UNASSIGNED: To develop a methodologically uniform digits-in-noise (DIN) test in 17 different languages.
UNASSIGNED: The DIN test was developed for Android devices as an extension to the open-access Hearing Test™ app, available on the Google Play store. It utilised professionally recorded female speech, speech-shaped noise, a digit scoring method and a variable step size. The test was adaptively optimised and evaluated as the results of tests taken online by users of the app became available.
UNASSIGNED: Optimisation using 35,534 ears, evaluation using 6012 ears.
UNASSIGNED: Optimisation improved the slopes of the psychometric functions for all languages by an average of 6.8%/dB. Evaluation included calculation of normative speech reception thresholds (SRTs) and estimation of test-retest standard deviations. Normative values for SRTs ranged from -14.2 dB SNR (95% CI -14.3 to -14.0) for Chinese to -11.2 dB SNR (95% CI -11.3 to -11.1) for Japanese, with reliability estimates ranging from 0.48 dB (95% CI 0.36-0.64) for Portuguese to 0.91 dB (95% CI 0.73-1.21) for Romanian.
UNASSIGNED: The optimisation of each language version was confirmed by the improvement in the slopes of the psychometric functions. The normative values obtained from the test evaluation were in agreement with literature data.
UNASSIGNED: Science Support Centre of Wroclaw Medical University BW-59/2020.

BACKGROUND: This study aimed to verify the influence of speech stimulus presentation and speed on auditory recognition in cochlear implant (CI) users with poorer performance.
METHODS: The cross-sectional observational study applied auditory speech perception tests to fifteen adults, using three different ways of presenting the stimulus, in the absence of competitive noise: monitored live voice (MLV); recorded speech at typical speed (RSTS); recorded speech at slow speed (RSSS). The scores were assessed using the Percent Sentence Recognition Index (PSRI). The data were inferentially analysed using the Friedman and Wilcoxon tests with a 95% confidence interval and 5% significance level (p < 0.05).
RESULTS: The mean age was 41.1 years, the mean duration of CI use was 11.4 years, and the mean hearing threshold was 29.7 ± 5.9 dBHL. Test performance, as determined by the PSRI, was MLV = 42.4 ± 17.9%; RSTS = 20.3 ± 14.3%; RSSS = 40.6 ± 20.7%. There was a significant difference identified for RSTS compared to MLV and RSSS.
CONCLUSIONS: The way the stimulus is presented and the speed at which it is presented enable greater auditory speech recognition in CI users, thus favouring comprehension when the tests are applied in the MLV and RSSS modalities.

UNASSIGNED: The speech reception threshold (SRT), synonymous with the speech recognition threshold, denotes the minimum hearing level required for an individual to discern 50% of presented speech material. This threshold is measured independently in each ear with a repetitive up-down adjustment of stimulus level starting from the initial SRT value derived from pure tone thresholds (PTTs), measured via pure-tone audiometry (PTA). However, repetitive adjustments in the test contributes to increased fatigue for both patients and audiologists, compromising the reliability of the hearing tests.
UNASSIGNED: Determining the first (initial) sound level closer to the finally determined SRT value, is important to reduce the number of repetitions. The existing method to determine the initial sound level is to average the PTTs called pure tone average (PTAv).
UNASSIGNED: We propose a novel method using a machine learning approach to estimate a more optimal initial sound level for the SRT test. Specifically, a convolutional neural network with 1-dimensional filters (1D CNN) was implemented to predict a superior initial level than the conventional methods.
UNASSIGNED: Our approach produced a reduction of 37.92% in the difference between the initial stimulus level and the final SRT value.
UNASSIGNED: This outcome substantiates that our approach can reduce the repetitions for finding the final SRT, and, as the result, the hearing test time can be reduced.

