Objective: The ''Occupational Earcheck'' (OEC) is a Dutch online self-screening speech-in-noise test developed for the detection of occupational high-frequency hearing loss (HFHL). This study evaluates an optimised version of the test and determines the most appropriate masking noise. Design: The original OEC was improved by homogenisation of the speech material, and shortening the test. A laboratory-based cross-sectional study was performed in which the optimised OEC in five alternative masking noise conditions was evaluated. Study sample: The study was conducted on 18 normal-hearing (NH) adults, and 15 middle-aged listeners with HFHL. Results: The OEC in a low-pass (LP) filtered stationary background noise (test version LP 3: with a cut-off frequency of 1.6 kHz, and a noise floor of À12 dB) was the most accurate version tested. The test showed a reasonable sensitivity (93%), and specificity (94%) and test reliability (intra-class correlation coefficient: 0.84, mean within-subject standard deviation: 1.5 dB SNR, slope of psychometric function: 13.1%/dB SNR). Conclusions: The improved OEC, with homogenous word material in a LP filtered noise, appears to be suitable for the discrimination between younger NH listeners and older listeners with HFHL. The appropriateness of the OEC for screening purposes in an occupational setting will be studied further.
Previously found effects of age on thresholds for speech reception thresholds in noise in adolescents as measured by an online screening survey require further study in a well-controlled teenage sample. Speech reception thresholds (SRT) of 72 normal-hearing adolescent students were analyzed by means of the online speech-in-noise screening tool Earcheck (In Dutch: Oorcheck). Screening was performed at school and included pure-tone audiometry to ensure normal-hearing thresholds. The students’ ages ranged from 12 to 17 years. A group of young adults was included as a control group. Data were controlled for effects of gender and level of education. SRT scores within the controlled teenage sample revealed an effect of age on the order of an improvement of −0.2 dB per year. Effects of level of education and gender were not significant. Hearing screening tools that are based on SRT for speech in noise should control for an effect of age when assessing adolescents. Based on the present data, a correction factor of −0.2 dB per year between the ages of 12 and 17 is proposed. The proposed age-corrected SRT cut-off scores need to be evaluated in a larger sample including hearing-impaired adolescents.
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.
Objectives The Occupational Earcheck (OEC) is an online internet test to detect high-frequency hearing loss for the purposes of occupational hearing screening. In this study, we evaluated the OEC in an occupational setting in order to assess test sensitivity, specificity, and validity. Methods A cross-sectional study was conducted in 2015, in which the optimized OEC was evaluated on 94 employees from the army and three different companies in construction and manufacturing. Subjects underwent OEC in an office-like room. Pure-tone air conduction audiometry was performed as a reference test. The OEC was repeated for a subset of subjects (N=19). Important test characteristics (ie, sensitivity and specificity, test validity, and test-retest reliability) were assessed. Results When analyzed on the individual level, the sensitivity and specificity of OEC were 90% and 77%, respectively. The speech reception threshold results correlated strongly with the pure-tone average of the frequencies 3, 4 and 6 kHz, reflecting good test validity (r=0.79). The difference between test and retest was not significant. The intra-class correlation coefficient was moderate (r=0.57), indicating a reasonable agreement between test and retest. Conclusions The OEC appears to be a suitable test for the detection of high-frequency hearing loss among noise-exposed employees, with good sensitivity and specificity values, even when performed in a semi-controlled occupational setting, though a possible learning effect should be taken into account.
The online test shows potential for routine-hearing screening of school-age children, and can be presented on either a desktop computer or smartphone. The test should be evaluated further in order to establish sensitivity and specificity for hearing loss in children.
Objective:The objective was to describe the speech intelligibility in noise test results among Dutch teenagers and young adults aged 12–24 years, using a national online speech reception threshold (SRT) test, the Earcheck. A secondary objective was to assess the effect of age and gender on speech intelligibility in noise.Design:Cross-sectional SRT data were collected over a 5-year period (2010–2014), from participants of Earcheck. Regression analyses were performed, with SRT as the dependent variable, and age and gender as explaining variables. To cross-validate the model, data from 12- to 24-year olds from the same test distributed by a hearing aid dispenser (Hoorscan) were used.Results:In total, 96,803 valid test results were analyzed. The mean SRT score was −18.3 dB signal-to-noise ratio (SNR) (standard deviation (SD) = 3.7). Twenty-five percent of the scores was rated as insufficient or poor. SRT performance significantly improved with increasing age for teenagers aged 12–18 years by 0.49 dB SNR per age-year. A smaller age-effect (0.09 dB SNR per age-year) was found for young adults aged 19–24 years. Small differences between male and female users were found.Conclusion:Earcheck generated large quantities of national SRT data. The data implied that a substantial number of users of Earcheck may have some difficulty in understanding speech in noise. Furthermore, the results of this study showed an effect of gender and age on SRT performance, suggesting an ongoing maturation of speech-in-noise performance into late adolescence. This suggests the use of age-dependent reference values, but for this purpose, more research is required.
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