Evaluating the user-operated audible contrast threshold test as a language-independent proxy of speech-in-noise perception

OBJECTIVE: This study aimed to evaluate the user-operated audible contrast threshold (U-ACT) test as an automated, language-independent proxy for the manual ACT test and for aided speech-in-noise perception. DESIGN: An equivalence study was conducted where U-ACT results were compared to manual ACT results and aided speech reception thresholds (SRTs) measured with the Hearing in Noise Test (HINT). Agreement between U-ACT and ACT was assessed using intraclass correlation (ICC), while the relationship with SRTs was evaluated using Pearson's correlation. STUDY SAMPLE: Thirty adults (aged 46-78) with hearing loss were recruited from a university hospital clinic. Participants were selected to ensure variation in audiometric thresholds and speech discrimination scores, representing a clinically diverse population. RESULTS: U-ACT demonstrated excellent agreement with the manual ACT test (ICC = 0.87). U-ACT also showed a strong and significant correlation with aided speech-in-noise perception (r = 0.69). This correlation was identical to that observed for the manual ACT test, indicating equivalent predictive validity. CONCLUSION: U-ACT is a reliable user-operated test that serves as an effective proxy for speech-in-noise perception. As an automated, language-independent measure of supra-threshold hearing ability, U-ACT can be implemented in audiology clinics to improve efficiency and support personalised hearing rehabilitation.