UNASSIGNED: Auditory brainstem response (ABR) is the gold standard for hearing testing in dogs. ABR is commonly used in puppies to diagnose congenital sensorineural deafness. Long test times limit the use for a more comprehensive hearing screening in veterinary practice. This study aimed to establish a super-fast hearing screening protocol in dogs.
UNASSIGNED: Hearing thresholds were routinely measured with a mobile device designed for newborn hearing screening in 90 dogs. We introduced modifications of the ABR protocol, e. g., a binaural test mode, higher stimulus rates, a broadband chirp stimulus, and an algorithm for automatic peak V detection in a stepwise fashion. Hearing thresholds were then measured with fast protocols utilizing either 30 Hz click or 90 Hz broadband chirp stimuli with 80, 60, 40, 30, 20, 10, 0 and -10 dBnHL stimulation intensities. Interrater reliability, agreement between click and chirp hearing thresholds and correlations with clinical characteristics of the dogs were assessed.
UNASSIGNED: Using all innovations, the test time for hearing threshold assessment in both ears was reduced to 1.11 min (mean). The chirp stimulus accentuated both, peak V and the subsequent trough, which are essential features for judgement of the hearing threshold, but preceding peaks were less conspicuous. Interrater reliability and agreement between click and chirp hearing threshold was excellent. Dogs >10 years of age and dogs with abnormal hearing score or otitis score had significantly higher hearing thresholds than younger dogs (p ≤ 0.001) or dogs without abnormalities (p < 0.001).
UNASSIGNED: The results demonstrate that modifications in ABR protocols speed-up test times significantly while the quality of the recordings for hearing threshold assessment is maintained. Modified ABR protocols enable super-fast hearing threshold assessment in veterinary practice.

UNASSIGNED: Approximately 466 million people suffer from hearing loss worldwide, with Indonesia ranking fourth in Southeast Asia. However, conventional pure-tone audiometry is not yet available in many areas because of its high cost. Numerous available smartphone-based audiometry applications are potential alternative screening tools for hearing loss, especially in Indonesia. This study examined the findings on the validation of smartphone-based audiometry applications to assess hearing functions available in Indonesia.
UNASSIGNED: Based on the established eligibility criteria, this study was conducted by browsing the relevant literature validating smartphone-based audiometry applications in Indonesia. Relevant study data, such as the author, year, location, implementation procedures, and outcomes, were extracted and summarized.
UNASSIGNED: This systematic review found 17 relevant and eligible publications. Of the six applications tested, 5 were found to have good validity, such as uHearTM, Audiogram MobileTM, AudCalTM, Hearing TestTM e-audiologia, and WuliraTM. All smartphone-based audiometry was tested only for the air conduction threshold and was influenced by several factors.
UNASSIGNED: Because smartphone-based audiometry is inexpensive, simple, and more accessible than conventional audiometric testing, it can be useful as a screening modality or alternative approach to assess hearing function. Unfortunately, smartphone-based audiometry cannot replace conventional audiometry in diagnosing hearing impairment.

BACKGROUND: Approximately 80% of primary school children in the United States and Europe experience glue ear, which may impair hearing at a critical time for speech acquisition and social development. A web-based app, DigiBel, has been developed primarily to identify individuals with conductive hearing impairment who may benefit from the temporary use of bone-conduction assistive technology in the community.
OBJECTIVE: This preliminary study aims to determine the screening accuracy and usability of DigiBel self-assessed air-conduction (AC) pure tone audiometry in adult volunteers with simulated hearing impairment prior to formal clinical validation.
METHODS: Healthy adults, each with 1 ear plugged, underwent automated AC pure tone audiometry (reference test) and DigiBel audiometry in quiet community settings. Threshold measurements were compared across 6 tone frequencies and DigiBel test-retest reliability was calculated. The accuracy of DigiBel for detecting more than 20 dB of hearing impairment was assessed. A total of 30 adults (30 unplugged ears and 30 plugged ears) completed both audiometry tests.
RESULTS: DigiBel had 100% sensitivity (95% CI 87.23-100) and 72.73% (95% CI 54.48-86.70) specificity in detecting hearing impairment. Threshold mean bias was insignificant except at 4000 and 8000 Hz where a small but significant overestimation of threshold measurement was identified. All 24 participants completing feedback rated the DigiBel test as good or excellent and 21 (88%) participants agreed or strongly agreed that they would be able to do the test at home without help.
CONCLUSIONS: This study supports the potential use of DigiBel as a screening tool for hearing impairment. The findings will be used to improve the software further prior to undertaking a formal clinical trial of AC and bone-conduction audiometry in individuals with suspected conductive hearing impairment.

