Real ear measures are an objective assessment of the sound pressure level generated in the ear canal while an individual is wearing a hearing aid. They serve as a quality control measure and have been the standard of care for more than 25 years. Every professional organization affiliated with hearing health care considers real ear measures to be an integral part of clinical best-practice guidelines.1,2
Typically, real ear measures are conducted on the day of the hearing aid fitting appointment. Because they don’t require a behavioral response from the patient, real ear measures can be made in a matter of minutes by a licensed audiologist or hearing instrument specialist. The primary objective of real ear measures is to ensure that a scientifically-validated prescriptive fitting target, which is primarily based on the audiogram of the patient, is closely matched by the hearing aid. Many factors, such as the size of the individual’s ear canal, shape of the pinna and sensitivity to loud sounds, influence the acoustic properties of the hearing aids. These factors can be accounted for when real ear measures are conducted. Decades of research indicate that compared to other approaches the use of a prescriptive hearing aid fitting method and the verification of that method with real ear measures will translate into successful hearing aid use.3
Real ear measures save time.
Real ear measures ensure that a range of soft, average and loud sounds are audible to the patient. To collect this information in the clinic without using real ear equipment would be nearly impossible. It would take hours of cumbersome work to gather it using behavioral methods in the sound booth – a task that no one does outside of a research lab.
Further, because real ear measures are objective, the audiologist knows precisely how much amplification is being provided in the ear canal for soft, average and loud sounds. If any of these sounds do not match the individual’s prescriptive target, the acoustic response of the hearing aid can be instantaneously modified with computer software. Although this approach doesn’t automatically translate into patient success, it has been shown in numerous studies to lead to a high probability that the outcome will be favorable.3 This process in which the hearing aids are determined to meet a pre-defined standard can free up valuable clinical time that can be spent on patient counseling. In addition, the use of a prescriptive fitting method that uses real ear measures can reduce the number of unnecessary patient visits for fine-tuning adjustments.
Real ear measures save money.
Although real ear equipment requires an investment of between $5,000 and $15,000, the time and money it saves in the long run makes it worthwhile. Because real ear measures can measure the function of the noise reduction features of hearing aids, it takes the guesswork out of quality control assessment. Thus, the audiologist is more likely to “get the fitting right the first time” and cut down on unnecessary returns and poor patient outcomes.4
Real ear measures generate revenue.
As we move into an era of over-the-counter devices, there will be opportunities to offer a fee-for-service for patients presenting to your clinic with a device they purchased online. Your clinic can offer a higher level of professional service and charge a fee for it by including real ear measures in the assessment process.
Real ear measures result in superior patient outcome.
There is ample evidence indicating patient benefit and satisfaction are markedly improved when real ear measures are included in the fitting process.4,5 At their core, real ear measures ensure that for each hearing aid user a balance between audibility and comfort of sound is achieved on the day of the fitting. This serves as an effective starting point for the patient and allows the audiologist to make more precise fine-tuning adjustments in the future.
More than 30 years of research and clinical experience shows that real ear measures lead to better patient outcomes and more efficient business operations.
Now is the time to introduce Real Ear into your practice. Contact your Regional Manager or Account Manager for more information on the MedRx opportunity brought to you by Fuel Medical and Oticon’s partnership.
 Guidelines for the Audiologic Management of Adult Hearing Impairment (2006) American Academy of Audiology Task Force.
 Clinical Practice Guideline: Verification and Validation (2016) International Hearing Society.
 Speech Mapping and Probe Microphone Measurements (2017) Mueller, Ricketts & Bentler, Plural Publishing, San Diego, CA
 Kochkin, S. (2011) MarkeTrak VIII: Reducing patient visits through verification and validation. Hearing Review. 6, 10-12.
 Abrams, Chisolm, McManus & McArdle (2012). Initial-fit approach versus verified prescription: comparing self-perceived hearing aid benefit. Journal of the American Academy of Audiology. 23, 768-78.