Why Real Ear Measurement Matters

Why Real Ear Measurement Matters

After dropping a substantial amount on a pair of hearing aids, you might think that the price would be enough to guarantee you the best hearing possible. This is sadly, not the case. A professional fitting of the hearing aids by an audiologist is also critical, and there is no better way to fit them than through a process called Real Ear Measurement.

All manufacturers of hearing aids have their software for the installation of their digitally programmable hearing aids. The software uses a standard fit protocol to determine the target response of hearing aids for each person's hearing loss, using a "best fit" approach.

Some recent studies have shown that the "best fit" programming target formula of most manufacturers today is less accurate than hearing aid wearers would like. The hearing aid manufacturers themselves are not at fault for this - it is too much to ask for a 'best-fit' approach to account for the endless configurations of hearing loss. Put simply; one size can never truly fit all.

That's why we fans of the Real-ear measurement approach to fitting hearing aids.

What is Real-ear measurement?

Real-ear measurement (REM), also referred to as live speech mapping, is the gold standard to assess whether or not a hearing aid patient receives the exact amplification level required at each sound frequency to achieve the best possible improvement in hearing.

How does it work?

  1. The audiologist will first examine the ear with an otoscope to ensure that there is no wax or other substance that would interfere with the examination.
  2. A probe-microphone is placed inside the ear canal until it is a quarter-inch away from the eardrum. Then, the hearing aid is put in place.
  3. Sounds are then played. These sounds are picked up by the hearing aid and processed.
  4. The processed sound is picked up by the probe microphone and analyzed using real-ear measurement software.
  5. Through this, we can see how well your hearing aids are currently doing by comparing it to what your prescription for hearing aids should be.

Is REM really that important?

In a nutshell, yes, it is!

A recent study by Washington University in St. Louis concluded that four out of five patients preferred the performance of hearing aids fitted using Real-ear measurements instead of factory default settings. The REM fittings gave them an average of 15 percent improved word recognition, as well as a significant improvement when listening in background noise.

We can think of two reasons why REM fittings improve hearing aid satisfaction rates:

More scientific: A common way for the audiologist to adjust settings is to fit hearing aids, then ask the user if that sounds better. This process is very subjective and is not always accurate. A real-ear measurement, however, produces the real-ear output of the hearing aid for the user. This lets the audiologist make more precise changes, which can have a significant effect on the performance of your hearing aid, ensuring that it is precisely designed for your hearing loss.

Adjusted for your precise measurements: Manufacturers of hearing aids develop a hearing aid and determine how to design it based on a standard size and shaped ear. In contrast, Real-ear measurements let us apply the fitting of the hearing aid to your particular ear shape and size. Using real-ear measurements, we can assess how your ear anatomy affects the hearing aid's strength and frequency response and change hearing aid settings based on that response. The effects are hearing aid settings ideally suited for your ear size and shape and hearing loss.

How widespread is the use of Real Ear Measurement?

REMs are recognized by industry experts as the gold standard when it comes to hearing aid measurement. However, a report published in the Hearing Review reports that only about a third of hearing practitioners regularly fit patients using REM equipment.

This is true even though more than half of all hearing professionals already have the equipment to administer the test. This suggests that two-thirds of those who dispense hearing aids are unable to perform REM for their patients, meaning as many as 60 percent of all hearing aid wearers are currently using devices that aren't optimally fit.

Hearing professionals who don't use REM might complain about the price of the equipment and the time of the procedure. We, however, believe that the time and expense are worth it if the hearing aid patient leaves fully satisfied. Also, the time spent doing REM is much less than the amount of time spent on follow-up visits to troubleshoot problems.

As part of our commitment to serving our patients with the best audiological treatment, we are proud to be one of the few hearing practices to perform Real-ear measurements. Whether you choose us or any other practice for your hearing aid services, we urge you not to settle for anything less.

Written by
Reviewed by
Dr. David DeKriek
Audiologist & Founder
Read full bio

David DeKriek, Au.D. has been helping the hearing impaired of Los Angeles County to hear better for more than 20 years. Dr. Dekriek gained experience in a wide range of medical environments before opening Fidelity Hearing Center.

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