Development and validation of a digits-in-noise hearing test in Persian

Zadeh, Lina Motlagh; Silbert, Noah H.; Sternasty, Katherine; Moore, David R.

doi:10.1080/14992027.2020.1814969

Cited by 5 publications

(3 citation statements)

References 54 publications

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“…While the slope for the three-digit sequence (18.79 %/dB) agreed with the slopes of most language versions of the DIN (i.e.,15 to 20 %/dB) (Van den Borre et al 2021), it was slightly shallower than the slopes obtained in some other language versions, such as German (19.6 %/dB), French (27.1 %/dB), and South African English (20 %/dB). It is important to emphasize that phonological differences across languages should be considered when comparing DIN SRTs in different languages (Motlagh Zadeh et al 2021). As spectral information is efficiently masked in long-term average speech spectrum-shaped noise, languages that primarily rely on spectral information for speech recognition are expected to have steeper slopes compared with those (e.g., Chinese) relying on temporal information (Xu & Pfingst 2008; Zokoll et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test

Wang,

Wong

2023

Ear &Amp; Hearing

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Objectives: The study aimed to develop and validate the Mandarin digit-in-noise (DIN) test using four digit (i.e., two-, three-, four-, and five-digit) sequences. Test-retest reliability and criterion validity were evaluated. How the number of digits affected the results was examined. The research might lead to more informed choice of DIN tests for populations with specific cognitive needs such as memory impairment. Design: The International Collegium of Rehabilitative Audiology guideline for developing the DIN was adapted to create test materials. The test-retest reliability and psychometric function of each digit sequence were determined among young normal-hearing adults. The criterion validity of each digit sequence was determined by comparing the measured performance of older adult hearing aid users with that obtained from two other well-established sentence-in-noise tests: the Mandarin hearing-in-noise test and the Mandarin Chinese matrix test. The relation between the speech reception thresholds (SRTs) of each digit sequence of the DIN test and working memory capacity measured using the digit span test and the reading span test were explored among older adult hearing aid users. Together, the study sample consisted of 54 young normal-hearing adults and 56 older adult hearing aid users. Results: The slopes associated with the two-, three-, four-, and five-digit DIN test were 16.58, 18.79, 20.42, and 21.09 %/dB, respectively, and the mean SRTs were −11.11, −10.99, −10.56, and −10.02 dB SNR, respectively. Test-retest SRTs did not differ by more than 0.74 dB across all digit sequences, suggesting good test-retest reliability. Spearman rank-order correlation coefficients between SRTs obtained using the DIN across the four digit (i.e., two-, three-, four-, and five-digit) sequences and the two sentence-in-noise tests were uniformly high (r s = 0.9) across all participants, when data from all participants were considered. Results from the digit span test and reading span test correlated significantly with the results of the five-digit sequences (r s = −0.37 and −0.42, respectively) but not with the results of the two-, three-, and four-digit sequences among older hearing aid users. Conclusions: While the three-digit sequence was found to be appropriate for clinical use for assessment of auditory perception, the two-digit sequence could be used for hearing screening. The five-digit sequence could be difficult for older hearing aid users, and with its SRT related to working memory capacity, its use in the evaluation of speech perception should be investigated further. The Mandarin DIN test was found to be reliable, and the findings are in line with SRTs obtained using standardized sentence tests, suggesting good criterion validity.

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Section: Discussionmentioning

confidence: 99%

Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test

Wang,

Wong

2023

Ear &Amp; Hearing

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“…However, the difference was small, and no task difficulty was observed. The type of background noise affects the result of the DIN test in certain conditions [26,27]. Smits et al [28] compared the Dutch DIN test and American-English DIN test for steadystate noise and interrupted noise in NH listeners.…”

