We compared the accuracy of seven methods of hearing loss prediction by the acoustic reflex in 60 subjects. The methods were two versions of Sensitivity Prediction by Acoustic Reflex, four regression equations, and the bivariate plot coordinate system. Accuracy of hearing loss prediction exceeded 60% for all methods. In general, the bivariate plot system most accurately identified hearing loss. Regression equations tended to under estimate loss. Sensitivity prediction by the acoustic reflex and the bivariate plot system tended to over predict loss. Accuracy of prediction was usually reduced in older subjects and in subjects with minor immittance abnormalities. The effect of age and immittance abnormalities, however, varied among methods.Address reprint requests to James W. Hall,