OBJECTIVE: Sudden hearing loss is a common presentation to ENT. In the authors\' practice, patients often wait many weeks for formal hearing testing. This study aimed to assess whether a tablet-based hearing test, hearTest, could aid clinical decision-making within secondary care ENT.
METHODS: This was a multi-centre, prospective, non-randomised study to assess the feasibility, usability and accuracy of hearTest.
RESULTS: In the sample, hearTest was shown to be an acceptable method of testing for hearing loss by both patients and clinicians. The 0.5-4 kHz range had an average clinical agreement rate of 95.1 per cent when compared with formal pure tone audiometry, deeming it an accurate test to diagnose hearing loss.
CONCLUSIONS: The authors propose that hearTest can be used within ENT as a clinical decision support tool when manual audiometry is not immediately available. Within the authors\' practice, hearTest is used to aid diagnosis and management of sudden sensorineural hearing loss.

OBJECTIVE: Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy.
METHODS: A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
METHODS: Adults and children, with and without diagnosis of hearing impairment.
METHODS: A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL.
RESULTS: Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability.
CONCLUSIONS: MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.

OBJECTIVE: Auditory Brainstem Response (ABR), the electrical responses in the neuronal pathways extending from the inner ear to the auditory cortex, are evaluated with auditory stimuli. ABR analysis evaluates waves I, III and V\'s absolute-latencies, amplitude values, interpeak-latencies, interaural-latency differences, and morphologies. This study aims to reveal the advantages of CE-Chirp® LS stimulus and its clinical uses to increase by comparing the amplitude, latency, and interpeak-latency differences of waves I, III, and V at 80 dB nHL and wave V at 60, 40, 20 dB nHL by using click and CE-Chirp® LS stimuli.
METHODS: 100 (54 boys, 46 girls) infants with normal hearing were included in the National Newborn Hearing Screening Program. With the click and CE-Chirp® LS ABR, the absolute latency and amplitude values of wave V at 20, 40, and 60 dB nHL, and the absolute-latency, interpeak-latency, and amplitude values of waves I, III, and V at 80 dB nHL are determined between stimuli and right-left ear.
RESULTS: When the wave V latency and amplitudes obtained at 80, 60, 40, and 20 dB nHL levels were examined between genders, and according to the risk factor, no significant difference was found between click and CE-Chirp® LS stimuli (p > 0.05). Waves I, III, and V absolute-latency, amplitudes were compared at 80 dB nHL and wave V absolute-latency, amplitudes at 60, 40, and 20 dB nHL; the amplitudes measured with CE-Chirp® LS were significantly higher than the click stimulus (p < 0.05). When two stimuli were compared for I-III and III-V interpeak-latency values at 80 dB nHL level, no significant difference was found between the two stimuli (p > 0.05). However, the I-V interpeak-latency value was statistically significantly decreased for two stimuli, regardless of the ear (p < 0.05).
CONCLUSIONS: It is suggested to increase the use of CE-Chirp® LS stimulus with better morphology and amplitude in clinics, believing that it facilitates clinicians\' interpretation.

UNASSIGNED: The aim of the research was to evaluate the feasibility of measuring the bone conduction hearing threshold using self-administered mobile audiometry.
UNASSIGNED: A single-centre, closed, cross-over trial was carried out on patients from the ENT Department. A mobile-based, self-administered, audiologist-assisted assessment of the bone conduction hearing threshold was carried out by means of the open-access, freeware app Hearing Test using two types of bone conduction headphones: professional B71 bone transducer and commercially available AfterShokz Openmove open-ear headphones.
UNASSIGNED: Seventy-seven ears.
UNASSIGNED: A test-retest examination revealed the lowest standard deviation for open-ear headphones at 3.33 dB (95% CI 2.92-3.79). When compared with pure tone audiometry, the intraclass correlations of 0.95 (95% CI 0.94-0.96) and 0.90 (95% CI 0.88-0.92) were obtained for the bone transducer and for the open-ear headphones, indicating excellent and good reliability, respectively. However, the regression slope of 0.67 was found for the air-bone gap when using open ear headphones, which was significantly different from 1 (p < 0.001).
UNASSIGNED: Open-ear headphones provide an alternative for estimating bone conduction once the air-bone gap has been adjusted by a factor of 1/0.6 7 ≅1.5. They demonstrate improved reproducibility over the bone transducer and are much easier to use with a mobile device. Trial Registration: Wroclaw Medical University, Science Support Centre, BW60/2020.