How to get reasonable fit without in-situ or REM?

Hearing Aids
#1

Is it reasonable for a hearing aid specialist or audiologist to reasonably adjust new hearing aids without in-situ or REM? Assume that an audiogram is available.

Neither were used: This is what I experienced with Jabra Enhance Select 300 with Premium (OTC) when working with a specialist over Zoom (they have live adjusting that they do during meeting) and I was told that HA were setup based on audiogram. I did use Jabra online hearing test wo HA b4 purchasing product also.

I am confident my 300’s were set quite low compared to audiogram (even after adjustment period with full adjustment in place), especially in the 3000 plus Hz., while using https://hearingtest.online/ based on flat output adjusted speakers (duplicated results with headphones), matching audiogram results and then testing Jabra 300.

The adjustability with the 300’s was quite limited so I could only slightly improve the results.

I should not have been sold any OTC product (based on my medium/ high losses found by audiogram) unless spending $1500+ is not affordable. Jabra 300 will be returned, and I have prescription HA on order that will be setup starting with REM. (Costco)

I am just curious how a good setup by Jabra could be possible wihout some kind of measurement with hearing aids in ears.

#2

I reckon it’d be possible, but it would take a lot of trial and error. You’d have to be constantly calling them and explaining what you don’t like, and hoping that they guess the right settings eventually. In my opinion it just sounds like a lot more hassle, for not much benefit.

Best of luck with the Costco HAs :slight_smile:

#3

It all depends on what you mean by reasonable fit. If you mean something that sounds comfortable, then yes. If you mean to ensure maximum effectiveness by reasonably meeting your prescribed gain targets, then no. It’s not possible to know with any degree of confidence whether your hearing aids are meeting your prescribed targets without REM. Any other method of calibrating is just shooting in the dark.

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#4

How does in-situ attempt to do this or is it just a better guess than the audiogram alone?

#5

A better guess is exactly what it is.

#6

My Audiologist didn’t use REM, and he did a great job. He didn’t explain why, but he had previously witnessed what caused my hearing loss.

Peter

#7

Since each person’s ears are different and the range of db in the ear will be different, I feel that adding an extra step, over just using an audiogram, with in-situ will improve the fit. I am sold on REM at this point and do not expect this to change.

I also was surprised how close the results wo HA from hearingtest.online was to the audiogram. Then after running the test with HA, I had a REM scheduled to see how close my test was to the REM. I was going to give this information to Jabra specialists in hope that they could then make the adjustment closer. They would not be adjusting live while REM was being done. From there I had planned to do my test again and make my own adjustments in HOPE of improving the fit. This would have been a messy and a quite inexact approach but better than the alternative with this product.

When I found, on my own that OTC products could not fully meet my prescription I canceled the $100 REM. I expected the Costco HA to cost more than they did so it ended up being a win in the end. The Jabra Enhance Select 300 Premium were $2000 minus $500 insurance. There is no insurance benefit available out of my network.

When the prescription HA arrive and are adjusted with REM I may run the online test again but only to see how they compare. If I do minor adjusting, I could, but likely won’t, also see what affect the controls have on each Hz point.

#8

Locally, REM costs $800 to $850 if you didn’t buy the aids from the clinic. This is New Jersey.

#9

That’s insane price! Name and shame for this clinic!

#10

You can do a REM and feedback measurement in Target, and all it does is restrict the amount of gain you need in those upper frequencies, so all you hear is sound like everyone has their hand over their mouth, which is worse than my analogue aids in 2009

#11

If you are talking about a truly REM fitting, it takes special REM equipment. My audi does not do that because she did not want to shell out the additional thousands or so dollars for the equipment.

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#12

The answer is No. You need to have an audiogram to have proper fitting of the hearing aids. I have had eight clients that had feedback issues and improperly fitted aids and using their audiogram they sent to me, l programmed the aids and all of the eight clients are happy.

Watch out for many OTC aids that are hearing amplifiers and are not hearing aids. For example, NANO.

In your case an basic digital hearing aid can might help improve the mid and high tones listening.

Depending on the audiologist clinic, l can get REM for each ear for 250-300 dollars.

#13

OTC and amplifier’s are not the same thing, OTC has a standard and is regulated.

And this here is why there’s a bit of confusion.

#14

Insurance in-network rate for a single REM fitting can be less than $50, even about $25. It doesn’t take long. $800+ is excessive. Even $250-300 is a lot.