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Quick Speech in Noise (QuickSIN)

Table of contents

1. What is the QuickSIN test?
2. Background
3. Required equipment
4. QuickSIN test procedure
5. Aided QuickSIN
6. QuickSIN results

What is the QuickSIN test?

The QuickSIN test provides an estimate of signal-to-noise (SNR) ratio loss in one minute. A list of six sentences with five key words per sentence is presented in four-talker babble noise. The sentences are presented at pre-recorded SNR ratios which decrease in 5-dB steps from 25 (very easy) to 0 (very difficult). These SNR ratios range from normal to severely impaired performance in noise.

Background

Difficulty with hearing in noise is a common complaint among hearing aid users.

Thus, the measurement of SNR loss is important, as you cannot determine a person’s ability to understand speech in noise based on the pure tone audiogram alone.

The QuickSIN test was developed to:

1. Provide a one-minute estimate of SNR loss
2. Provide a quick way for clinicians to quantify a patient’s ability to hear in noise
3. Determine if extended high frequency emphasis improves or degrades understanding of speech in noise
4. Assist professionals in choosing appropriate amplification and other assistive technologies
5. Show that hearing aids with directional microphones improve speech intelligibility in noise
6. Provide many similar test lists for use in clinical and research work
7. Provide information useful in counseling patients and managing their expectations

Required equipment

1. Headphones, insert phones, or a free field speaker
2. Standalone AC40/AD629/AA222, or in hybrid mode using Diagnostic Suite

QuickSIN test procedure

Figure 1: QuickSIN test screen.

The test is outlined below step-by-step, using the above-mentioned equipment, and with references to Figure 1 throughout.

1. Select QuickSIN

Press and hold the ‘Tests’ button and use the black scroll wheel to select QuickSIN.

2. Wave file

The audiometer will default to ‘Wave file’.

Press and hold ‘List’ to select the desired wave file.

You can use practice lists A, B, and C to familiarize with the test.

3. How to instruct your patient

You can use the script below for inspiration:

“Imagine that you are at a party. There will be a woman talking and several other talkers in the background. The woman’s voice is easy to hear at first, because her voice is louder than the others. Repeat each sentence the woman says. The background talkers will become louder, making it difficult to understand the woman’s voice, but please guess and repeat as much of each sentence as possible.”

It may help to stress to the client to repeat anything they have heard, even if they have only heard one word from the sentence, as this may improve their score.

4. Presentation level

You may choose your own preferred test level.

We recommend 70 dB HL in clients with a pure-tone average (PTA) of 45 dB or below.

In clients with a PTA of 50 dB or above, you will need to exceed 70 dB HL without testing at an uncomfortable level for your client.

5. Begin the test

Press the play button to begin the test.

6. Scoring

In each list there are 6 sentences, each with 5 key words highlighted in bold.

You must score the client on how many of these key words the client correctly repeats back to you.

Thus, you can either score 0, 1, 2, 3, 4, or 5.

Once you have scored a sentence, the next sentence will be presented automatically.

7. Final score

Once you have scored all 6 sentences, you will get an SNR loss in dB.

You can use this to categorize the degree of SNR loss and for expected improvements with directional microphones.

More on this below.

8. Store the results

Save the QuickSIN test by clicking the ‘Save Session’ button.

9. Bonus step: Averaging

Averaging several QuickSIN lists (only lists 1-12 at the same intensity level) will improve the reliability of the results.

This will be particularly useful when comparing aided versus unaided or before versus after hearing aid adjustments.

Aided QuickSIN

It is possible to do an aided QuickSIN when using the audiometer via Diagnostic Suite, given the audiometer is free field calibrated.

Aided versus unaided is a useful tool to test the benefit of a hearing aid treatment in noisy environments.

To activate the aided function, select ‘Free Field’ as the transducer.

Click on the aided button (ear with hearing aid) to add an extra column to the scoring table.

You can see what this looks like in the next section.

QuickSIN results

The SNR loss is 25.5 minus the total score (Figure 2).

Figure 2: QuickSIN results.

You can then categorize the SNR loss based on Table 1, which also shows the expected improvements with directional microphones.

Table 1: SNR loss definitions.