Relationship between pure-tone audiogram findings and speech perception among older Japanese persons

Objective: To clarify how the pure-tone threshold (PTT) on the PTA predicts speech perception (SP) in elderly Japanese persons.

Methods: Data on PTT and SP were cross-sectionally analyzed in Japanese persons (656 ears in 353 patients, aged ≥65 years). Correlations of SP and average PTT in all tested frequencies were evaluated by Pearson’s correlation coefficient and simple linear regression. After adjusting for sex, laterality of ears, and age, the relationship of average and frequency-specific PTT with impaired SP ≤50% was estimated by logistic regression models.

Results: SP correlated well (r?=??0.699) with the average PTT of all tested frequencies. On the other hand, the correlation between patient age and SP was weak, especially among ≤85-year-old persons (r?=??0.092). Linear regression showed that the average PTT corresponding to SP of 50% was 76.4?dB nHL. Odds ratios for impaired SP were highest for PTT at 2000?Hz. Odds ratios were higher for middle (500, 1000, 2000?Hz) and high frequencies (4000, 8000?Hz) than low frequencies (125, 250?Hz).

Conclusion: The PTT on the pure-tone audiogram (PTA) is a good predictor of SP by speech audiometry among older persons, which could provide clinically important information for hearing aid fitting and cochlear implantation.     

Construction and evaluation of the Mandarin Chinese matrix (CMNmatrix) sentence test for the assessment of speech recognition in noise

Abstract

Objective: Development of the Mandarin Chinese matrix (CMNmatrix) sentence test for speech intelligibility measurements in noise according to the international standard procedure.

Design: A 50-word base matrix representing the distribution of phonemes and lexical tones of spoken Mandarin was established. Hundred sentences capturing all the co-articulations of two consecutive words were recorded. Word-specific speech recognition functions, speech reception thresholds (SRT: signal-to-noise ratio (SNR), that provides 50% speech intelligibility) and slopes were obtained from measurements at fixed SNRs. The speech material was homogenised in intelligibility by applying level corrections up to ± 2?dB. Subsequently, the CMNmatrix test was evaluated, the comparability of test lists was measured at two fixed SNRs. To investigate the training effect and establish the reference data, speech recognition was measured adaptively.

Study sample: Overall, the study sample contained 80 normal-hearing native Mandarin-speaking listeners.

Results: Multi-centre evaluation measurements confirmed that test lists are equivalent in intelligibility, with a mean SRT of ?10.1?±?0.1?dB SNR and a slope of 13.1?±?0.9 %/dB. The reference SRT is ?9.3?±?0.8 and ?11.2?±?1.2?dB SNR for the open- and closed-set response format, respectively.

Conclusion: The CMNmatrix test is suitable for accurate and internationally comparable speech recognition measurements in noise.     

Early detection of hearing impairment in patients with diabetes mellitus with otoacoustic emission. A systematic review and meta-analysis

Conclusions: The distortion product otoacoustic emission (DPOAE) amplitudes in diabetics were significantly lower than those in controls when pure tone audiometry (PTA) was within normal limits, implying cochlear function impairment in the early stage of diabetes mellitus. Retrocochlear damage was suggested by elongated wave latencies and the wave interval of auditory brainstem response (ABR) in diabetics.

Objectives: This study aimed to systematically analyze the application of DPOAE in evaluation of the hearing function of diabetics.

Data sources and review methods: Eligible articles were identified through searches of nine different electronic databases. Two investigators reviewed the original articles independently, with pre-defined inclusion and exclusion criteria. Meta-analyses were conducted by using Metan module.

Results: There were seven articles eligible for the analysis. PTA thresholds were within normal limits in all diabetics at low–middle frequencies. The mean DPOAE amplitudes of diabetics were significantly lower than those of controls. The standardized mean difference (SMD) (95% CI) was ?0.49 (?0.70, ?0.27), ?0.46 (?0.63, ?0.30), and ?0.60 (?0.77, ?0.43) at 1, 2, and 4?kHz, respectively. The latencies of waves I, III, and V in diabetes were significantly longer than those of controls (0.43 (0.23, 0.64), 0.54 (0.33, 0.75), and 0.56 (0.35, 0.77), respectively). The wave interval I–V was significantly longer in diabetics (p?相似文献   

Investigation of a matrix sentence test in noise: Reproducibility and discrimination function in cochlear implant patients

