliff, I've been testing the Oticon OPN 3 and I want the best hearing quality possible. One of my options are the brand Resound, I'm not sure which one but I'm sure it's a newer model. Can you better explain to me from you're personal experience which is better? Or if you have another brand that you think is best. Alsooooo is it really that much of a difference, I'm aware each brand has a unique signature sound. Pleaseeeeeeeeeeee answer bro
If you want the best hearing quality possible you need to either go to an OPN 1 or Resound LiNX Quattro 9. The Quattro is popular because it is new, but the OPN has been the most popular hearing aid over the past 2+ years. I am a fan of both, but if you want rechargeable go with the ReSound Quattro.
@@DrCliffAuD so OPN 3, is the entry level and OPN 1 is the premium? Thanks so much brotha maynee!
No Problem A1 Z. Glad to help!
Wow, this is very informative.
However i check with my hearing consultant, she told it not a standard practice in my country.
She told me for my fitting - they use algorithm software to determine my hearing loss.
Sad.
I feel sorry for you. REM makes a huge difference.
@@DrCliffAuD Hi Dr Cliff, May I check whether Real Ear Measurement equipment consists of a machine (Is it big) and expensive?
Just got my Widex 440. My Dr. audiologist said they weren’t allowed to do REM from the the college of audiology here in Canada because of COVID. She testes my aids in a machine that looks like a food sealer and then did an ear by ear hearing test in the office.
What should I do, look for someone else?
You could look elsewhere or you could wait until the Covid pandemic is over and go back.
I teach band and just got hearing aids. The hearing aids aren't anplifying true to pitch and everything sounds out of tune. Can this be fixed.
Yes, but it will likely take a number of visits to your hearing care provider for modification. Hopefully you have a Widex or ReSound hearing aid.
Never "sick" of hearing importance of reality.
Hi Dr Cliff, After watching your brilliant video and doing other research I have been seeking fitting with REM. I have been told that REM can't be used on a custom fit IIC as the probe tube is crushed. Is this true? Thanks
Hi Mandy. That is false. The only device I have not been able to use REM with is the Lyric extended wear IIC.
@@DrCliffAuD Thank you xx
how can I find an audiologist that uses rem? They dont list it in the websites and I would just be going over and over asking until I firnd one?
Where do you live?
My audiologist says that the Phonak Marvel 90 does not need REM?
Your Audiologist is either uninformed or lying to you. Neither reason is acceptable.
In India they generally don't do REM. I am using g HA since 1988. Started with analog HA those days then to Digital with different Audiologists. My last was Phonak Naida 5s. They never did REM. Here they suggest some brand or model assuring you that it would give best quality hearing experience. But they just adjust it to a workable label just you are able to hear to some extent. Even after spending a heavy amount your right to quality hearing is not met. Most of the time they set a costly and feature rich HA which gives you hearing experience of cheap chinese amplifiers, just increasing amplification not the quality. Here most of the Audiologist behave like a sales person only to sell any HA to you for a profit and only a few take pain and spend some time in setting the HA to the optimum quality. Most audi turn a good HA to as good as a cheap HA.
It is very difficult to find a good audiologist in Delhi out of so many here and there. Very frustrated on their attitude to wards the consumer. They think that they are making a great favour to us by making us just able to hear (Not quality wise).
Absolutely no audiologist in my area conducts REM's. I have called all of the audiologists in my area and none of them do REM's so I am stuck.
If it was me. I would hop on a plane to the closest audiologist who performs REMs.
As a hearing instrument specialist it unnerves me to hear of other specialists NOT using REM/LSM. Verify, verify, verify. I don't care how long you've been in this profession. REM always sounds better.
Totally agree Tina!
If I ask my provider to perform a Real Ear Measurement how can I know he/she has done so?
Sounds like I need to make a video about it. Until then, watch all of my other REM videos. I have one that is called How I do REMs.
Hello. Im a hearing instrument specialist and i mostly fit Oticon hearing aids. My company does not provide us REM and many of us are fighting for it. Do you have any tips for best programming until we get some? Many people dont have programming knowledge and id like to share something that shows them some simple ways to improve programming skills. Thank you
Unfortunately, there is no programming advice that I could provide that would remotely make up for not performing REMs. My only recommendation would be to find another employer who values patient performance more than they value their own profit.
Why wouldn't an audiologist use real ear measurements? It is it because it involve expensive equipment to do which they haven't invested in or does it take too much time and they can't be bothered? Also what year was real ear measurement introduced? I don't recall having real ear measurements when I bought my last pair in 2014
Yes, cost and laziness are two big reasons why providers do not use REMs. It has been around for decades.
My Audi wont do a REM because he says the Opticon s doesn't this automatically. Oh brother
With Oticon Opn S depending on the audiometer, you can perform AutoRems