Difference in SII provided by initial fit and NAL-NL2 and its relation to self-reported hearing aid outcomes

Sreeram K. Narayanan*, Palle Rye, Sabina Storbjerg Houmøller, Anne Wolff, Dan Dupont Hougaard, Michael Gaihede, Jesper Hvass Schmidt, Dorte Hammershøi

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


OBJECTIVE: The speech intelligibility index (SII) is used to quantify the audibility of the speech. This study examined the relationship between self-reported hearing aid (HA) outcomes and the difference in aided SII (SIIA) calculated from the initial fit (IF) gain and that prescribed as per the second generation of National Acoustic Laboratory Non-Linear (NAL-NL2).

DESIGN: A prospective observational study.

STUDY SAMPLE: The study included 718 first-time and 253 experienced HA users. All users had a valid real-ear measurement (REM) at three input levels (55, 65 and 80 dB SPL).

RESULTS: The gain provided by IF was lower than NAL-NL2 at 55 and 65 dB SPL. IF gain exhibited reduced compression than NAL-NL2 as input levels increased from 55 to 80 dB SPL. On average, the SIIA provided by IF was significantly lower than that for NAL-NL2 at all input levels. The difference in SIIA between IF and NAL-NL2 at 80 dB SPL input level with 0 dB signal-to-noise ratio (SNR) turned out to be a predictor for self-reported outcome for first-time HA users.

CONCLUSION: The study suggests that an SIIA close to that provided by NAL-NL2 at high input levels would be preferred to obtain a better self-reported outcome. .

Original languageEnglish
JournalInternational Journal of Audiology
Number of pages8
Publication statusE-pub ahead of print - 19 Dec 2023


  • Gain prescription
  • hearing aids
  • self-reported outcome
  • speech intelligibility index


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