The audiogram only captures detection thresholds and fails to predict real-world speech perception

Evidence

The audiogram, as a representation of hearing abilities, has a great deal of historical impact, and it has essentially been used in the same form for almost a century now. We should recognize, however, that the audiogram is grossly limited in its ability to characterize how well a particular patient might understand speech in a noisy or complex situation. Because it can only characterize perceptual abilities at the detection threshold level, it is not a terribly useful tool for assessing perception at other levels. I would suggest that a focus of the next century could be the development of better tools and metrics that identify the specific deficits experienced by listeners, with thought toward using that information to determine which rehabilitation options may be the most beneficial to individual patients. — Jennifer Lentz, Psychoacoustics- Perception of Normal…, 115

Categorization

• QUESTION: What candidate replacement metrics exist — speech-in-noise tests, psychoacoustic tuning curves, temporal processing measures — and which shows clinical promise?
• SEED: An essay or professional piece arguing that clinical audiology’s century-old gold standard measures thresholds rather than the abilities that actually matter to patients.