Speech-in-noise screening tests by internet, Part 1: Test evaluation for noise-induced hearing loss identification

Abstract

Abstract

Objective: In the Netherlands three internet-based self-screening tests have been developed; the National Hearing Test (NHT), Earcheck (EC), and Occupational Earcheck (OEC). These tests are adaptive speech-in-noise tests using either digit triplets or monosyllables, presented in stationary speech-shaped noise. These tests can be highly valuable in increasing the awareness and prevention of noise-induced hearing loss (NIHL). This study evaluates these online speech-in-noise tests and investigates their potential to detect NIHL. Design: In a multi-centre study the results of the three online screening tests are compared to pure-tone audiometry and to the Dutch sentence SRT test (), which is considered the clinical standard. Study sample: In total, 49 normal-hearing listeners and 49 patients with different degrees of NIHL participated. Results: The online tests show good reliability, but there is much overlap in outcomes between normal-hearing listeners and participants with early NIHL. In addition, rather low correlations of the test results with both the Dutch sentence SRT test and pure-tone thresholds are found. These findings result in rather low test sensitivity: 54% (NHT) and 51% (EC), or low specificity: 49% (OEC). Conclusions: The online screening tests in their current form are unsuitable to be used for early NIHL screening purposes.

Sumario

Objetivo: Tres pruebas auto-aplicadas de tamiz por internet han sido desarrolladas en Holanda; la Prueba Nacional de Audición (NHT), la prueba Earcheck (EC) y la prueba Earcheck Ocupacional (OEC). Estas son pruebas adaptativas de lenguaje en ruido que utilizan cifras de tres dígitos o monosílabos, presentados en ruido estacionario de configuración lingüística. Estas pruebas pueden tener un alto valor en la concienciación y la prevención de hipoacusia por ruido (NIHL). Este estudio evalúa estas pruebas de lenguaje en ruido hechas por internet e investiga su potencial para detectar NIHL. Diseño: En un estudio multicéntrico los resultados de las tres pruebas de tamiz por internet, son comparados con una audiometría tonal y con la prueba SRT de frases en holandés () que es considerada el estándar clínico. Muestra: Participaron 49 sujetos normoyentes y 49 pacientes con diferentes grados de NIHL. Resultados: Las pruebas por internet mostraron una buena fiabilidad, pero hay mucho traslape entre los resultados entre los normoyentes y los participantes con NIHL incipiente. Adicionalmente se encontró una baja correlación entre los resultados de las pruebas y la prueba SRT de frases en holandés y la audiometría tonal. Estos resultados implican una muy baja sensibilidad de la prueba 54% (NHT) y 51% (EC), o una baja especificidad, 49% (OEC). Conclusiones: las pruebas de tamiz por internet, en su forma actual, no son apropiadas para la detección de NIHL incipiente

Key Words::

• Noise-induced hearing loss
• Speech-in-noise
• Self-screening
• Speech reception threshold
• Prevention

Acknowledgements

The authors would like to thank ZICHT for implementing and adapting the online tests for the experimental purposes. Special thanks to Prof. Ad Snik and Joop Leijendeckers of UMC St Radboud Nijmegen and Jan-Willem van As of the Leids University Medical Centre Leiden, for their contribution in the data collection of this multi-centre study and contribution to this manuscript. This study was funded by Stichting Hoortoestelbranche and Revalidatiefonds via the Dutch National Hearing Foundation.

Note

1. In the case of the measurements in LUMC in the quiet room, ambient noise levels were monitored during the experimental sessions. These levels, in 1/3 octave bands, were compared to ambient noise exposure limits defined in ISO-6189, concerning measurements of pure-tone thresholds for screening purposes down to 0 dB HL. Ambient noise levels exceeded these limits at only one frequency, by only 5 dB. Ambient noise levels are assumed to be sufficiently reduced by the (circum-aural) HDA-headphones, and were thus considered to be of no influence on performing the supra-threshold speech-in-noise tests.

Declaration of interest: The authors report no conflict of interest.