Is the role of probe-tube, real-ear measurements changing for adults with mild-to-moderate hearing loss?

Objective: This study compared the deviation from target before and after fine tuning using probe-tube real-ear measurements (REMs). This was done to investigate if recent findings (e.g., little additional benefit of REMs in adults fitted with Oticon hearing aids) generalise to a different manufacturer's fitting software.

Design: Retrospective analysis of clinical fitting data of the Initial Fit (IF) using NAL-NL2 and after REMs.

Study Sample: The fitting data of 256 new adult hearing aid users with mild-to-moderate hearing loss were analysed.

Result: REMs did not reduce the median deviation from target compared to IF for 65 dB SPL input level, except at 4 kHz where fine tuning resulted in a lower underfit (-2 dB vs. -5 dB). The range of deviations was not reduced after fine tuning, except at 2 and 4 kHz where the distributions were narrower for REM.

Conclusions: These findings confirm that improvements in fitting software mean there is less evidence that REMs and fine-tuning improve the match to target for many new fittings in adults with mild-to-moderate hearing loss. Further research is needed to generalise the findings to other manufacturers, input levels and prescription methods. Future studies should integrate perceptual and financial dimensions to comprehensively understand the benefits and trade-offs of REM for average and outlier users.