title: The effect of repeated measurements and working memory on the most comfortable level in the ANL test.
abstract: OBJECTIVE
  To study the effect of a large number of repetitions on the most comfortable level (MCL) when doing the acceptable noise level (ANL) test, and explore if MCL variability is related to central cognitive processes.
  
  
  METHODS
  Twelve MCL repetitions were measured within the ANL test using interleaved methodology during one session using a non-semantic version. Phonological (PWM) and visuospatial working memory (VSWM) was measured.
  
  
  METHODS
  Thirty-two normal-hearing adults.
  
  
  RESULTS
  Repeated measures ANOVA, intraclass correlations, and the coefficient of repeatability (CR) were used to assess the repeatability. Repeated measures ANOVA and CR indicated poor agreement between the two first repetitions. After excluding the first repetition, analyses showed that the MCL in the ANL test is reliable. A negative association was found between PWM and MCL variability indicating that subjects with higher PWM show less variability.
  
  
  CONCLUSIONS
  The findings suggest that, after excluding the first repetition, the MCL in the ANL test is reliable. A single repetition of the MCL in the ANL test should be avoided. If an interleaved methodology is used, a single ANL repetition should be added prior to the actual testing. The findings also suggest that MCL variability is associated to PWM but not VSWM.
authors.affiliation: * Department of Logopedics, Phoniatrics and Audiology, Clinical Sciences, Lund University , Sweden.
authors.forename: K Jonas
authors.initials: KJ
authors.lastname: Brännström
authors.forename: Steen Østergaard
authors.initials: SØ
authors.lastname: Olsen
authors.forename: Lucas
authors.initials: L
authors.lastname: Holm
authors.forename: Tobias
authors.initials: T
authors.lastname: Kastberg
authors.forename: Tina
authors.initials: T
authors.lastname: Ibertsson
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone / Q000523:psychology; D001302:Audiometry, Speech / Q000379:methods; D001309:Auditory Threshold; D005260:Female; D006309:Hearing; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D009622:Noise; D010470:Perceptual Masking; D015203:Reproducibility of Results; D013067:Speech Perception
keywords: Most comfortable level; background noise level; coefficient of repeatability; fatigue; order effect; phonological loop; repeated measures; training; visuospatial sketchpad; working memory