REM based live speech mapping used for fitting has nothing similar. Because this method sends speech through the speaker in front of you, and measuring tube checks what came near your eardrum (4mm away) afer your HAs processed the sound.
First step of that process is indeed white noise sound made for pure calibration of instruments and your canal.
In situ audiogram is just that, audiogram. Beeps.
Yes, it does implicitly take into the account your ear canal, but how well you hear beeps unfortunately isn’t the same as how well HA process speech and if thing that comes to your drum is even comprehensible for the machine, let alone your brain.
Yes, your fitter has no clue what’s the purpose of it. And is seller.
You can be without equipment and still know what you’re talking about or what the equipment is really used for.
Also, WRS measuring doesn’t ask for REM equipment, just a speaker and sw with prerecorded words. And if fitted aids on 65db sound from speaker cannot deliver wrs that was measured with headphones (to see what db you need to get the best score, so, amount of amplification), then they’re not fitted properly.
Word lists are especially made to cover all types of vocals and hearing issues, so from listening 20 words, and repeating them back, it’s easy to both asses the progress and see where aids need tweaking eg which sounds you don’t hear but you should since you heard them during initial wrs with headphones and those words on blastingly loud.
Rem based live speech mapping makes process easier and faster for them. Gives good baseline and comprehension for you in just a few minutes of doing it.
So basically, it’s beneficial for fitter since it saves time enormously. One fitting session of 10-15 minutes and you immediately have the best speech comprehension in quiet.
However, it isn’t necessary. Unfortunately, people who don’t do that, also don’t do anything else. So ‘do you do REM’ is simple question to filter out good fiter.
However wrs with headphones to see how much help you actually can get from ampflication and then tweaking aids until you can get at least the same wrs using them on normal loud sounds (65db), is a bare minimum!!
In situ audiogram has nothing to do with how well you understand speech with aids.
Aids are just amplifiers. So if your initial wrs test showed that you need 100db input and you understand 80% of words, then well fitted aids should give you 80% of the same words on all sounds.
So, if I speak to you on 65db, aids should boost that to give 100db your ear need.
But if you heard wood correctly but not house during initial wrs, and with aids you don’t hear any, aids aren’t fitted properly, no matter the fitting process (rem is that, fitting process). However, no aid in the world will give you back house if your cochlea is that damaged and just cannot hear those sounds.
In other words, if your initial wrs is 90 or more, that means that aids can help you to understand almost everything.
If wrs is 50, aids won’t bring you up to 90, however, without them, you cannot hear even that 50, so they’re still useful to deliver that 50.
You only care about end results after all.
How can they know if you hear well if they don’t test and verify what they’re done?
‘how do you hear me now’ aren’t words from word list that addresses tricky sounds
Tell them you won’t need their services obviously, so, ask for unbundled price, just aid, without endless hours of pathetic work based on ‘how do you hear me now’. You can do better yourself, if nothing then from the sheer fact that you can directly test and tweak in your environment eg home, and not perfectly quiet office.
And from the fact that phonak programming software has a wizard which helps with fitting.
Like ‘problem with own voice’, then you click, and it adjust gains. Or ‘problem with female voices’. Or ‘problem with s, sh sound’ or many others.
You don’t need to be an expert to read that and click around.
It’s literally made in ‘for dummies’ approach.
Good fitter doesn’t use that since they now how sound behaves and they directly adjust gains when you tell them and describe your issue.
But sw is so good that you can pick an issue and it will do gain adjustment per frequency for you.
And I think we all are ‘smart’ enough to not click ‘problem with own voice’ if we have problems with sh sound.
And you can record your list, and put it on repeat and check which words you hear completely and which don’t.
It’s not even about perfect recording or calibration, it’s about being able to repeat the process in the same conditions and being able to compare before and after tweak.
And yes, sw has ‘undo’ and even direct comparison between two points in time/sessions.
It’s just that ‘how do you hear me now’ aren’t useful words for testing. Especially since you probably look at person.