Accuracy of an Automated Hearing Aid Fitting Using Real Ear Measures Embedded in a Manufacturer Fitting Software

Background  Hearing aid fitting guidelines recommend real ear measures (REM) to verify hearing aid performance. Unfortunately, approximately 70 to 80% of clinicians do not use REM, but instead download manufacturer first-fit. Studies report differences in performance between first-fit and programmed-fit with greatest differences in the higher frequencies. Recently, hearing aid and real ear analyzer (REA) manufacturers allow REA communication with hearing aid software feature to automatically program hearing aids to target. Little research is available reporting the accuracy of this feature. Purpose  The aim of the study is to examine whether differences exist at 50, 65, and 80 dB SPL between two ReSound first-fit formulae (Audiogram+ and NAL-NL2) using ReSound AutoREM and Aurical NAL-NL2 Research Design  The study design is of repeated measure type. Study Sample  The study sample includes 48 ears. Data Collection and Analysis  For the two fitting formulae, AutoREM real ear insertion gain (REIG) was measured at 50, 65, and 80 dB SPL and compared with measures from Aurical NAL-NL2. Results  Mean AutoREM REIG for ReSound NAL-NL2 was 3 to 8 dB below Aurical NAL-NL2 for 50 dB SPL, within 1 to 3 dB for 65 dB SPL and 1 to 5 dB above for 80 dB SPL. Mean AutoREM REIG for Audiogram + was 1 to 12 dB below Aurical NAL-NL2 for 50 dB SPL, within 2 to 5 dB for 65 dB SPL and 1 to 7 dB above NAL-NL2 for 80 dB SPL. Conclusion  Relative to the Aurical NAL-NL2, AutoREM REIG 50 for Audiogram + and ReSound NAL-NL2 was lower. Relative to the Aurical NAL-NL2, AutoREM REIG 65 for Audiogram + was higher at 1,000 Hz and lower at 4,000 to 6,000 Hz and for ReSound NAL-NL2 it was lower at 500 Hz and 4,000 Hz and higher at 3,000 Hz. Relative to the Aurical NAL-NL2, AutoREM REIG 80 for Audiogram + was higher at 500 to 3,000 Hz and 6,000 Hz and ReSound NAL-NL2 was higher at 500 to 6,000 Hz. Because of wide intersubject variability clinicians should continue to use REM as a check and balance when using AutoREM.