Real Ear Measurement vs. Auto Hearing Aid Programming

Real Ear Measurement vs. Auto Hearing Aid Programming

43 thoughts on “Real Ear Measurement vs. Auto Hearing Aid Programming”

  1. If the customer feels the sound is too loud/sharp/harsh when programmed to the real ear measurement, do you lower the volume or inform the patient that they simply 'need to get use to the amplification level?'

  2. I have come to the place where I need hearing aids. After watching your previous video on REM I decided that was a requirement for me. I called all the local audiologists and found only one 30 miles away that preformed REM. I had my fitting two days ago and the chart on the screen didn’t look like the one you show. Hopefully they did it right. I have been keeping them turned down because they seen too loud on high frequencies. It may just be part of the adjustment process. Anyway, thank you for making me an informed consumer.

  3. Never stop your amazing work. We need to talk with our colleagues about this until 100% of them have joined the verification club.

  4. A couple of things:

    First, thanks for providing this information. I'm not tired at all about you talking REM's until you are blue in the face. You should be proud of the fact that this information and process needs to be best practices in your 
    industry. This is your military training coming through 🙂

    What do your colleagues say when you tell them you insist on doing REM's for a proper fitting? Do you get a
    lot of eye rolls?

    Is there an industry association for clinicians like you (I'm sure there is), and if so, why isn't REM a standard of care via their recommendations and educational influence?

    These auto-program algorithms are also something that the manufacturers use as a selling point to clinicians like you. "See, you don't have to take the time or have the equipment to do REMs. Just hit this button on the

    I have my first appointment with an audiologist that is supposed to be experienced in tinnitus management. If she recommends hearing aids as the first step, but does not offer REM's, I will have to find another provider.

    Thanks for educating the consumer. Your efforts will not go unnoticed.


  5. Dr. Cliff, AuD., At my last fitting for Phonak Audeo B90 312 I asked my Audi if they could do a REM. I never knew it existed until I got hold of your video training YouTube series. Keep 'em coming! Anyway we did the REM and I witnessed the first fit didn't match the Rx and then watched to see my Audi make the adjustments to more closely match the Rx. The match fell away from the curve as the frequency went up over 8k and higher. Schweet! Thanks Doc!!

  6. I have the same question asked by Brad Wood. Also, I purchased Oticon OPN1 aids, which I can tell are great compared to what I tried before, but my provider only does first fit (budget was a factor). My loss is cookie bite and I’m highly annoyed by amplified higher frequencies. If I were to pay another provider for real ear measurements, what would be a reasonable fee range? Thanks for what you do, and for your response.

  7. Absolutely no audiologist in my area conducts REM's. I have called all of the audiologists in my area and none of them do REM's so I am stuck.

  8. Thank you so much for sharing your knowledge with all of us. I have bilateral nerve damage hearing loss your vids help me through the process and help me understand. For this I am very grateful I appreciate you

  9. Hey Dr. Cliff! What’s a good online resource to learn about all the latest hearing aid technology and current research going on in the field of hearing healthcare?

  10. Great video. I've personally experienced the difference that REM can make vs. first fit and definitely agree that all HA fittings should include REM. Thanks for being an advocate and champion for this, Cliff!

  11. Hello Doctor Cliff, I've been testing the Oticon OPN 3 and I want the best hearing quality possible. One of my options are the brand Resound, I'm not sure which one but I'm sure it's a newer model. Can you better explain to me from you're personal experience which is better? Or if you have another brand that you think is best. Alsooooo is it really that much of a difference, I'm aware each brand has a unique signature sound. Pleaseeeeeeeeeeee answer bro

  12. As a hearing instrument specialist it unnerves me to hear of other specialists NOT using REM/LSM. Verify, verify, verify. I don't care how long you've been in this profession. REM always sounds better.

  13. OTOMED Aparaty słuchowe

    great video! i used REM in Poland. In my country REM is not popular but i watch that so clever and smart. my pacjent’s are so happy when i used REM in first settings hearing aids. ( sorry my English…)

  14. Hi Dr Cliff, After watching your brilliant video and doing other research I have been seeking fitting with REM. I have been told that REM can't be used on a custom fit IIC as the probe tube is crushed. Is this true? Thanks

  15. Wow, this is very informative.

    However i check with my hearing consultant, she told it not a standard practice in my country.

    She told me for my fitting – they use algorithm software to determine my hearing loss.


  16. Dr. Cliff, AuD., What is your opinion regarding REM manual fit and REM Autofit or autoREMfit?
    see the link below for further clarification, you should do a Video on this subject topic !!!! !!!

    Oticon: REM Auto-Fit

    Phonak: TargetMatch

    ReSound: AutoREM

    Signia: AutoFit

    also what is your opinion on Live Speech mapping in the grand scheme of things?

  17. Hi Dr. Cliff. I was wondering if you could assist me in the issue of loud noises being too loud. Say you've adjusted the amplification to meet target through REM, and a patient on a follow up visit is complaining about loud noises; what is your method of dealing with this issue?
    I've heard things like simply lowering the overall amplification, lowering the high frequencies, but I would like to know you take on this. Maybe finding the true LDL and adjusting MPO to these values? Or is there some magic tricks with REM and MPO settings?