Abstract

Objective: The aim of this study was to describe common properties (reproducibility, discrimination function, and its steepness) of matrix tests used for cochlear implant (CI) users and to obtain data for the German-language version matrix test, the Oldenburg sentence test (OLSA), presented in noise. Design: The speech reception thresholds (SRT) in noise were measured by means of an adaptive test procedure, and by measurement at various signal-to-noise ratios to determine the course of the entire discrimination function per subject. Study sample: The measurements were performed on 38 CI users fitted with a Cochlear^? Freedom^® or a Cochlear^? Nucleus^® 5 CI system. Results: The test–retest reproducibility showed a significant dependence on the SRT in noise. For the better performers, the test-retest difference was found to be smaller, while for the poorer performers the difference increased. For the better performers, the slope of the discrimination function at SRT (s50) was comparable to that for individuals with normal hearing, while for the poorer performers the s50 tended to be significantly reduced. Conclusions: As the CI users differed significantly in their SRT and their s50, a unified discrimination function for CI users must not be used. Further tailoring of the procedure may be required, especially for poorer CI performers.     

The development and evaluation of the Finnish digit triplet test

Objectives: The aim of the study was to develop a reliable and easily accessible screening test for primary detection of hearing impairment.

Methods: Digits 0–9 were used to form quasirandom digit triplets. First, digit specific intelligibility functions and speech recognition thresholds (SRTs) were determined. To homogenize the test material digits with steep intelligibility function slopes were chosen and level correction up to ±2?dB were applied to the digits as needed. Evaluation measurements were performed to check for systematic differences in intelligibility between the test lists and to obtain normative reference function for normal-hearing listeners.

Results: The mean SRT and the final slope of the test lists were ?10.8?±?0.1?dB signal-to-noise ratio (SNR) and 21.7?±?1.8%/dB, respectively (measurements at constant level; inter-list variability). The mean SRT and slope of the test subjects were ?10.8?±?0.5?dB SNR and 23.4?±?5.2%/dB (measurements at constant level; inter-subject variability). The mean SRT for normal-hearing young adults for a single adaptive measurement is ?9.8?±?0.9?dB SNR.

Conclusion: The Finnish digit triplet test is the first self-screening hearing test in the Finnish language. It was developed according to current standards, and it provides reliable and internationally comparable speech intelligibility measurements.     

Interaction of tinnitus suppression and hearing ability after cochlear implantation

Objectives: To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on.

Methods: Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients’ satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score.

Results: With CI ‘OFF’, 42?CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI ‘ON’ in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI ‘ON’ in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r?=?.674, p?Conclusion: The study suggests six-month CI activation can be effective for suppressing tinnitus. The tinnitus loudness may affect patients’ satisfaction with the use of CI.     

Effects of early intratympanic steroid injection in patients with acoustic trauma caused by gunshot noise

Conclusion: This study evaluated the efficacy of concurrent administration of ITSI and systemic steroids in delayed treatment of NIHL after gunshot noise exposure. The results showed additional hearing benefits with administration of ITSI. Further evaluation is warranted to confirm this efficacy.

Objective: This investigation evaluated the effects of early administration of an intratympanic steroid injection (ITSI) in combination with systemic steroids treatment in patients with acoustic trauma caused by gunshot noise.

Methods: Nineteen patients eligible under the criteria established concerning delayed treatment for noise-induced hearing loss (NIHL) were enrolled in this study. Patients were divided into two groups: those who received prednisolone (PD) only (n?=?8), and those who received PD with ITSI (n?=?11). ITSI treatment was initiated simultaneously alongside systemic PD administration. These patients received ITSI every other day for a total of four treatments. Pure-tone air conduction threshold audiometry, to record the pure-tone average (PTA) at 2, 4, and 8?kHz, was conducted upon each patient’s initial visit, and 1 month after starting treatment, to evaluate the degree of hearing gain (hearing gain (dB)?=?(initial PTA) – (final PTA)).

