Comparison of performance with hearing aid programmed to NAL-NL1 first-fit and optimized-fit

PURPOSE: The initial-fit provided by the hearing aid manufacturer’s software is generally a display of measurement done in the ear simulators. The need for verification of hearing aid output and gain in the real ear using probe-microphone measurement to match the prescriptive target is highlighted. The objective of the study was to evaluate the difference in real-ear aided response (REAR), real-ear insertion gain (REIG), aided thresholds, articulation index (AI) and word recognition score (WRS) in quiet, with hearing aid programmed to NAL-NL1 first-fit and NAL-NL1 optimized-fit using the probe-microphone technique. METHODS: In a repeated measure experimental design, 11 participants with a mean age of 41.09 (SD=±9.95) years having moderate and moderately-severe sensorineural hearing loss were tested monaurally in two aided conditions, with a 16-channel hearing aid programmed for manufacturer’s NAL-NL1 first-fit and optimized-fit to NAL-NL1 using probe-microphone verification. The REAR, REIG, aided threshold, articulation index and word recognition scores in quiet were obtained for both aided conditions. RESULTS: The REAR, REIG, aided threshold, AI and WRS in quiet were significantly better with the NAL-NL1 optimized-fit compared to manufacturer’s NAL-NL1 first-fit. CONCLUSION: The optimized-fit yields better audibility and improved word recognition in quiet. This supports best practice guidelines of many professional organizations regarding the use of probe-microphone measurement as the “Gold standard” for verification of hearing aid fitting, thereby providing better satisfaction and quality of life to hearing aid users.