Does the acceptable noise level (ANL) predict hearing-aid use?

Objective: It has been suggested that individuals have an inherent acceptance of noise in the presence of speech, and that different acceptance of noise results in different hearing-aid (HA) use. The acceptable noise level (ANL) has been proposed for measurement of this property. It has been claimed that the ANL magnitude can predict hearing-aid use patterns. Many papers have been published reporting on different aspects of ANL, but none have challenged the predictive power of ANL. The purpose of this study was to discuss whether ANL can predict HA use and how more reliable ANL results can be obtained. Design: Relevant literature regarding the ANL was found on Medline, Embase, and Google Scholar. Additional information was found as references in the included papers and through personal contacts, for instance when attending audiology conferences. Study sample: Forty-five papers published in peer reviewed journals as well as a number of papers from trade journals, posters and oral presentations from audiology conventions. Conclusions: An inherent acceptance of noise in the presence of speech may exist, but no method for precise measurement of ANL is available. The ANL model for prediction of HA use has yet to be proven valid.