Section: Is the K-din Test Affected By Noise Type?mentioning

confidence: 99%

Factors Influencing the Korean Version of the Digit-in-Noise Test

et al. 2023

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Background and Objectives:The digits-in-noise (DIN) test was developed as a simple and time-efficient hearing-in-noise test worldwide. The Korean version of the DIN (K-DIN) test was previously validated for both normal-hearing and hearing-impaired listeners. This study aimed to explore the factors influencing the outcomes of the K-DIN test further by analyzing the threshold (representing detection ability) and slope (representing test difficulty) parameters for the psychometric curve fit. Subjects and Methods: In total, 35 young adults with normal hearing participated in the K-DIN test under the following four experimental conditions: 1) background noise (digit-shaped vs. pink noise); 2) gender of the speaker (male vs. female); 3) ear side (right vs. left); and 4) digit presentation levels (55, 65, 75, and 85 dB). The digits were presented using the method of constant stimuli procedure. Participant responses to the stimulus trials were used to fit a psychometric function, and the threshold and slope parameters were estimated according to pre-determined criteria. The accuracy of fit performance was determined using the root-mean-square error calculation. Results: The listener's digit detection ability (threshold) was slightly better with pink noise than with digit-shaped noise, with similar test difficulties (slopes) across the digits. Gender and the tested ear side influenced neither the detection ability nor the task difficulty. Additionally, lower presentation levels (55 and 65 dB) elicited better thresholds than the higher presentation levels (75 and 85 dB); however, the test difficulty varied slightly across the presentation levels. Conclusions: The K-DIN test can be influenced by stimulus factors. Continued research is warranted to understand the accuracy and reliability of the test better, especially for its use as a promising clinical measure.

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“…The first DIN was released as a national hearing test over landline telephone in The Netherlands in 2004 (Smits et al 2004) and had a large-scale uptake of more than 160,000 tests two and a half years after its release (Smits & Houtgast 2005). Many more language and dialect versions of the DIN have been developed, some of which have been offered to the public as either landline or internet-based screening tests (Ozimek et al 2009; Jansen et al 2010; Watson et al 2012; Motlagh Zadeh et al 2021; Van den Borre et al 2021). To increase global accessibility, including low- and middle-income countries, newer versions used a downloadable app where the test could be completed on iOS or Android operated smartphone or other mobile devices like the World Health Organization’s official hearing test app, hearWHO (Potgieter et al 2015, 2018; Swanepoel et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Diotic and Antiphasic Digits-in-noise Testing as a Hearing Screening and Triage Tool to Classify Type of Hearing Loss

et al. 2021

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Objectives:The digits-in-noise test (DIN) is a popular self-test measure that has traditionally been used to screen for hearing loss by providing either a pass or refer result. Standard approaches either tested each ear monaurally or used a binaural diotic version where identical digits and noise were presented simultaneously to both ears. Recently, a dichotic, antiphasic version was developed, increasing sensitivity of the DIN to unilateral or asymmetric sensorineural hearing loss (SNHL) and conductive hearing loss (CHL). The purpose of this study was to determine predictors and normative ranges of the antiphasic and diotic DIN and to determine if a combination of diotic and antiphasic DIN could accurately categorize hearing into (1) normal, (2) bilateral SNHL, or (3) unilateral SNHL or CHL. Design:The analytical sample consisted of 489 participants between the ages of 18 and 92 years with varying types, symmetry, and degrees of hearing loss. Degree and type of hearing loss were determined based on standard clinical four-frequency (0.5-4 kHz) pure-tone air and bone conduction threshold averages. The sample consisted of bilateral normal hearing (n = 293), bilateral SNHL (n = 172), unilateral SNHL (n = 42), and CHL (n = 32). All participants (n = 489) first completed an antiphasic DIN (digit stimuli 180° out-of-phase between ears), while 393 of the sample also completed a diotic DIN. Two procedures were assessed for their ability to categorize hearing into one of the three hearing groups. The first used a fixed antiphasic cutoff combined with a cutoff formed by a linear combination of antiphasic and diotic speech recognition threshold (SRT) or binaural intelligibility-level difference.Results: Poorer ear pure-tone average was the strongest predictor of antiphasic DIN score, whereas better ear pure-tone average explained more of the variance in diotic SRT. The antiphasic DIN sensitivity and specificity was 90% and 84%, respectively, for detecting hearing loss, with outstanding area under the receiver operating characteristics values exceeding 0.93 to identify hearing loss in the poorer ear. The first fixed SRT cutoff procedure could categorize 75% of all participants correctly, while the second procedure increased correct categorization to 79%. False negative rates for both procedures were below 10%. Conclusions:A sequential antiphasic and diotic DIN could categorize hearing to a reasonable degree into three groups of (1) normal hearing;(2) bilateral SNHL; and (3) unilateral asymmetric SNHL or CHL. This type of approach could optimize care pathways using remote and contactless testing, by identifying unilateral SNHL and CHL as cases requiring medical referral. In contrast, bilateral SNHL cases could be referred directly to an audiologist, or nontraditional models like OTC hearing aids.

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Development and validation of a digits-in-noise hearing test in Persian

Cited by 5 publications

References 54 publications

Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test

Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test

Factors Influencing the Korean Version of the Digit-in-Noise Test

Diotic and Antiphasic Digits-in-noise Testing as a Hearing Screening and Triage Tool to Classify Type of Hearing Loss

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