Results: The initial PTA in PD-only and PD with ITSI groups were 52.75?±?15.50?dB and 50.27?±?12.01?dB, respectively. There were no significant differences in the baseline characteristics of the two groups, which include age and the number of days that treatment was delayed. In the multivariable linear regression analysis, both the initial PTA and the treatment method showed a significant association (R^2?=^?0.41). The unstandardized regression coefficient of the initial PTA was 0.47 (p?=?0.02). Patients with additional ITSI showed significant improvement in the degree of hearing gain compared with the PD-only group (unstandardized regression coefficient =11.48, p?=?0.03)     

Cochlear implantation in recipients with single-sided deafness: Audiological performance

Objective: To examine the auditory benefit of cochlear implants (CI) in patients with single-sided deafness (SSD).

Material and methods: Twenty patients with a normal pure tone audiogram (n?=?8) or moderate hearing loss (n?=?12) in one ear and a CI system MED-EL SONATA/CONCERTO?+?OPUS2 (n?=?12), COCHLEAR CI24RE(ST)?+?CP810 (n?=?7) and Advanced Bionics HiRes90?K?+?Harmony (n?=?1) in the contralateral ear and with at least 6 months of CI experience were tested with respect to directional hearing, speech perception in noise, binaural loudness matching, and binaural pitch matching. Twenty-six normal hearing controls were included for normative reference.

Results: Addition of the CI significantly improves directional hearing (percentage of correct source identifications improved from 14.9 to 15.6%, root mean square error decreased from 125 to 93°) and improves speech perception in noise (speech perception threshold median improved from ?2.3 to ?6.0?dB signal to noise ratio, equivalent to a binaural intelligibility level difference?=?3.7?dB). Alternate binaural loudness balancing showed that matching takes place at levels between 48 and 55?dB HL (group averages). In the pitch matching experiment, the standard deviation of the relative interaural frequency difference at 500, 1000, and 2000?Hz was 24.5, 22.8, and 24.0%, respectively (compared to 11.7, 14.4, and 12.3% in the control group).

Conclusions: In SSD, cochlear implantation considerably improves audiological performance in terms of directional hearing, binaural signal equivalence, and speech perception.     

Diagnostic role of cone beam computed tomography for the position of straight array

Objective: To assess the usefulness of cone beam computed tomography (CBCT) for characterizing electrode insertion and evaluate the influence of electrode insertion status on post-cochlear implantation (CI) outcomes.

Design: Twenty-six ears with post-CI CBCT scans were included. The devices were MED-EL Flex28 (n?=?21) and Nucleus slim straight (n?=?5). The parameters including cochlear duct length (CDL), insertion depth angle (IDA), insertion length of electrode (IL), and cochlear coverage (CC) were analyzed and compared with aided pure-tone threshold (PTA) with implant in free field, and open-set sentence score.

Results: The mean CDL was 36.8?±?1.4?mm. Electrode array was dislocated into scala tympani in two ears. The mean IL and IDA were 26.5?±?1.9?mm and 541.4?±?70.2°. The mean linear CC (IL/CDL, 0.73?±?0.06) was larger than the mean angular CC (IDA/900, 0.60?±?0.08). The CBCT parameters showed correlation one another. While the aided pure-tone threshold was correlated with IL and IDA, there were no significant correlations in the open-set sentence score. For the postlingually deaf patients with single electrode (Flex 28), the sentence score had no significant correlation and the aided PTA was positively correlated with IL (R?=?0.517, p?=?.028).

Conclusions: This study validated the CBCT evaluating the electrode array position. The CBCT could be helpful for the preoperative selection of the optimal array and prediction of the CC.     

Evidence-based guidelines for recommending cochlear implantation for young children: Audiological criteria and optimizing age at implantation

Abstract

Objective: Establish up-to-date evidence-based guidelines for recommending cochlear implantation for young children. Design: Speech perception results for early-implanted children were compared to children using traditional amplification. Equivalent pure-tone average (PTA) hearing loss for cochlear implant (CI) users was established. Language of early-implanted children was assessed over six years and compared to hearing peers. Study sample: Seventy-eight children using CIs and 62 children using traditional amplification with hearing losses ranging 25–120?dB HL PTA (speech perception study). Thirty-two children who received a CI before 2.5 years of age (language study). Results: Speech perception outcomes suggested that children with a PTA greater than 60?dB HL have a 75% chance of benefit over traditional amplification. More conservative criteria applied to the data suggested that children with PTA greater than 82?dB HL have a 95% chance of benefit. Children implanted under 2.5 years with no significant cognitive deficits made normal language progress but retained a delay approximately equal to their age at implantation. Conclusions: Hearing-impaired children under three years of age may benefit from cochlear implantation if their PTA exceeds 60?dB HL bilaterally. Implantation as young as possible should minimize any language delay resulting from an initial period of auditory deprivation.     

