Over 360 million people worldwide suffer from disabling hearing loss. Most of them can be treated with hearing aids. Unfortunately, performance with hearing aids and the benefit obtained from using them vary widely across users. Here, we investigate the reasons for such variability. Sixty-eight hearing-aid users or candidates were fitted bilaterally with nonlinear hearing aids using standard procedures. Treatment outcome was assessed by measuring aided speech intelligibility in a time-reversed two-talker background and self-reported improvement in hearing ability. Statistical predictive models of these outcomes were obtained using linear combinations of 19 predictors, including demographic and audiological data, indicators of cochlear mechanical dysfunction and auditory temporal processing skills, hearing-aid settings, working memory capacity, and pretreatment self-perceived hearing ability. Aided intelligibility tended to be better for younger hearing-aid users with good unaided intelligibility in quiet and with good temporal processing abilities. Intelligibility tended to improve by increasing amplification for low-intensity sounds and by using more linear amplification for high-intensity sounds. Self-reported improvement in hearing ability was hard to predict but tended to be smaller for users with better working memory capacity. Indicators of cochlear mechanical dysfunction, alone or in combination with hearing settings, did not affect outcome predictions. The results may be useful for improving hearing aids and setting patients’ expectations.

Differentiating the relative importance of the various contributors to the audiometric loss (HL(TOTAL)) of a given hearing impaired listener and frequency region is becoming critical as more specific treatments are being developed. The aim of the present study was to assess the relative contribution of inner (IHC) and outer hair cell (OHC) dysfunction (HL(IHC) and HL(OHC), respectively) to the audiometric loss of patients with mild to moderate cochlear hearing loss. It was assumed that HL(TOTAL) = HL(OHC) + HL(IHC) (all in decibels) and that HL(OHC) may be estimated as the reduction in maximum cochlear gain. It is argued that the latter may be safely estimated from compression threshold shifts of cochlear input/output (I/O) curves relative to normal hearing references. I/O curves were inferred behaviorally using forward masking for 26 test frequencies in 18 hearing impaired listeners. Data suggested that the audiometric loss for six of these 26 test frequencies was consistent with pure OHC dysfunction, one was probably consistent with pure IHC dysfunction, 13 were indicative of mixed IHC and OHC dysfunction, and five were uncertain (one more was excluded from the analysis). HL(OHC) and HL(IHC) contributed on average 60 and 40 %, respectively, to the audiometric loss, but variability was large across cases. Indeed, in some cases, HL(IHC) was up to 63 % of HL(TOTAL), even for moderate losses. The repeatability of the results is assessed using Monte Carlo simulations and potential sources of bias are discussed.