Efficient Hearing Screening in Noise-Exposed Listeners Using the Digit Triplet Test

Jansen, Sofie; Luts, Heleen; Dejonckere, Philippe H.; Wieringen, Astrid Van; Wouters, Jan

doi:10.1097/aud.0b013e318297920b

Cited by 47 publications

(53 citation statements)

References 28 publications

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“…The DTT choice of single digit words promotes easy understanding and the opportunity to ‘fill-in’ missed acoustic information, while steady-state, speech-shaped noise enables masking across the speech range, but does not allow the ‘glimpsing’ that can reduce masking in more complex noise. Overall, DTT performance correlates more closely with PTA than do some other SiN tests [10]. The DTT is reproducible, easy to standardize, available in several languages, does not require a sound booth, and may be delivered through the internet.…”

Section: Introductionmentioning

confidence: 77%

“…These principles were first recognized long ago [4]–[7], as was the finding that speech-in-noise (SiN) hearing ability decreases with age [3], even while the audiogram may remain relatively stable [4]. SiN measures that use familiar speech correlate with the average level of hearing based on the pure-tone audiogram (the ‘pure tone average’, PTA [8]–[10]) and may offer an alternative gold standard more relevant to everyday hearing. Despite much research, SiN hearing has until recently received little attention in large population studies and limited clinical application.…”

Section: Introductionmentioning

confidence: 99%

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Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

et al. 2014

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BackgroundHealthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition.Methods and FindingsAbout half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing.ConclusionsOlder people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.

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Section: Introductionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

et al. 2014

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“…Thresholds at these four frequencies showed the largest effects of hearing loss which can most probably be attributed to excessive noise exposure. Each of these frequencies separately also proved to be a significant predictor for the Digit Triplet SRT (Jansen et al, 2013). In Figure 2 the scatter plot of the SRT versus the PTA 2,3,4,6 is given per speech-in-noise test.…”

Section: The Srt-pta Relationshipmentioning

confidence: 99%

“…As the target of these tests is screening for early signs of high-frequency hearing loss, a higher sensitivity and specificity was expected with broadband stimuli presented through a broadband transducer (Smits et al, 2004;Jansen et al, 2013). For the CVC test, a LP-filtered version of the standard speech-shaped noise of that test was generated as well.…”

Section: Speech Materialsmentioning

confidence: 99%

“…Therefore, two SRTs were calculated per test, one based on the first half of the trials that were normally taken into account for the SRT calculation, and the other based on the second half. The measurement error was then determined as described above, and divided by to correct for the halving of the number of trials used for the calculation of the two SRTs (Smits et al, 2004;Jansen et al, 2013). …”

Section: Measurement Errormentioning

confidence: 99%

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Exploring the sensitivity of speech-in-noise tests for noise-induced hearing loss

Jansen

Luts

Dejonckere

et al. 2013

International Journal of Audiology

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Objective: Recently, the Digit Triplet test was shown to be a sensitive speech-in-noise test for early high-frequency hearing loss in noise-exposed workers. This study investigates if a further improvement is achieved when using a closed set of consonant-vowel-consonant (CVC) speech items with the same vowel, and/or a low-pass (LP) filtered version of the standard speech-shaped noise.Design: Speech reception thresholds in noise were gathered for the Digit Triplet, CVC, and CVC_LP test and compared to the high-frequency pure-tone average (PTA). Study sample: 118 noiseexposed workers showing a wide range of high-frequency hearing losses. Results: For the 84 Dutchspeaking participants, the CVC test showed an increased measurement error and a decreased between-subject variation, leading to a weaker correlation with the PTA 2,3,4,6 (R=0.64) and thus a lower sensitivity compared to the Digit Triplet test (R=0.86). However, the use of LP-filtered noise resulted in a sensitivity improvement (R=0.79 versus R=0.64) due to the large increase in betweensubject spread. Similar trends were found for the 34 French-speaking workers. Conclusions: Using CVC words with the same vowel could not increase the sensitivity to detect isolated high-frequency hearing loss. With LP-filtered noise, test sensitivity improved, but it did not surpass the original Digit Triplet test.

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Accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss: incorporating automatic conditional rescreening

Rashid

Dreschler

2018

Int Arch Occup Environ Health

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PurposeTo validate the accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss (HFHL) ‘Occupational Earcheck (OEC)’ incorporating an automatic conditional rescreening, in an occupationally noise-exposed population. Secondary objectives were to assess the effects of age on test accuracy measures, and to assess the test accuracy for different degrees of HFHL.MethodsA study was conducted on cross-sectional data of occupational audiometric examinations, including the index test OEC and reference standard pure-tone air conduction audiometry, of 80 noise-exposed workers. Sensitivity, specificity, and likelihood ratios were calculated for the OEC, after automatic conditional rescreening, for a younger and an older age group, and for two degrees of HFHL (HFHL25: PTA3,4,6 ≥ 25 dB HL, and HFHL35: PTA3,4,6 ≥ 35 dB HL, both for at least one ear).ResultsTest specificity for HFHL25 after a single test was 63%, and improved to 93% after the automatic conditional rescreen. Test sensitivity for HFHL25 decreased from 65% to 59%. Test sensitivity and specificity including automatic conditional rescreening for HFHL35 was 94% and 90%, respectively. The positive likelihood ratio for HFHL25 was 8.4, and for HFHL35 9.4. The negative likelihood ratio for HFHL35 was below 0.1.ConclusionsThe OEC is an appropriate screening test, especially for HFHL35. Normal-hearing workers who obtained a positive test result for the first test for one or two ears, benefit from having an automatic rescreen, resulting in an improvement of the test specificity, and hence prevent unnecessary referral.

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Efficient Hearing Screening in Noise-Exposed Listeners Using the Digit Triplet Test

Cited by 47 publications

References 28 publications

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

Exploring the sensitivity of speech-in-noise tests for noise-induced hearing loss

Accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss: incorporating automatic conditional rescreening

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