J Am Acad Audiol 2001; 12(01): 15-36
DOI: 10.1055/s-0041-1741116
Original Article

Clinical Application of the SADL Scale in Private Practice II: Predictive Validity of Fitting Variables

Holly Hosford-Dunn
Tai Inc., Tucson, Arizona
Jerry Halpern
Department of Biostatistics, Stanford University, Stanford, California
› Author Affiliations


Predictive validity of 44 independent variables and their interactions with Satisfaction with Amplification in Daily Life (SADL) scores was assessed. SADL scores were influenced by patient age, years of hearing aid experience, hours of use per day, perceived hearing difficulty, pure-tone average, hearing aid style, processor type, and manufacturer's invoice cost. The relative importance of these variables to SADL measures was complex and very small, but the variables and their squares and interactions improved r2 predictions of SADL Global and subscale scores in a separate stepwise multiple linear regression procedure by 12 to 33 percent compared to SADL norms alone. More research with additional variables is needed to develop a clinically useful model for predicting wearer satisfaction. Clinically, SADL scores yield subscale-specific patterns of satisfaction and dissatisfaction that help in intervention planning and serve as graphic "snapshots" of satisfaction status. A series of patient profiles are presented illustrating the potential usefulness of the SADL in predicting hearing aid satisfaction. With its good construct and psychometric properties, the SADL could serve as a gold standard for satisfaction outcomes and a basis for development of a predictive model of hearing aid fitting success.

Abbreviations: ANOVA = analysis of variance, BTE = behind the ear, CIC = completely in the canal, DSP = digital signal processing, ITC = in the canal, ITE = in the ear, PP-SADL = private practice SADL group, PTA = pure-tone average, SADL = Satisfaction with Amplification in Daily Life

Publication History

Article published online:
28 February 2022

© 2001. American Academy of Audiology. This article is published by Thieme.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA


  • Abrams H, Hnath-Chisolm T. (2000). Outcomes. In: Hosford-Dunn HL, Roeser R, Valente M, eds. Audiology Practice Management. New York: Thieme, 69-95.
  • Beamer SB, Grant KW, Walden BE. (2000). Hearing aid benefit in patients with high-frequency hearing loss. J Amer Acad Audiol 11:429-437.
  • Cox RM, Alexander GC. (1999). Measuring satisfaction with amplification in daily life: the SADL scale. Ear Hear 20:306-319.
  • Dillon H, James A, Ginis J. (1997). Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids. J Am Acad Audiol 8:27-43.
  • Dillon H, Birtles G, Lovegrove R. (1999). Measuring the outcomes of a national rehabilitation program: normative data for the Client Oriented Scale of Improvement (COSI) and the Hearing Aid Users Questionnaire (HAUQ). J Am Acad Audiol 10:67-79.
  • Gatehouse S. (1999). Glasgow Hearing Aid Benefit Profile: derivation and validation of a client-centered outcome measure for hearing aid services. J Am Acad Audiol 10:80-103.
  • Gordon-Salant S, Fitzgibbons PJ. (1999). Profile of auditory temporal processing in older listeners. J Speech Lang Hear Res 42:300-311.
  • Hosford-Dunn HL, Baxter JH. (1985). Prediction and validation of hearing aid wearer benefit: preliminary findings. Hear Instr 36:34-41.
  • Hosford-Dunn H, Halpern J. (2000). Clinical application of the Satisfaction with Amplification in Daily Life Scale in private practice I: statistical, content, and factorial validity. J Am Acad Audlol 11:523-539.
  • Huch JL, Hosford-Dunn H. (2000). Inventory of self-report outcome measures of hearing aid use. In: Sandlin R, McCandless G, eds. Hearing and Amplification. 2nd Ed. San Diego: Singular, 489-555.
  • Humes LE. (1999). Dimensions of hearing aid outcomes. J Am Acad Audiol 10:26-39.
  • Jerger J, Mahurin R, Pirozzolo F. (1990). The separability of central auditory and cognitive deficits: implications for the elderly. J Am Acad Audiol 1:116-119.
  • Kochkin S. (1996). Customer satisfaction and subjective benefit with high-performance hearing instruments. Hear Rev 3(12):16-26.
  • Kochkin S. (1999). MarkeTrak V: "Baby Boomers" spur growth in potential market, but penetration rate declines. Hear J 52(l):33-48.
  • Kochkin S. (2000). Quantifying the obvious: the impact of hearing instruments on quality of life. Hear Rev 7(1):6-34.
  • Pichora-Fuller KM, Schneider BA, Daneman M. (1995). How young and old adults listen and remember speech in noise. J Acoust Soc Am 97:593-608.
  • Resnick S. (1998). Breakdown in the fitting process. In: Tobin H, ed. Practical Hearing Aid Selection and Fitting. Washington, DC: Department of Veterans Affairs.
  • Sandridge SA, Newman CW. (1998). Subjective Satisfaction Ratings for Digital Signal Processing Hearing Aids. Paper presented at the American Speech-Language-Hearing Association Annual Convention. San Antonio, TX.
  • Schum D. (1992). Responses of elderly hearing aid users on the Hearing Aid Performance Inventory. J Am Acad Audiol 3:308-314.
  • Schum D. (1999). Perceived hearing aid benefit in relation to perceived need. J Am Acad Audiol 10:40-45.
  • Smedley TC. (1990). Self-assessed satisfaction levels in elderly hearing aid, eyeglass, and denture wearers. Ear Hear 11 (Suppl 5):41S-47S.
  • Sweetow RW. (1999). Counseling: it's the key to successful hearing aid fittings. Hear J 52(3):10-17.
  • Van Vliet D. (2000). Hide and seek. Hear J 53(1):88.