Is the digit triplet test an effective and acceptable way to assess speech recognition in adults using cochlear implants in a home environment?

Objectives: To evaluate the validity of the Digit Triplet Test (DTT) in a simulated home environment for measuring speech recognition in adults with cochlear implants by comparing the result to clinic speech perception tests. To evaluate the acceptability of the DTT in adults using cochlear implants.

Methods: A prospective single-centre study with the following outcomes:

??DTT Speech Reception Threshold

??Clinic speech perception tests (BKB sentences in quiet and noise, City University of New York sentences with lip-reading)

??A satisfaction questionnaire to assess patient perception of the DTT

Sixteen people using cochlear implants aged from 43 to 83 years took part.

Results: ??Eighty-eight percent of participants were able to be tested on the DTT; there were no floor or ceiling effects.

??DTT SRT was highly correlated with clinic BKB sentence scores in quiet and adaptive noise, and participants felt positive about using the DTT for home testing.

Conclusion: The majority of adults using cochlear implants in this study were able and willing to use the DTT to test their speech recognition in a simulated home environment. The DTT SRT was highly correlated with traditional clinic sentence scores, supporting its validity as a home test for hearing in adults using cochlear implants. Hearing testing in the clinic is still the gold standard of clinical care for people with cochlear implants, but a home test could provide a useful addition.     

扩展高频畸变产物耳声发射在纯音听阈正常的耳鸣患者中的临床应用

目的 分析纯音听阈正常的耳鸣患者扩展高频畸变产物耳声发射(EHF DPOAE)的特点，探讨在常规纯音检测结果正常情况下，EHF DPOAE发现早期隐匿性听力损失的临床意义。方法 选取常规纯音听阈正常的耳鸣患者68例(104耳)为实验组，对照组为纯音听阈正常无耳鸣症状的志愿者40例(40耳)。两组均用Neuro-Audio耳声发射仪进行常规频率(1～6 kHz)畸变产物耳声发射(DPOAE)测试、EHF DPOAE(8～12 kHz)测试。结果 对照组常规频率DPOAE的平均检出率为97.2%,EHF DPOAE的检出率为88.7%;实验组常规频率DPOAE的检出率为72.2%,EHF DPOAE的检出率为51.2%。实验组EHF DPOAE引出率明显低于对照组EHF DPOAE引出率(P<0.001);实验组EHF DPOAE中振幅值明显低于对照组EHF DPOAE的振幅值(P<0.001);实验组EHF DPOAE的平均信噪比值明显低于对照组EHF DPOAE的平均信噪比值(P<0.001)。结论 在常规纯音听力检测正常的特发性耳鸣患者中，EHF DPOAE的引出率...     

Intratympanic Methylprednisolone as Rescue Therapy in Sudden Sensorineural Hearing Loss

Treatment in sudden sensorineural hearing loss is a contentious issue, today, oral steroids are the most common choice and considered the best treatment option, but the use of intratympanic steroids has become an attractive alternative, especially in cases when systemic therapy fails, or to avoid the side effects of the systemic use of steroids.AimTo describe the results of intratympanic methylprednisolone in idiopathic sudden sensorineural hearing loss after failure of oral prednisolone.MethodsIn a prospective study fourteen patients with idiopathic sudden sensorineural hearing loss were treated with intratympanic methylprednisolone after failing in the treatment with systemic steroids. Pretreatment and post-treatment audiometric evaluations including pure tone average (PTA) and speech reception thresholds (SRT) were analyzed.ResultsTen from 14 patients treated with intra-tympanic methylprednisolone presented with hearing recovery > 20 dB in PTA or 20% in SRT.ConclusionThree intratympanic injections of methylprednisolone improved pure-tone average or speech discrimination scores for a subset of sudden hearing loss subjects that failed to benefit from oral steroids.     

Finite element analysis of auditory characteristics in patients with middle ear diseases

Conclusion: This study validates that a finite element model of the human ossicular chain and tympanic membrane can be used as an effective surgical assessment tool in clinics.

Objective: The present study was performed to investigate the application of a finite element model of ossicular chain and tympanic membrane for fabrication of individualized artificial ossicles.

