# Efficacy of a coupler-based fitting approach for experienced users receiving replacement hearing aids

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2021 · —

## Abstract

In the VA system, hearing loss is the second-most common service-connected condition
affecting 933,182 Veterans, exceeded only by tinnitus which affects 1,121,709 Veterans (data
from Veterans Benefit Report for Fiscal Year 2016). In FY 2016, the VA dispensed 750,075
hearing aids at a net procurement of nearly $270 million (report generated from VA Denver
Acquisition and Logistics Center [DALC] Remote Order Entry System [ROES]). Half of the hearing
aids dispensed were to experienced hearing aid users receiving replacement hearing aids
(Dennis, 2014). VA Audiology caseload is significant and Veterans can experience long wait-times
for fitting appointments to obtain new hearing aids (Office of the Inspector General, 2014).
 The purpose of the fitting appointment is to program and verify the hearing aids and orient the
patient to hearing aid use/care. For patients obtaining replacement hearing aids, the orientation
typically is unnecessary, and the programming is simplified; consisting mainly of matching the
individual's real-ear aided response (REAR) and hearing aid output to appropriate target values.
In contrast to adults, REAR measurements are not well-tolerated by children due to the
requirement for placement of a probe tube in the ear canal. Therefore, a hearing aid fitting
procedure that circumvents the need for in situ REAR measurements (real ear coupler difference
or RECD) is the standard-of-care (SoC) for children. Considerable research clearly has shown the
equivalency of in situ REAR and RECD fitting procedures (e.g., Moodie et al., 1994). RECD fitting
procedures rarely are used with adults; however, such an approach could preclude the need for
direct physical contact with the patient at the time of the hearing aid fitting. Three experiments are
proposed. The purpose of the first study is to evaluate coupler-based fitting approach for groups
of experienced users obtaining replacement hearing aids and compare the accuracy of those
fittings to the prescription and their outcomes to norms. The second study aims to develop
correction factors for venting of open-fit hearing aids. The third study will focus on comparing
coupler-based fittings of open-fit hearing aids (using correction factors developed from study two
results) to an SoC (active control) group who will have their open-fit hearing aids fitted in face-to-
face appointment via standard in situ REAR procedures. In Study 1 and 3, both groups will return
for in situ REARs and self-report outcomes assessment one month after the hearing-aid fitting.
The results of this study should determine the efficacy of a RECD-based, hearing-aid fitting
approach for experienced hearing-aid users who are receiving replacement hearing aids
consisting of a variety of styles. If the approaches are equivalent, then this study will provide an
evidence-based, RECD fitting approach that should result in greater patient satisfaction and
reduced costs.

## Key facts

- **NIH application ID:** 10071097
- **Project number:** 5I01RX002777-03
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Sherri L. Smith
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-01-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10071097

## Citation

> US National Institutes of Health, RePORTER application 10071097, Efficacy of a coupler-based fitting approach for experienced users receiving replacement hearing aids (5I01RX002777-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10071097. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*