Oticon REM AutoFit Manual de usuario

REM AutoFit

Quick Guide

How to complete the REM

process in under six minutes

Before using REM AutoFit

REM AutoFit

Quick Guide

How to complete the REM process in under six

minutes

What is REM AutoFit?

REM AutoFit is an intuitive tool in Genie and

Genie 2 that allows the HCP to match real ear

targets automatically. This makes the real ear

measurement (REM) process more efficient

whilst ensuring the HCP maintains quality and

control over the fitting. This gives the client a

more comfortable fitting experience and it

saves time for the HCP. REM AutoFit is suitable

for both open and closed fittings.

This guide provides step-by-step support

through the REM AutoFit process to allow the

HCP to perform quick, efficient and accurate

REMs.

Why do audiologists perform real ear

measurements?

The main reason is to verify that speech sounds

are audible for the client. Ensuring that targets

for a chosen rationale are being met is a good

starting point for a new fitting. Real ear mea-

surements (REMs) must therefore be consis-

tent, reliable, repeatable, and correct.

Before using REM AutoFit

Hearing aid settings during measurement

Step 2: UnaidedStep-by-step Guide Step 4: Finish

Automatic

Step 3: Aided

Manual

Removing measured real ear dataStep 1: Calibrate

Before using REM AutoFit, ensure you:

• Have installed an IMC 2 compatible

REM module (Interacoustics, MedRx

or Otometrics). See www.himsa.com

for IMC-compliant module versions.

• Have NOAH 4.5.1 or later

• Have selected the appropriate IMC 2 com-

patible REM module in Preferences > Edit

Preferences > Customise Software >

Measurement Modules > REM AutoFit

Selected Module (this preference is saved

for future fitting sessions)

• Connect the hearing aids

• Ensure up-to-date hearing aid firmware if

necessary using Firmware Updater (Genie 2 only)

• Connect and switch on your REM equipment.

Close the REM software if it has already

been opened.

• Select the acoustics (venting, tubing,

earpiece/dome) and power levels in

Genie/Genie 2 which match those of the

hearing aid. Note: It is recommended to use

the dome or earmould prescribed by Genie.

If the selected acoustics are too open, gain

may be limited due to the risk of feedback.

If this occurs, change to a less open option

before launching REM AutoFit.

• Perform a feedback analysis (see Feedback

Manager/Feedback Analyser)

• Select fitting rationale

• Set up program linking as desired. REM

AutoFit sets the program to P1.

Hearing aid settings during measurement

The following controls are set automatically during REM AutoFit measure-

ments and restored to their original states afterwards, except for Overall

Loudness (Super Power instruments only) which stays on 0.

Genie 16.2

onwards

Genie 2 16.2

onwards

Noise Management Current setting in

Automatics

Current setting in

OpenSound Navigator

Feedback Manager On On

Adaptive Directionality Off Off

Adaptation Manager 3 3

Overall Loudness

(Super Power

Instruments only)

0N/A

Speech Rescue

(Super Power

Instruments only)

Off N/A

Step-by-step Guide

On the Fitting step in Genie/Genie 2, enter the REM tool from the More

Tools menu in the left taskpane. Launch REM AutoFit from the bottom of the

REM tool.

Step 1: Calibrate

It is necessary to calibrate the probe tube before measurement.

a. Align the probe tube(s) with the reference microphone(s) and hold 0.5

m from the loudspeaker. Check the REM system’s guidance on accept-

able distance.

b. Click Start on the relevant side to measure one side. To calibrate both

sides, click Both. Depending on the REM system, binaural measurement

may take place simultaneously or sequentially.

c. The system automatically turns off the signal when the calibration is

complete. If you need to stop the calibration prior to completion, click

Stop.

d. The result of the tube calibration is displayed on the graphs.

e. Repeat these steps for each new probe tube.

f. When you are satisfied with the calibration, proceed to Step 2:

Unaided.

Hearing aid settings during measurement

Step 2: UnaidedStep-by-step Guide Step 4: Finish

Automatic

Step 3: Aided

Manual

Removing measured real ear dataStep 1: Calibrate

Before using REM AutoFit

Step 2: Unaided

Perform an otoscopic examination of the ear canal prior to doing REM to ensure

no excessive wax or other contraindications.

a. Position the client in front of the loudspeaker at the distance recom-

mended by the REM system (usually 0.5-1 m). Instruct the client to

remain still during each sequence of measurements.

b. Place the probe tube in the client’s ear canal. The recommended inser-

tion depth of the probe tube is 6 mm from the tympanic membrane and

a minimum of 5 mm beyond where the sound outlet of the instrument

will be positioned for the aided measurements in Step 3: Aided.

c. Verify the probe tube placement in the ear canal by performing

otoscopy.

d. Click Start on the relevant side to measure one side. To calibrate both

sides, click Both. Depending on the REM system, binaural measurement

may take place simultaneously or sequentially.

e. The system automatically turns off the signal when the measurements

are complete. If you need to stop the measurement prior to completion,

click Stop.

f. Ensure that the unaided gain at 6 kHz intersects the x-axis at approxi-

mately 0 dB (+/- 5), if possible. If it does not, reposition the probe tube.

The grey curve that is already shown is a predicted REUG.

g. If you are satisfied with the unaided measurement, proceed to

Step 3: Aided.

h. To re-measure the unaided measurement, repeat points d-g above.

Note: if REM AutoFit adjustments are subsequently applied to the fitting (in

Step 4: Finish), the unaided measurement (REUG) is saved to the REUG tool

and will overwrite any previous REUG. If REM AutoFit is discarded or exited

prematurely, the unaided measurement is not saved.