  18. Just completed my second day wearing Resound LinX Quattro 61 9 with tulip domes. Great clarity and reliable bluetooth integrations but awful clashes with impact noises in kitchen had to turn them down to half way. The sound of your good self on video and people speaking on any TV program sounds way too harsh/sharp…as if emitted from a very cheap 1970s radio! I conclude there must be a need for a REM sesson with the audiologist though when i mentioned the idea to her (even before trying new hearing aids) I forget her exact opinion but it was ultimately a little on the wary side if i remember correctly…I'm hesitant to ask her again. But shall do. I've already placed my $1000 deposit and will lose some of that should I opt out and go for another brand. Previously a Moxi, then Phonak user and happy with both, natural sounds, nothing like the 'sound as if i'm in a bathroom' thing, having to get used to with the tulip domes and Resound, rechargeable, bluetooth etc. One more thing, am feeling tied to my App and phone to make adjustments, as many are needed in different situations at the moment. It's early days, am hoping all will be resolved.

  19. I am new to hearing aids. I did a trial with Starkey AI 2400s and they were fitted using the REM. I purchased the Starkey 2400s without the AI. However a new REM was not done to the new aids that I purchased.Since its basically the same software without the extra sensors am I good ? They sound pretty good to me. But like I said this is my first set and I am still getting used to all the new sounds.

  20. shahrzad akbarizadeh

    I’m an Audilogist and agree with you totally. I have verified more than 1000 hearing aids in my clinic , I use REM lately that make my fitting different .thank you for good information !

  21. I reside in Sydney Australia and I have tried to find someone who may do R.E.M. Without success.
    Dr are you able to recommend someone as I do believe R.E.M. Will make a difference and establish the correct prescription values to my hearing devices.
    Thank you. Joe

  22. John Wade Long Jr

    THANKS for this video! Is there a listing of which audiologists offer REM? Telephoning them all is pretty tedious, and it is likely that the receptionists won't have a clue what you're talking about. Thanks! – Johnny

  23. I have gone thru many of your videos. I think you are singularly contributing a lot on YouTube about ideal parameters for a really a good HA experience by users.

  24. Definitely keep talking about this! Im a provider and other providers in my company have been begging for REM but due to the cost they wont pay for the equipment. The providers who actually care for patients want this. The others are not much more than salesmen.

  25. Hi Dr. Cliff,
    I was wondering in your experiences, is it possible that patients prefer the sound of first fit because the gain of high frequency is less ?
    Because many of my patients feel that the sound is unnatural when they first time wear the hearing aid and they say sounds very "microphone"
    But after dropping the gain of high frequency they feel more acceptable with the sound.
    Thank you very much !

  26. Thanks Doc was considering audicus clara but since they are not a brick and mortar it would only be first fit programming. I have check my other option from Costo which does incorporate REm with the final in house fitment. I came this close to maybe making a regrettable mistake if not for your video.

  27. Hello. Im a hearing instrument specialist and i mostly fit Oticon hearing aids. My company does not provide us REM and many of us are fighting for it. Do you have any tips for best programming until we get some? Many people dont have programming knowledge and id like to share something that shows them some simple ways to improve programming skills. Thank you

  28. Enthused by your videos, I asked my audiologist to apply REM (which was available ) to the very recent
    fitting of Phonak Audeo Marvel M90 RIC aids which he had strongly recommended. He stated, categorically, that REM 'CAN NOT' be used with this product and that if I wanted REM, I would have to switch to another make, say Siemens. Is he correct?
    Please advise.
    E. Giblin

  29. In India they generally don't do REM. I am using g HA since 1988. Started with analog HA those days then to Digital with different Audiologists. My last was Phonak Naida 5s. They never did REM. Here they suggest some brand or model assuring you that it would give best quality hearing experience. But they just adjust it to a workable label just you are able to hear to some extent. Even after spending a heavy amount your right to quality hearing is not met. Most of the time they set a costly and feature rich HA which gives you hearing experience of cheap chinese amplifiers, just increasing amplification not the quality. Here most of the Audiologist behave like a sales person only to sell any HA to you for a profit and only a few take pain and spend some time in setting the HA to the optimum quality. Most audi turn a good HA to as good as a cheap HA.
    It is very difficult to find a good audiologist in Delhi out of so many here and there. Very frustrated on their attitude to wards the consumer. They think that they are making a great favour to us by making us just able to hear (Not quality wise).

  30. I'm a long time hearing aids user. I was recently fitted with Phonak Virtro 90 hearing aids. They seem very good. My Audi. used the REM to set them up. I've used Starkey hearing aids for years. Recently tried the Oticon's which seemed ok. The two prior aids seemed ok too. These Phonaks feel good and the sounds they produce are very good. However, a new version of the Resound Lynx Quatro in the ear version was mentioned. Any thoughts on trying this first gen Resounds vs. my current Phonaks? Thanks

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