oticon REM AutoFit Quick Manual

REM AutoFit
Quick Guide

How to complete the REM
process in under six minutes

2

Before using REM AutoFit

REM AutoFit
Quick Guide

How to complete t he REM process in under six
minu tes

What is REM AutoFit?

REM AutoFit is an intuitive tool in Genie and
Genie 2 that allows the HCP to match real ear
targets automatic ally. This makes the real ear
measurement (REM) process more efficient
whilst ensur ing the HCP maintains qualit y and
control over the fitting. This gives the client a
more comfortable fitting experience and it
saves time for t he HCP. REM AutoFit is suit able
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 reaso n is to verify that spe ech sounds
are audible for t he client. Ensuring tha t targets
for a chosen rationale are being met is a good
starting point for a new fitting. Real ear mea­surements (REMs) must therefore be consis­tent, 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

Print

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

necessar y using Firmware Upd ater (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 selec ted 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.

3

Hearing aid settings during measurement

The following controls are set automatically during REM AutoFit measure­ments and restored to their original states af terwards, 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)

0 N/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
Too ls menu in the left taskp ane. Launch REM AutoFit f rom the bottom of t he
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 accept­able 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

Print

Before using REM AutoFit

4

Step 2: Unaided

Perfor m an otoscopic examina tion of the ear canal pr ior 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 t ympanic 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. Verif y 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 of f 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 a djustments are subs equently applied to the f itting (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

Print

Before using REM AutoFit

5

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 inser tion 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 re al ear data. The automa tic process in REM AutoFi t 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
prescrib ed target (whilst tak ing into account the limit ations of the instr ument
and the acoustics) and then per forms 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. Clic k 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 satis fied 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

Print

Before using REM AutoFit

6

Manual

The manual pro cess in REM AutoFit lets yo u 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 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 aided measurements, proceed to Step 4:

Finish.

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

Check the Help file for some use ful troubleshooting tip s if you cannot reach
the prescr ibed target. Note: If t he selected acoust ics are too open, the mea­sured 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

Print

Before using REM AutoFit

7

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 m anually fine-tuned gain should b e included or not. The grap hs
and the instruments update according to what you select, so you can dem­onstrate 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 fine­tuning is included, it is only applied to the current program and linked
programs.

Select Discard All to dis card REM AutoFit adjus tments. The data i n 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 Auto Fit Results. This option is on ly available if correc tions
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 th e acoustics, REUG or REC D data after comple ting REM AutoFit,
the fitting soft ware 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.

Print

In Step 4: Finish, you can print t he measurements ac cording to your current
on-screen selection. To print af ter 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

Print

Before using REM AutoFit

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23026UK / 2018.05.07