Automated Screening for High-Frequency Hearing Loss

Abstract

Objective:Hearing loss at high frequencies produces perceptual difficulties and is often an early sign of a more general hearing loss. This study reports the development and validation of two new speech-based hearing screening tests in English that focus on detecting hearing loss at frequencies above 2000 Hz.Design:The Internet-delivered, speech-in noise tests used closed target-word sets of digit triplets or consonant–vowel–consonant (CVC) words presented against a speech-shaped noise masker. The digit triplet test uses the digits 0 to 9 (excluding the disyllabic 7), grouped in quasi-random triplets. The CVC test uses simple words (e.g., “cat”) selected for the high-frequency spectral content of the consonants. During testing, triplets or CVC words were identified in an adaptive procedure to obtain the speech reception threshold (SRT) in noise. For these new, high-frequency (HF) tests, the noise was low-pass filtered to produce greater masking of the low-frequency speech components, increasing the sensitivity of the test for HF hearing loss. Individual test tokens (digits, CVCs) were first homogenized using a group of 10 normal-hearing (NH) listeners by equalizing intelligibility across tokens at several speech-in-noise levels. Both tests were then validated and standardized using groups of 24 NH listeners and 50 listeners with hearing impairment. Performance on the new high frequency digit triplet (HF-triplet) and CVC (HF-CVC) tests was compared with audiometric hearing loss, and with that on the unfiltered, broadband digit triplet test (BB-triplet) test, and the ASL (Adaptive Sentence Lists) speech-in-noise test.Results:The HF-triplet and HF-CVC test results (SRT) both correlated positively and highly with high-frequency audiometric hearing loss and with the ASL test. SRT for both tests as a function of high-frequency hearing loss increased at nearly three times the rate as that of the BB-triplet test. The intraindividual variability (SD) on the tests was about 2.1 (HF-triplet) and 1.7 (HF-CVC) times less than that for the BB-triplet test. The effect on the HF-triplet test of varying presentation method (professional or cheap headphones and loudspeakers) was small for the NH group and somewhat larger, but nonsignificant for the hearing-impaired group. Test repetition produced a moderate, significant learning effect for the first and second retests, but was small and nonsignificant for further retesting. The learning effect was about two times larger for the HF-CVC test than for the HF-triplet test. The sensitivity of both new tests for high-frequency hearing loss was similar, with an 87% true-positive and 7% false-positive ratio for detecting an average high-frequency hearing loss of 20 dB or more.Conclusions:The new HF-triplet and HF-CVC tests provide a sensitive and accurate method for detecting high-frequency hearing loss. The tests may signal developing hearing impairment at an early stage. The HF-triplet is preferred over the HF-CVC test because of its smaller learning effect, smaller error rate, greater ...

Laboratory evaluation of an optimised internet-based speech-in-noise test for occupational high-frequency hearing loss screening: Occupational Earcheck

“…Vlaming et al (2014) reported a similar correlation with PTA HF of 0.79, and 0.82, for the high frequency triplet and CVC tests, respectively. Jansen et al (2014) compared the broadband French digit triplet test (DTT) with a CVC test in standard speech-shaped noise, and with the CVC test in a LP filtered masking noise.…”

“…The discriminative power of LP 3 was also reflected in the highest values for sensitivity and specificity, respectively 93 and 94%. The results can be well compared with the results of Vlaming et al (2014). They developed two high frequency (HF) tests, both with a LP filtered speech shaped noise masker, one using digit triplets, and one using CVC words.…”

“…Possible adaptions include adjusting the root mean square levels of the words to achieve equal intelligibility, and filtering of the masking noise. Previous work suggested that a test with a spectrally filtered masking noise better distinguishes between normal-hearing (NH) and hearing-impaired (HI) listeners (Leensen et al, 2011b;Jansen et al, 2014;Vlaming et al, 2014). A stationary low-pass (LP) filtered masker stimulates the use of high-frequency speech information, which is advantageous for NH listeners.…”

“…50%) of the speech material is correctly identified. Over the past few years several telephone-and internet-based speech-in-noise selftests have been developed in various languages, with different purposes, and aimed at various populations (Smits et al, 2004(Smits et al, , 2006Jansen et al, 2010;Leensen et al, 2011a;Watson et al, 2012;Mollander et al, 2013;Paglialonga et al, 2014;Vlaming et al, 2014;Williams-Sanchez et al, 2014). These tests differ in important test characteristics such as speech stimuli, type of background noise and test procedure.…”

Development and validation of a smartphone-based digits-in-noise hearing test in South African English

“…A correction factor was calculated by subtracting this SNR from the average SNR of all digits (Vlaming et al, 2014). The correction factors were applied to the digits to align the 50% correct recognition probabilities for all the digits.…”