The Acceptable Noise Level Test as a predictor of real-world hearing aid benefit

Historically, audiologists and others who fit hearing aids often have relied on the results of pre-fitting tests to predict patient benefit from amplification in everyday listening situations. Traditional word-recognition testing or speech-intelligibility-in-noise tests have frequently been used as part of this pre-fitting test battery, although there is little evidence of their effectiveness in predicting realworld hearing aid outcomes.1 This article examines the use of a different speech test, the Acceptable Noise Level Test, to predict real-world hearing aid outcome. There are a few reasons why audiologists and hearing instrument specialists might be interested in predicting how patients will perform in the real world with hearing aids. One, most clinicians pride themselves on providing patients with a detailed explanation of test results, along with recommendations based on these results. Predicting benefit allows patients to leave the pre-fitting appointment with a more precise and individualized idea as to how much benefit they will receive from hearing aids before they start using them. Secondly, being able to predict benefit allows the practitioner to position herself or himself as the expert. Experts don’t have all the answers, but they are able to gather meaningful information, organize it, and accurately inform patients about what they should expect from a treatment. This concept is similar to what surgeons do prior to an operation. Using test results, they give the patient a prognosis of the expected outcome in everyday living situations, Finally, all of us feel a little more at ease with a major purchase when we are offered some reassurance that it will indeed work where and when we need it most. If hearing healthcare providers can rely on certain pre-fitting tests to make more accurate predictions of real-world outcomes with hearing aids, patients will be more likely to feel confident about the decision to purchase hearing aids.