Methods: Twenty patients (20 ears) who underwent surgery for middle ear disease (n?=?20) and 10 healthy controls (10 ears) were enrolled in the hospital. Computed tomography (CT) and pure tone audiometry were performed before and after surgery. A finite element model was developed using CT scans, and correlation analysis was conducted between stapes displacement and surgical methods. An audiometric test was also performed for 14 patients before and after surgery.

Results: Stapes displacement in the healthy group (average?=?3.31?×?10^?5?mm) was significantly greater than that in the impaired group (average?=?1.41?×?10^?6 mm) prior to surgery. After surgery, the average displacement in the impaired group was 2.55?×?10^?6 mm, which represented a significant improvement. For the patients who underwent the audiometric test, 10 improved hearing after surgery, and stapes displacement increased in nine of these 10 patients.     

Sealing of the round and oval window niches with triamcinolone-soaked fascia as salvage surgical therapy in sudden sensorineural hearing loss

Conclusions: Triamcinolone-soaked fascia seems to show better hearing improvement when added to tympanotomy for sudden idiopathic sensorineural hearing loss (SSHL), compared to fascia round window occlusion without triamcinolone.

Objectives: To analyse if adding triamcinolone to sealing the round and oval window niches with fascia results in improved audiological outcome for acute SNHL.

Methods: Fifty-three patients (27m:43?±?12 years, 26f:45?±?14 years) with acute SSHL ≥50dB over 3 frequencies, who failed primary therapy, underwent transcanal tympanotomy. Twenty-five patients (Group A;cortisone:14m, 11f:46?±?9 years) received sealing of the round and oval window with fascia soaked in triamcinolone (1ml; 40mg/ml) and 28 controls (Group B;no-cortisone:13m, 15f, 42?±?12 years) without triamcinolone. Frequency specific and pure tone average (PTA =500–1000–2000–3000Hz) results were compared between Group A and B pre- and postoperatively.

Results: In Group A the PTA improved by ≥10dB in 21/25(83%) cases; in Group B 18/28(63%). Group A showed a statistically significantly better improvement across all frequencies, while linear regression revealed a significant decrease of posttherapeutic PTA to 94.96% of the initial PTA (p?=?.037). The overall PTA improved by 24dB. Group A improved from 73dB to 41dB(-32dB) PTA, Group B improved from 76dB to 56dB PTA (-20dB) (p?p?相似文献   

Value of pre-operative caloric test in predicting speech perception after cochlear implantation in adults with post-lingual hearing loss

Conclusion: This study shows that, in cochlear implantation (CI) surgery, pre-operative caloric test results are not correlated with post-operative outcomes of dizziness or speech perception.

Objectives: To determine the role of pre-operative caloric tests in CI.

Methods: The records of 95 patients who underwent unilateral CI were reviewed retrospectively. Patients were divided into four groups according to caloric response. Forty-six patients with normal caloric responses were classified as Group A, 19 patients who underwent CI in the ear with worse caloric responses as Group B, 18 patients with bilateral loss of caloric responses as Group C, and 12 patients who underwent CI in the ear with better caloric responses as Group D. Speech performance and post-operative dizziness were compared between the four groups. Speech perception was determined by evaluating consonant-vowel phoneme detection, closed-set word and open-set mono-syllabic and bi-syllabic word identification, and sentence comprehension test scores.

Results: The speech perception and aided pure-tone average (PTA) test results at 3 and 6 months and at 1, 2, and 3 years after implantation were not significantly different between Groups A, B, C, and D (p?>?0.05). Eight patients (8.4%) reported post-operative dizziness, but there was no significant difference between the four groups (p?=?0.627).     

Psychometrically equivalent bisyllabic words for speech recognition threshold testing in Vietnamese

Objective: This study identified, digitally recorded, edited and evaluated 89 bisyllabic Vietnamese words with the goal of identifying homogeneous words that could be used to measure the speech recognition threshold (SRT) in native talkers of Vietnamese. Design: Native male and female talker productions of 89 Vietnamese bisyllabic words were recorded, edited and then presented at intensities ranging from ?10 to 20 dBHL. Logistic regression was used to identify the best words for measuring the SRT. Forty-eight words were selected and digitally edited to have 50% intelligibility at a level equal to the mean pure-tone average (PTA) for normally hearing participants (5.2 dBHL). Study sample: Twenty normally hearing native Vietnamese participants listened to and repeated bisyllabic Vietnamese words at intensities ranging from ?10 to 20 dBHL. Results: A total of 48 male and female talker recordings of bisyllabic words with steep psychometric functions (>9.0%/dB) were chosen for the final bisyllabic SRT list. Only words homogeneous with respect to threshold audibility with steep psychometric function slopes were chosen for the final list. Conclusions: Digital recordings of bisyllabic Vietnamese words are now available for use in measuring the SRT for patients whose native language is Vietnamese.     

