Auditory Tests for Characterizing Hearing Deficits in Listeners With Various Hearing Abilities: The BEAR Test Battery

Abstract

The Better hEAring Rehabilitation (BEAR) project aims to provide a new clinical profiling tool—a test battery—for hearing loss characterization. Although the loss of sensitivity can be efficiently measured using pure-tone audiometry, the assessment of supra-threshold hearing deficits remains a challenge. In contrast to the classical “attenuation-distortion” model, the proposed BEAR approach is based on the hypothesis that the hearing abilities of a given listener can be characterized along two dimensions, reflecting independent types of perceptual deficits (distortions). A data-driven approach provided evidence for the existence of different auditory profiles with different degrees of distortions. Ten tests were included in a test battery, based on their clinical feasibility, time efficiency, and related evidence from the literature. The tests were divided into six categories: audibility, speech perception, binaural processing abilities, loudness perception, spectro-temporal modulation sensitivity, and spectro-temporal resolution. Seventy-five listeners with symmetric, mild-to-severe sensorineural hearing loss were selected from a clinical population. The analysis of the results showed interrelations among outcomes related to high-frequency processing and outcome measures related to low-frequency processing abilities. The results showed the ability of the tests to reveal differences among individuals and their potential use in clinical settings.

A flexible data-driven audiological patient stratification method for deriving auditory profiles

“…The profiles of ( 18 ) are interpretable due to the hypothesis of two distortion types and the variables related to each distortion type; however, the obtained interpretation depends on the available measures in the dataset. That means that it needs to be ensured to employ an appropriate database, as was achieved in Sanchez-Lopez et al ( 18 ) with the BEAR test battery ( 7 ), following the findings of ( 17 ) where the choice of data led to different, not completely plausible interpretations based on the two different analyzed datasets. In contrast, our profiling approach does not include explicit interpretability of every profile yet, but instead, interpretability needs to be added as an additional step.…”

“…For instance, van Esch et al ( 6 ) proposed a test battery (“ auditory profile ”) for standardized audiological testing comprising eight domains (pure-tone audiometry, loudness perception, spectral and temporal resolution, speech perception in quiet and in noise, spatial hearing, cognitive abilities, listening effort, and self-reported disability and handicap) aiming to describe all major aspects of hearing impairment without introducing redundancy among measures. Similarly, the BEAR test battery was proposed for research purposes to characterize different dimensions of hearing and was evaluated with patients with symmetric sensorineural hearing loss ( 7 ). In spite of the benefit of the proposed test batteries, widespread adoption in clinical practice is currently lacking.…”

“…In spite of the benefit of the proposed test batteries, widespread adoption in clinical practice is currently lacking. The complete BEAR test battery, for instance, takes ~2.5 h to complete ( 7 ), even though a shorter version for clinical purposes was also proposed in ( 8 ). Nevertheless, in clinical practice, time is short and the assessment of patients on such a multitude of tests may not be feasible.…”

“…Sanchez-Lopez et al ( 18 ) improved the profiling method to be more robust (e.g., due to bootstrapping, a more flexible number of allowed variables, and estimating the association of a patient to a profile based on probability) and applied it to the BEAR test battery ( 7 ), which was designed for the purpose of including all relevant measures according to the literature and previous work. As a result, a plausible interpretation of the two distortion dimensions was obtained, namely being associated with speech intelligibility and loudness perception, respectively ( 18 ).…”

Towards Auditory Profile-Based Hearing-Aid Fittings: BEAR Rationale and Clinical Implementation

“…Using various diagnostic tests, patients are stratified into four distinct groups called profiles A, B, C and D. This is achieved using a data-driven method [ 5 ]. This method was developed based on a relatively large dataset stemming from a sample of listeners with a wide range of hearing abilities who were tested with a comprehensive auditory test battery [ 6 ]. The test battery was afterwards reduced, based on considerations of cost-effectiveness and reliability, to arrive at the most informative diagnostic measures.…”