Objectives.-A confluence of recent developments in cloud computing, real-time web audio and machine learning psychometric function estimation has made wide dissemination of sophisticated turn-key audiometric assessments possible. The authors have combined these capabilities into an online (i.e., web-based) pure-tone audiogram estimator intended to empower researchers and clinicians with advanced hearing tests without the need for custom programming. The objective of this study is to assess the accuracy and reliability of this new online machine learning audiogram method relative to a commonly used hearing threshold estimation technique also implemented online for the first time in the same platform.Design.-The authors performed air-conduction pure-tone audiometry on 21 participants between the ages of 19 and 79 years (mean 41, standard deviation 21) exhibiting a wide range of hearing abilities. For each ear, two repetitions of online machine learning audiogram estimation and two repetitions of online modified Hughson-Westlake ascending-descending audiogram estimation were acquired by an audiologist using the online software tools. The estimated hearing thresholds of these two techniques were compared at standard audiogram frequencies (i.e., 0.25, 0.5, 1, 2, 4, 8 kHz).Results.-The two threshold estimation methods delivered very similar threshold estimates at standard audiogram frequencies. Specifically, the mean absolute difference between threshold estimates was 3.24 ± 5.15 dB. The mean absolute differences between repeated measurements of the online machine learning procedure and between repeated measurements of the Hughson-Westlake procedure were 2.85 ± 6.57 dB and 1.88 ± 3.56 respectively. The machine learning method generated estimates of both threshold and spread (i.e., the inverse of psychometric slope)

Psychometric functions are typically estimated by fitting a parametric model to categorical subject responses. Procedures to estimate unidimensional psychometric functions (i.e., psychometric curves) have been subjected to the most research, with modern adaptive methods capable of quickly obtaining accurate estimates. These capabilities have been extended to some multidimensional psychometric functions (i.e., psychometric fields) that are easily parameterizable, but flexible procedures for general psychometric field estimation are lacking. This study introduces a nonparametric Bayesian psychometric field estimator operating on subject queries sequentially selected to improve the estimate in some targeted way. This estimator implements probabilistic classification using Gaussian processes trained by active learning. The accuracy and efficiency of two different actively sampled estimators were compared to two non-actively sampled estimators for simulations of one of the simplest psychometric fields in common use: the pure-tone audiogram. The actively sampled methods achieved estimate accuracy equivalent to the non-actively sampled methods with fewer observations. This trend held for a variety of audiogram phenotypes representative of the range of human auditory perception. Gaussian process classification is a general estimation procedure capable of extending to multiple input variables and response classes. Its success with a two-dimensional psychometric field informed by binary subject responses holds great promise for extension to complex perceptual models currently inaccessible to practical estimation.

Behavioral testing in perceptual or cognitive domains requires querying a subject multiple times in order to quantify his or her ability in the corresponding domain. These queries must be conducted sequentially, and any additional testing domains are also typically tested sequentially, such as with distinct tests comprising a test battery. As a result, existing behavioral tests are often lengthy and do not offer comprehensive evaluation. The use of active machine-learning kernel methods for behavioral assessment provides extremely flexible yet efficient estimation tools to more thoroughly investigate perceptual or cognitive processes without incurring the penalty of excessive testing time. Audiometry represents perhaps the simplest test case to demonstrate the utility of these techniques. In pure-tone audiometry, hearing is assessed in the two-dimensional input space of frequency and intensity, and the test is repeated for both ears. Although an individual's ears are not linked physiologically, they share many features in common that lead to correlations suitable for exploitation in testing. The bilateral audiogram estimates hearing thresholds in both ears simultaneously by conjoining their separate input domains into a single search space, which can be evaluated efficiently with modern machine-learning methods. The result is the introduction of the first conjoint psychometric function estimation procedure, which consistently delivers accurate results in significantly less time than sequential disjoint estimators.

The original version of this article neglected to mention a conflict of interest. DLB has a patent pending on technology described in this manuscript.The online version of the original article can be found at https://doi