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a year that relates to fitting hearing aids. Sometimes we talk about features, sometimes selection and verification, and other times, like last year, we gather a group of “Knights” at a round table and talk about products. This year we’re going to visit the “pre-test world” of the overall hearing aid fitting process. There we will consider what tests might provide useful information prior to the fitting of amplification. Usually we’re thinking in terms of new hearing aid users, but it’s reasonable to think that experienced users would benefit from pretesting too. There are some commonly conducted pre-tests, such as the pure-tone audiogram, immittance, and wordrecognition testing. These, however, really are part of the diagnostic battery, and are routinely conducted even on people who are not hearing aid candidates. What I’m referring to are pre-tests that are specifically conducted to assist in the selection and fitting of hearing aids. This could involve measures of loudness discomfort, speech understanding, noise annoyance, central auditory processing, cognitive function, expectations of hearing aid performance, or even personality assessment. With so many tests, which do we do? Pre-testing takes time, and we all know Benjamin Franklin’s adage, “Time is money.” However, we must also remember the advice of Mark Twain: “Always do right. This will gratify some people and astonish the rest.” All “Best Practice” guidelines discuss the importance of pre-testing. But what is the “right” amount of pre-testing to conduct? One could write a Cover Story about any one of the different areas of pre-testing. For now, I’m going to focus on three different speech-in-noise tests. On the surface, they might seem similar, yet research suggests that they assess different patient attributes—attributes that just might impact on hearing aid use, benefit, and satisfaction. The tests I’m referring to are the QuickSIN (SIN = Speech In Noise), the Acceptable Noise Level (ANL) test, and the Performance-Perceptual Test (PPT), which includes the calculation of the performance/perceptual discrepancy, referred to as the PPDIS. All three tests have been available for clinical use for at least 10 years, and all have been recommended as part of a pre-fitting protocol.

Three pre-tests: What they do and why experts say you should use them more