Do Modern Hearing Aids Have Built-in Real Ear Measurements?
A reader asked us recently whether modern hearing aids had built-in real ear measurement systems. I was a little fascinated by the question and I asked him for the context. Apparently, an audiologist had told them that modern hearing aids did have real ear measurements built in so they wouldn't need to do probe microphone measurements (REMs, Real Ear Measurements). Unfortunately, that's a lie, a fib, but like all good lies, it is wrapped up in some truth. Let's talk about built-in hearing aid personalisation systems in modern hearing aids and why they don't overcome the need to undertake some sort of probe tube measurement.
Personalisation Measures in Modern Hearing Aids
In recent years hearing aid manufacturers have introduced methods to personalise a hearing aid to the ear that it is in. Those methods could be construed as some sort of real ear measurements, however, they are not REMs in the traditional form, nor do they meet the goals of REMs. The two methods are:
- In-situ audiometry
- Feedback calibration/sound leakage measurement
Let's take a look at them and what they are trying to do.
In-situ audiometry is as it sounds, the hearing aids play pure-tone sounds and the professional measures the softest sounds you can hear from the hearing aid in your ear. This is an excellent tool and it has proven to successfully increase the fit efficacy of hearing aids. While it is a measure of what you can hear through the hearing aid in your ear, it does not measure the level of amplification delivered as REMs do.
Feedback Calibration/sound leakage measurements
Every manufacturer undertakes feedback calibration, while some do both feedback calibration and sound leakage measurements. They are undertaken in the same way but offer two differing outcomes. Let me explain. Widex do both, they use one measurement for both purposes. The feedback calibration part sets the feedback reduction system and reduces the amplification and headroom in areas where they may be feedback.
The sound leakage measurement tries to understand how much low-frequency sound is escaping from the ear in order that it can better set the low-frequency amplification to better meet the prescriptive targets. Again, this is a fantastic system, but it does not measure the level of amplification delivered as REMs do.
Real Ear Measurements
A Real Ear Measurement is a verification of a prescriptive target. Real Ear Measurements are designed to verify that the hearing aids in your ears are actually hitting the targets prescribed by the fitting prescriptions. When REMs are done, both the professional and you the consumer can be satisfied that your hearing aids are delivering what they should. There is no other system that meets this need, don't listen to anyone who tells you there is.
Find A Provider Who Does
It is our best advice to you, knowing what we know, after studying the studies available, and indeed through my own experience fitting hearing aids, that you need probe tube measurements as part of your hearing aid journey. It is our best advice to you, to find a hearing care provider who does offer them when you are purchasing hearing aids. Ask any provider you deal with, do they offer probe tube measurements, if they say no, tell them you will go somewhere else.
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