Oticon - is REM still needed?

Hi all

I just talked with my audiologist and asked for a trial with Oticon and then I asked about the REM fitting and she said Oticon has its own REM test inside the fitting software so its not necessary etc bla bla and she also said that the REM is just a big fuss.
Thoughts?

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Time for a new AuD that understands and uses best practices.

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I agree with you.
in the whole country there is only one office that does REM: Signia
Even those from Signia asked me if I do really want a REM.
I said yes and after the REM she said: you were right, left side wasn’t well calibrated.
WTF?!

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I don’t know what it is about Oticon, but my Audi told me the same thing when I was wearing Oticons,

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Based on my experience, REM is very important as there’s always a significant chance of ending up with over or under amplification here and there compared to the prescribed target.

Alternatively, you can do an in-situ audiometry and then use pure tones for a makeshift REM. That is what I do, and it’s helped me improve my setup considerably. However, I doubt your HCP would consider this route with you, as hearing aids don’t treat pure tones gently, lol.

Anyways, during my recent trial of the Phonak Lumity, I was surprised that the Phonak-owned clinic I visited did not perform REM. I’ve also undergone REM once for my Oticon More, and I wasn’t very satisfied with the results. I’m pretty sure it wasn’t done properly.

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It’s a lie to say that because the Oticon Genie 2 software has the REM Autofit feature inside already so it’s not necessary to do REM. It’s as if she’s implying that Genie 2 will “automagically” do REM for you all by itself without the HCP having to lift a finger, which is a blatant lie.

The REM Autofit feature MUST be UTILIZED by the HCP to do REM, it doesn’t just turn on and do it for you without being activated by the HCP. And the REM Autofit is only the software portion of the REM process (it reads the measured results into the Genie 2 software and Genie 2 will adjust the measured gain results to the target gain curves for you, which is the “Autofit” part. It’s compatible with a number of REM hardware brands, but the HCP still has to supply the REM hardware to hook up on your ears and use the Genie 2 REM Autofit software instead of using a third party REM software to do the adjustment to targets.

REM is not a big fuss, it’s a best practice to ensure that your hearing amplification is up to target. OK, if you’re lucky and your hearing aids set up is already up to target to begin with, then REM adjustment is not required. But if you don’t do REM measurement, how would you know if your hearing aids set up is up to target or not? So it’s verification and correction (if necessary) in one process.

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I perfectly understand you.
well, some “audiologists” think they are better than the rest of the world … unfortunately.
I don’t have any chance to get REM done l, the only way is to take a trip to some normal country :innocent:

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@Liviu - No. REM is still needed. I just bought a new Oticon XCeed 1 UP aid + CROS, and my audiologist used REM to fine tune it and get an even better fit. Beyond the hearing aid itself, it’s the best I have heard in 10 years.

I think it’s time for a new audiologist. My former audiologist (who I fired, by the way) fed me some BS line about my hearing loss not being able to understand the sounds in the REM test machine. Which turned out to not be true when my new audiologist did it. I understood it all just fine. And it helped to verify my loss and gave me better clarity as a result.

Your mileage may vary.

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no one in Romania is doin REM except one office that sells Signia…that sucks.

Not really, it’s just another tool in the toolbox they can use, no need to stress about it, doesn’t work out for everyone anyway and since your going to do a bit of DIY it’s a moot point, but your not alone, most clinics downunder aren’t offering it either! Why so many professional’s choice is not to bother is hard to understand…

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what really is bothering me is their ignorance to understand the purpose of the REM.
and also, I don’t understand why all the manufacturers out there don’t oblige them to.do REM.
The device will work better, client will be more happy.
More sellings! I guess

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I’ve been wearing hearing aids for almost 20 years and have never heard of “REM”. Someone please educate me! Thx

This is the best video out there on the topic, I think - https://youtu.be/cHR0Oa6I-wY?si=lI1x4_7uqARYdExS

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real ear measurement

there is a device that will measure the output of your device, in other words REM, subjectively will say if the device is configured correctly and also will say what modifications are needed.

It really just amazes me some of the excuses inferior audiologists are using to get out of doing real ear measurement.

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Ahhhh… Yes, I’ve had real ear measurement - I guess I never heard it referred to as REM. Duh… Thanks!

Maybe you’d be better off just buying a pair of Signia hearing aids. Their current models are very good.

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Im amazed how many similarities there are between “hearing” and “Obstructive Sleep Apnea” treatment.

Can’t trust my sleep doc. Can’t trust my dispensing audiologist for my Phonaks. He quit helping. Good thing.

There are many good people in each field. Just have to find them.

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While it’s nice to have REM to verify (scientifically by measurement) whether your hearing aids setup is on target or not, it’s not the end of the world if you don’t get to do REM to verify.

The alternative is to “verify by ear”. Of course this is the less desired alternative because it’s subjective by having your brain deciding whether you hear well enough yet, and usually it would be the longer route to get to where you’re satisfied with the hearing aids.

For example, if your hearing aids setup underperforms to target across all frequency range, and no REM is available and done, then your brain will perceive that you’re not hearing loud enough. So you complain to your audi and they increase the overall gain for you a little at a time until you’re happy. So this would be a much more crude (and time consuming) way to make the (almost) equivalent of the up-front REM adjustment. But as long as you get there eventually and are happy with your hearing aids’ performance after several visits to the audi for adjustments, in the end, you still end up achieving the same goal → you can hear better.

Of course if your hearing aids’ setup underperforms only in certain frequency ranges and not across the board, then it’d be much more complicated to try to get it right than a simple across-the-board volume increase like in the simplified example above. But the principle is still the same → you keep having your audi do (more complicated) adjustments until you’re happy.

I’m not saying this as an excuse for not having REM done when possible. I’m just saying that if REM is not possible at all, it’s still not the end of the world as long as you eventually get to the point where you are satisfied with your hearing aids’ performance. It may take several more visits and adjustments to achieve this compared to if REM is done, but as long as the audi is competent to adjust until you’re happy, then it may be a longer journey to get there, but eventually hopefully you get there.

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My HCP who actually has REM equipment but still wouldn’t do REM for me when fitting me with my OPN 1 said the following when I asked her why she didn’t do REM for me: “Well, I found for the most part that Oticon aids are usually not very much off target, so there’s no need to do REM. But if a patient seems to be struggling a lot after being fitted and comes back asking for many adjustments, then I will do REM for them because that is a sign that something is off.”

Needless to say, I’m not planning to do future business with her anymore. Also, because of this, I decided to take up the DIY route. A DIY person who buys from a local HCP can probably still get REM done for them by the HCP first (assuming that this best practice for that HCP), then just do incremental adjustments off of the REM adjusted results. This would be the ideal DIY scenario.

But a DIY person who buys from a remote source will not be able to get REM done unless they pay someone locally to do it for them. So these DIY folks don’t have the luxury of having REM done either. But in exchange for the lack of REM, they can rapidly make as many adjustments to their aids as they want until they’re happy with it → verify subjectively by ear instead of verify objectively by machine measurements.

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