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Yes, Real-Ear Measures Matter to Your Patients

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1.  The use of real-ear measures:
  1. Is no longer necessary with the advanced technology available today.
  2. Is a goal unto itself; once completed, the patient will be completely satisfied.
  3. Is a method employed to achieve the appropriate amount of gain and output for any type of amplification to ensure the patient/consumer’s hearing loss is adequately treated.
  4. Is something every audiologist ascribes to in every instance when amplification is prescribed.
2.  PSAPs, Direct to Consumer (DTC) devices, Over the Counter (OTC) devices and other such amplification:
  1. Can be used by some consumers to successfully help them hear when real-ear measures are implemented to ensure the best possible gain and output setting.
  2. Will likely be a passing fad.
  3. Should never be used as none of them are any good.
  4. Cannot be tested with real-ear measures because many cannot be traditionally programmed.
3.  In our practice, when making real-ear measurements with traditional hearing aids previously fit by an audiologist when no verification measures were used, we find that:
  1. The patient is wildly successful and needs no adjustments to the device programming.
  2. The programming the patient has been using is close to the prescriptive target for 65, 50, and 80dB SPL gain.
  3. The MPO is set too high and power receivers (for RICs) are generally used.
  4. Gain approximates 2-5dB across tested frequencies, MPO is set too low (it was never measured) and the wrong receiver and dome (for RICs) is typically used, barring the ability to reach target gain and control MPO.
4.  Performing real-ear measures for all types of amplification:
  1. Is a technique that should be used only when the patient/consumer complains about how the device sounds to them.
  2. Helps the patient learn the benefit of adequate hearing from the start and gets their brain used to amplified sound more efficiently – it also helps them see how professional intervention helps the “widget” work better.
  3. Is only something learned by students during their training at the university.
  4. Is excessively time-consuming and completely unnecessary.
5.  When making real-ear measurements with PSAPs and OTC devices:
  1. One only needs to measure gain at a single input level.
  2. The first fit is usually close to the prescriptive target for 65, 50, and 80dBSPL gain.
  3. The fitting usually over amplifies gain in the low-to-mid frequencies and often exceeds MPO.
  4. The amount of time needed to set the devices is typically 32 minutes.

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