Can Real-Ear Insertion Gain Deviations from Generic Fitting Prescriptions Predict Self-Reported Outcomes?

Sreeram Kaithali Narayanan*, Palle Rye, Tobias Piechowiak, Gert Ravn, Anne Wolff, Sabina Storbjerg Houmøller, Jesper Hvass Schmidt, Dorte Hammershøi

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

4 Citations (Scopus)


Objective: To determine whether the differences in insertion gains from the first fit to generic prescriptions of hearing aids can predict the self-reported hearing aid outcomes for first-time and experienced hearing aid users.

Design: A prospective observational study.

Study Sample: The study included 885 first-time and 330 experienced hearing aid (HA) users with a valid real-ear measurement on both ears and answers to the abbreviated version of the Speech, Spatial, and Quality of Hearing (SSQ12) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires.

Results: K-means clustering of gain differences between individual real-ear insertion gain to three generic gain prescriptions (NAL-NL2, NAL-RP, and one-third gain rules) was performed. The gain difference at higher frequencies generally differentiated the clusters. The experienced users in the cluster with fittings closest to NAL-NL2 and NAL-RP prescription were found to exhibit a higher IOI-HA Factor 1 score (representing the overall benefit of the hearing aid use). The gain differences to generic prescription did not affect other self-reported outcomes for first-time and experienced HA

Conclusion: The experienced HA users with minimal gain deviations from generic prescriptions reported better self-perceived benefits than users with larger deviations. However, this was not apparent in first-time users.
Original languageEnglish
JournalInternational Journal of Audiology
Issue number5
Pages (from-to)433-441
Number of pages9
Publication statusPublished - 2023


  • Real-ear measurement
  • gain prescription
  • hearing aids
  • self-reported outcome


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