QuickSIN™ Speech-in-Noise Test

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QuickSIN™ Speech-in-Noise Test

Quick Overview

The QuickSIN is a speech-in-noise test that quickly and easily measures the ability to hear in noise.

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Purpose of the QuickSIN™

The QuickSIN is a speech-in-noise test that quickly and easily measures the ability to hear in noise. Speech understanding in noise cannot be reliably predicted from the pure tone audiogram or other standard audiometric tests. The QuickSIN test should be used on all adult patients as part of the audiometric test battery.

Advantages of the QuickSIN™

  • Quick and easy to administer and score
  • Results can be used to make specific treatment recommendations (e.g., hearing aids, directional microphones, array microphones, FM systems)
  • Useful for counseling patients regarding realistic expectations
  • High face validity; patients report that QuickSIN lists sound just like the problem they have in the real world

Instructions For Use


QuickSIN Methodology

The QuickSIN is comprised of sentences recorded in four-talker babble. It represents a realistic simulation of a social gathering, in which the listener may "tune out" the target talker and "tune in" one or more of the background talkers. Each of the twelve QuickSIN lists has six sentences, one sentence at each signal-to-noise ratio (SNR) of 25, 20, 15, 10, 5, and 0 dB. These SNRs encompass the range of normal to severely impaired performance in noise. Each sentence has five key words that are scored as correct/incorrect. A single QuickSIN list takes approximately one minute to administer and score. The QuickSIN manual contains reliability data based on the number of lists administered.


  • Connect a CD player to the speech circuit of the audiometer.
  • Using the calibration tone on Track 1, adjust both channels of the audiometer to read 0 VU.
  • Present the test through earphones or in a sound field with the attenuator set to 70 dB HL. For subjects with PTA hearing losses greater than 45 dB HL, set the attenuator to a level that is "Loud, but OK."
  • Test monaurally or binaurally. Insert earphones (ER•3A or ER•5A) are recommended for monaural testing; their high interaural attenuation typically makes masking of the non-test ear unnecessary.


  • Administer a practice list to familiarize the patient with the task.
  • Instruct the patient to repeat the sentences spoken by the target talker.
  • Score the five key words in each sentence, giving one point for each word repeated correctly. Calculate SNR Loss using the formula on the score sheets.
  • Use of several lists is recommended; when administering more than one list, average the SNR Loss scores across lists.

For more detailed information, see the QuickSIN Manual.

What is SNR Loss?

SNR loss is the increased signal-to-noise ratio required by an individual to understand speech in noise, as compared to normal performance. A normal-hearing person requires about +2 dB SNR (target talker 2 dB louder than background babble talkers) to correctly repeat 50% of the key words on the QuickSIN test. We call this the SNR-50. A hearing-impaired person who requires the target speech to be 12 dB higher than the noise to achieve a 50% correct score would have a 10 dB SNR loss.

QuickSIN scores are reported in SNR loss because it is substantially independent of calibration and test material. Calibration and/or test material differences that affect the SNR-50 values equally for normal and hearing-impaired subjects will "cancel out" in the SNR loss calculation.

SNR Loss Solutions

Hearing aids (regardless of the type of signal processing they use) cannot improve the SNR for the most commonly encountered difficult listening situation, i.e., when what the listener wants to hear is speech, and what the listener doesn't want to hear is also speech. SNR improvement can be provided by directional hearing aid microphones, array microphones, and FM systems. The QuickSIN test can be used to determine which, if any, of these technologies is appropriate for a given patient, as well as to counsel the patient regarding realistic expectations from a given technology.

Separated Speech & Noise Channel Recordings

Separated Speech & Noise Channel Recordings

Separated Speech & Noise Channels

Tracks 24-35 on the QuickSIN CD contain the 12 standard QuickSIN lists, with the speech and four-talker babble recorded on separate channels:

Channel 1: Target Speech
Channel 2: Four-Talker Babble
  • These lists can be used in the sound field to demonstrate the ability of directional microphone hearing aids to reduce sound from the sides and rear.
  • When comparing two conditions, administering two lists in each condition (four total) will provide a valid comparison to an accuracy of 1.8 dB at the 80% confidence level.

For more detailed information, see the QuickSIN Manual.

Filtered Recordings

High-Frequency Filtered (HFE) and Low-Pass (HFE-LP) Lists

Data on patients with ski-slope hearing loss indicate some of these individuals benefit from extended high frequency amplification (full bandwidth response), while others perform poorer with a full bandwidth response.

HFE recordings

  • High frequency emphasis was added to the QuickSIN recordings using the gain values prescribed by the FIG6 fitting formula for 65 dB inputs, using an audiogram with a 60-70 dB ski-slope loss.

HFE-LP recordings

  • The HFE-LP recordings were generated by low-pass filtering the HFE recordings with a brickwall filter set at 2.5 kHz.
Prescribed Gain For Conversational Speech

By comparing the results obtained with the HFE and HFE-LP lists, it may be possible to determine whether or not extended high frequency amplification is useful for an individual having a ski-slope hearing loss. When comparing HFE and HFE-LP conditions, administering two lists in each condition (four total) will provide a valid comparison to an accuracy of 1.8 dB at the 80% confidence level.

For more detailed information, see the QuickSIN Manual.

CPT Codes

CPT Codes for Speech-in-Noise Tests

At present, no CPT code exists for speech-in-noise tests. Practitioners who submit for reimbursement use CPT 92700 (Unlisted ENT Service or Procedure). Using this code requires a narrative describing the procedure and its purpose, as well as substantiation from the literature.

  • Reimbursement is typically fair.
  • If the third-party payer is a private carrier (such as a PPO), the practitioner could meet with the insurance company to negotiate a fee for the procedure. The insurance company would then assign its own code for this procedure.
  • Alternatively, the practitioner may choose to bill the patient for the procedure as a non-covered benefit, providing they discuss the charges with the patient prior to testing.


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