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J Am Acad Audiol. 2012 Jul-Aug;23(7):534-41.

Intertester reliability of the acceptable noise level.

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  • 1Department of Speech Language Pathology and Audiology, University of South Alabama, Mobile, AL 36688-002, USA.



The acceptable noise level (ANL) serves to accurately predict the listener's likelihood of success with amplification. It has been proposed as a pre-hearing aid fitting protocol for hearing aid selection and counseling purposes. The ANL is a subjective measure of the listener's ability to accept background noise. Measurement of ANL relies on the tester and listener to follow the instructions set forth. To date, no research has explored the reliability of ANL as measured across clinicians or testers.


To examine the intertester reliability of ANL.


A descriptive quasi-experimental reliability study was completed. ANL was measured for one group of listeners by three testers.


Three participants served as testers. Each tester was familiar with basic audiometry. Twenty-five young adults with normal hearing served as listeners.


Each tester was stationed in a laboratory with the needed equipment. Listeners were instructed to report to these laboratories in a random order provided by the experimenters. The testers assessed most comfortable listening level (MCL) and background noise level (BNL) for all 25 listeners.


Intraclass correlation coefficients were significant and revealed that MCL, BNL, and ANLs are reliable across testers. Additionally, one-way ANOVAs for MCL, BNL, and ANL were not significant. These findings indicate that MCL, BNL, and ANL do not differ significantly when measured by different testers.


If the ANL instruction set is accurately followed, ANL can be reliably measured across testers, laboratories, and clinics. Intertester reliability of ANL allows for comparison across ANLs measured by different individuals. Findings of the present study indicate that tester reliability can be ruled out as a factor contributing to the disparity of mean ANLs reported in the literature.

American Academy of Audiology.

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