Do you hear the noise? The German matrix sentence test with a fixed noise level in subjects with normal hearing and hearing impairment

Objective: The aim of this study was to determine the relationship between hearing loss and speech reception threshold (SRT) in a fixed noise condition using the German Oldenburg sentence test (OLSA). Design: After training with two easily-audible lists of the OLSA, SRTs were determined monaurally with headphones at a fixed noise level of 65 dB SPL using a standard adaptive procedure, converging to 50% speech intelligibility. Study sample: Data was obtained from 315 ears of 177 subjects with hearing losses ranging from ? 5 to 90 dB HL pure-tone average (PTA, 0.5, 1, 2, 3 kHz). Results: Two domains were identified with a linear dependence of SRT on PTA. The SRT increased with a slope of 0.094 ± 0.006 dB SNR/dB HL (standard deviation (SD) of residuals = 1.17 dB) for PTAs < 47 dB HL and with a slope of 0.811 ± 0.049 dB SNR/dB HL (SD of residuals = 5.54 dB) for higher PTAs. Conclusion: The OLSA can be applied to subjects with a wide range of hearing losses. With 65 dB SPL fixed noise presentation level the SRT is determined by listening in noise for PTAs < ～47 dB HL, and above it is determined by listening in quiet.     

Dynamic current focusing for loudness encoding in cochlear implants: a take-home trial

Objective: This study aimed to evaluate a more energy-efficient dynamic current focussing (DCF) speech-processing strategy after long-term listening experience. In DCF, tripolar stimulation is used near the threshold and loudness is controlled by the compensation coefficient σ. A recent acute pilot study showed improved spectral-temporally modulated ripple test (SMRT) scores at low loudness levels, but battery life was reduced to 1.5–4?hours.

Design: Within-subject comparisons were made for the clinical versus. DCF strategy after 5?weeks of at-home usage. Speech intelligibility in noise, spectral ripple discrimination, temporal modulation detection, loudness growth, and subjective ratings were assessed.

Study sample: Twenty HiRes90K (Advanced Bionics, Valencia, USA) cochlear implant (CI) users.

Results: Average battery life was 9?hours with the newly implemented DCF compared to 13.4?hours with the clinical strategy. Compared with measurements made at the beginning of the study, SMRT-scores and speech intelligibility in noise were significantly improved with DCF. However, both measures suffered from unexpected learning effects over time. The improvement disappeared and speech intelligibility in noise declined significantly relative to the final control measurement with the clinical strategy.

Conclusion: Most CI users can adapt to the DCF strategy in a take-home setting. Although DCF has the potential to improve performance on the SMRT test, learning effects complicate the interpretation of the current results.     

Internationally comparable screening tests for listening in noise in several European languages: The German digit triplet test as an optimization prototype

Abstract

Objective: A review is given of internationally comparable speech-in-noise tests for hearing screening purposes that were part of the European HearCom project. This report describes the development, optimization, and evaluation of such tests for headphone and telephone presentation, using the example of the German digit triplet test. In order to achieve the highest possible comparability, language- and speaker-dependent factors in speech intelligibility should be compensated for. Materials and methods: The tests comprise spoken numbers in background noise and estimate the speech reception threshold (SRT), i.e. the signal-to-noise ratio (SNR) yielding 50% speech intelligibility. Results: The respective reference speech intelligibility functions for headphone and telephone presentation of the German version for 15 and 10 normal-hearing listeners are described by a SRT of ?9.3?±?0.2 and ?6.5?±?0.4 dB SNR, and slopes of 19.6 and 17.9%/dB, respectively. Reference speech intelligibility functions of all digit triplet tests optimized within the HearCom project allow for investigation of the comparability due to language specificities. Conclusions: The optimization criteria established here should be used for similar screening tests in other languages.