Yes, exactly that, per my last answer. You end up with a series of potentially overprescribed aids which people return or don’t use; especially in noisy environments……
The Modernising NHS Programme went through quite a series of this as there were many early mandates that Hearing Aids ‘must’ be fitted to full DSL/NAL2 targets. Some manufacturers added ‘test/REM modes’ to meet the requirements of the fitting/REM, but in my mind that’s just cheating as the actual real-world performance of the Aid will differ (significantly possibly) under real world conditions.
And if you think about a system like Phonak’s Autosense - how do you determine which mode the hearing aid is in when you perform the test.
Isn’t the “official” line from Phonak (and I think most of the big HA companies) that the fitting should be verified with REM set to NAL-NL2 values? It’s like they give two messages. If you want to follow best practices, you should do REM. If you just want to sell hearing aids, just use First Fit.
Yes, manufacturers tell you to verify against NL2. You can also verify a proprietary rationale against DSL, but because they are all based on NL2 it just requires a lot more wrangling. Recall, rationales are just gain targets, so it can certainly be done. It will just start out further away and you have to make more changes to get to DSL.
No manufacturer has ever once suggested to me that a user might have a better experience with their proprietary rationale. It’s not an expectation.
Just because I wanted to de-mystify it a bit. They are talking to an audiologist. An audiologist who has better knowledge of the particular product and is employed by Oticon to help out other clinicians. But they are still providing audiological recommendations, just with a deeper understanding of the product than some clinicians have.
I think I answered your other question above (or in another similar thread right now?) Manufacturers typically develop proprietary fitting rationales to try to minimize returns in a young industry that has a lot of weak providers. Keep in mind that they are also international, and as much as many users of this forum struggle for access to good hearing care, there are a lot of other countries where that access is much worse.
But you bring up a good point–there are individuals who are part of a ‘small population’ of hearing loss for whom independent targets have not been developed. If a manufacturer can say, “Hey, we did this for you and incorporated the results into our proprietary fitting” that is absolutely a sales feature. On the other hand, I don’t think you’re on the right track when you suggest that their proprietary rationales are also circumventing weaknesses in their devices. If their device cannot manage two of the most frequently used systems in the world then they have a real problem.
Thanks for your answers, @Neville . I agree that mfgs wouldn’t use their own rationales to circumvent weaknesses in their devices, because there shouldn’t be any weaknesses and the minimal standard should be to be able to perform to par with the standard rationales at the minimum in the first place.
It’s more often likely the opposite, where they have strengths in their devices that cannot be optimized with features or parameters that can be shared with the standard rationales, so they use their proprietary rationales to incorporate those special strengths from either their hardware devices, or from the proprietary knowledges they gain through their research into the implementation of their own rationales (like with how they might have chosen to handle the cookie bite loss differently and incorporate it into their rationales as they’ve indicated in that educational video I mentioned earlier).
Interesting how so many here feel like fitting algorithms are so unique and special when hearing aids can be adjusted so many ways.
Switching algorithm alone does make a difference in my experience. But, if a person’s hearing aids have been properly tuned for a person’s hearing loss when the fitting algorithm is changed that person’s speech understanding will go down. Then the aids will need to be re-tuned for optimum performance.
My hearing loss was pretty bad when I did these tests. Maybe someone with less hearing loss would get different results but my experience changing fitting algorithms has proven to just require re-tuning
the aids for best speech understanding.
I had great luck with Insitu self programming hearing aids thanks to help from many here on this forum.
Hi, is the book mentioned above worth having for a DIY member?
In particular I’m thinking of the tricky part of recognising sound qualities and the remedy.
Only book I saw mentioned was on post #86Fitting and Dispensing Hearing Aidsemphasized text**
I’m not familiar with it, but in general increasing your understanding of what you’re doing is good, but I wouldn’t expect it to give specific remedies for different sound qualities. All of the HA programming software I’ve seen does usually have a section that deals with recommended solutions.
Thankyou Mdb, the problem I have is I always seem to be moving away from the starting point ie using audibilty fine tuning makes it worse.
I think it may be a REM issue, trying to reproduce a regime fitted with it but only using in situ.
There should be a section in the software that is aimed at basic issues and offers suggested solutions. Is that what you’re talking about? In Phonak’s Target software it’s called Automatic Fine Tuning. DIY section of the forum is likely a better place to get more info.