Hearing aid settings during measurement

Step 2: UnaidedStep-by-step Guide Step 4: Finish

Automatic

Step 3: Aided

Manual

Removing measured real ear dataStep 1: Calibrate

Before using REM AutoFit

Step 3: Aided

REM AutoFit handles open fit calibration automatically. There are two ways

of performing real ear aided measurement sequences: Automatic and

Manual. This can be selected using the tabs below the right ear graph.

a. Insert the hearing aid carefully in the client’s ear without moving the

probe tube (mute the hearing aids during insertion if necessary).

b. Perform one of the following workflows:

• Automatic only

• Automatic followed by Manual

• Manual only

(Note: If Manual is followed by Automatic, the manual fine-tuning will

be overwritten)

Automatic

Without measured real ear data, the fitting software has to prescribe gain

using average real ear data. The automatic process in REM AutoFit measures

and updates the client’s real ear data to use the measured data. This data is

applied throughout Genie/Genie 2 to all programs.

When you run a measurement in the Automatic tab, the fitting software

measures the current hearing aid gain, automatically adjusts it towards the

prescribed target (whilst taking into account the limitations of the instrument

and the acoustics) and then performs another measurement to confirm the

target match.

a. Select the desired measurement input levels: 50, 65 or 80 dB. Gain

adjustments at all levels are based on the 65 dB measurement.

b. Instruct the client to face the loudspeaker and to remain still during

each sequence of measurements.

c. Click Start on the relevant side to measure one side. To calibrate both

sides, click Both. Depending on the REM system, binaural measurement

may take place simultaneously or sequentially.

d. The system automatically turns off the signal when the measurements

are complete. If you need to stop the measurement prior to completion,

click Stop.

e. If you are satisfied with the measurements, proceed to Step 4: Finish.

f. If you want to make further fine-tuning, you can proceed to Manual.

Hearing aid settings during measurement

Step 2: UnaidedStep-by-step Guide Step 4: Finish

Automatic

Step 3: Aided

Manual

Removing measured real ear dataStep 1: Calibrate

Before using REM AutoFit

Manual

The manual process in REM AutoFit lets you fine-tune the hearing aid gain to

get even closer to target or to personalise the fitting based on the client’s

own comments. This can be done after or instead of the automatic process.

Any manual fine-tuning performed in REM AutoFit applies to the current

program and linked programs in the same way as manual fine-tuning in

other tools.

a. Select the desired measurement input levels: 50, 65 or 80 dB.

b. If there is a previous measurement displayed from Automatic or

Manual, use the fine-tuning controls to fine-tune the gain based on

the measurement.

c. Instruct the client to face the loudspeaker and remain still during the

measurement sequence.

d. Click Start on the relevant side to measure one side. Click Both to mea-

sure both sides. Depending on the REM system, binaural measurement

may take place simultaneously or sequentially. The system automati-

cally turns off the signal when the measurements are complete. If you

need to stop the measurement prior to completion, click Stop.

e. If you are satisfied with the aided measurements, proceed to Step 4:

Finish.

f. To further fine-tune the gain, repeat points b-f.

Check the Help file for some useful troubleshooting tips if you cannot reach

the prescribed target. Note: If the selected acoustics are too open, the mea-

sured gain graphs on the Fitting step in Genie/Genie 2 will show a lack of

gain in the high frequencies due to the risk of feedback. In this case, try a

more closed dome or earmould.

Hearing aid settings during measurement

Step 2: UnaidedStep-by-step Guide Step 4: Finish

Automatic

Step 3: Aided

Manual

Removing measured real ear dataStep 1: Calibrate

Before using REM AutoFit

Step 4: Finish

The graph now displays the hearing aid gain measured in your client’s ear,

and you can apply the adjustments from Step 3: Aided. You can choose

whether the manually fine-tuned gain should be included or not. The graphs

and the instruments update according to what you select, so you can dem-

onstrate each option to the client.

Select Apply REM AutoFit to apply automatic adjustments. REM AutoFit

data measured in previous fittings will be overwritten. Gain modifications

from the automatic adjustment are applied to all programs. If manual fine-

tuning is included, it is only applied to the current program and linked

programs.

Select Discard All to discard REM AutoFit adjustments. The data in use before

you entered REM AutoFit is then restored.

Removing measured real ear data

If you no longer want to use the REM AutoFit adjustments and want to use

the predicted data instead, do as follows:

1. Leave the REM tool if it is open.

2. Go to the Hearing Instrument menu on the menu bar and select

Remove REM AutoFit Results. This option is only available if corrections

based on REM AutoFit are in use.

If you also want to remove Unaided measurement data, do as follows:

1. Open the REUG tool in the Selection step.

2. Change REUG to predicted or delete REUG data.

If you change the acoustics, REUG or RECD data after completing REM AutoFit,

the fitting software will represcribe using predicted real ear data (i.e. REM

AutoFit adjustments are removed). To use measured data, you must repeat

the REM AutoFit process.

However, the automatic adjustments from REM AutoFit will still be used to

calculate the prescribed setting if there are changes to anything else, such

as the audiogram, fitting rationale or age.

In Step 4: Finish, you can print the measurements according to your current

on-screen selection. To print after you have closed the REM AutoFit tool, go

to the Genie/Genie 2 top menu and click Print.

Hearing aid settings during measurement

Step 2: UnaidedStep-by-step Guide Step 4: Finish

Automatic

Step 3: Aided

Manual

Removing measured real ear dataStep 1: Calibrate

Before using REM AutoFit

www.oticon.com

23026UK / 2018.05.07

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