Digit Triplet Test Hearing Screening With Broadband and Low-Pass Filtered Noise in a Middle-Aged Population

Vercammen, Charlotte; Goossens, Tine; Wouters, Jan; Wieringen, Astrid Van

doi:10.1097/aud.0000000000000524

Cited by 16 publications

(20 citation statements)

References 15 publications

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“…For the DTT, the reference value of−11.1 (±1.6) dB SNR obtained in this study agrees with previously reported values of−11.5 and−11.1 dB SNR for young (20–30 years) and middle-aged (40–60 years) adults (Vercammen et al., 2017), respectively, and the original reference value of −11.7 dB SNR found by Jansen et al. (2013) in young adults.…”

Section: Resultssupporting

confidence: 92%

“…A growing trend has been the use of automated suprathreshold self-tests based on speech perception in noise for adult hearing screening (De Sousa, Swanepoel, Moore, & Smits, 2018; Folmer, Vachhani, Mcmillan, Kidd, & Feeney, 2017; Jansen et al., 2010; Jansen, Luts, Dejonckere, van Wieringen, & Wouters, 2014; Koole et al., 2016; Potgieter, Swanepoel, Myburgh, & Smits, 2018a; Smits & Houtgast, 2005; Smits, Merkus, & Houtgast, 2006; Vercammen, Goossens, Wouters, & van Wieringen, 2017; Vlaming, MacKinnon, Jansen, & Moore, 2014; Watson, Kidd, Miller, Smits, & Humes, 2012), for example, for online hearing screening and screening via mobile devices (Stenfelt, Janssen, Schirkonyer, & Grandori, 2011). One commonly used test is the Digit Triplet Test (DTT), in which combinations of three digits are presented in speech-shaped noise at different signal-to-noise ratios (SNRs) using an adaptive test procedure.…”

Section: Introductionmentioning

confidence: 99%

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Language-Independent Hearing Screening Based on Masked Recognition of Ecological Sounds

et al. 2019

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A language-independent automated self-test on tablet based on masked recognition of ecological sounds, the Sound Ear Check (SEC), was developed. In this test, 24 trials of eight different sounds are randomly presented in a noise that was spectrally shaped according to the average frequency spectra of the stimulus sounds, using a 1-up 2-down adaptive procedure. The test was evaluated in adults with normal hearing and hearing loss, and its feasibility was investigated in young children, who are the target population of this test. Following equalization of perceptual difficulty across sounds by applying level adjustments to the individual tokens, a reference curve with a steep slope of 18%/dB was obtained, resulting in a test with a high test–retest reliability of 1 dB. The SEC sound reception threshold was significantly associated with the averaged pure tone threshold ( r = .70), as well as with the speech reception threshold for the Digit Triplet Test ( r = .79), indicating that the SEC is susceptible to both audibility and signal-to-noise ratio loss. Sensitivity and specificity values on the order of magnitude of ∼70% and ∼80% to detect individuals with mild and moderate hearing loss, respectively, and ∼80% to detect individuals with slight speech-in-noise recognition difficulties were obtained. Homogeneity among sounds was verified in children. Psychometric functions fitted to the data indicated a steep slope of 16%/dB, and test–retest reliability of sound reception threshold estimates was 1.3 dB. A reference value of −9 dB signal-to-noise ratio was obtained. Test duration was around 6 minutes, including training and acclimatization.

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Section: Resultssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Language-Independent Hearing Screening Based on Masked Recognition of Ecological Sounds

et al. 2019

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“…Using a fixed-SNR procedure, Smits (2017) showed that the number of digit triplets in a DIN could be reduced to as few as 8 trials, without compromising sensitivity and specificity but sacrificing accurate estimation of the SRT. Furthermore, with the early appearance and high prevalence of high frequency hearing loss, use of low-pass filtered masking noise to improve sensitivity of the DIN to high frequency hearing loss has been investigated, showing either higher (Vlaming et al 2014) or similar (Vercammen et al 2018) area under the receiver operating characteristics (ROC) curve compared to DINs with standard speech-shaped noise. Therefore, when using homogenized digits to ensure high testretest reliability, these modifications could make the DIN test more applicable to persons with noise-induced or age-related hearing loss (Vlaming et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Improving Sensitivity of the Digits-in-Noise Test using Antiphasic Stimuli

Sousa

Swanepoel

Moore

et al. 2019

Preprint

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Objective: The digits-in-noise test (DIN) has become increasingly popular as a consumer-based method to screen for hearing loss. Current versions of all DINs either test ears monaurally or present identical stimuli binaurally (i.e., diotic noise and speech, NoSo). Unfortunately, presentation of identical stimuli to each ear inhibits detection of unilateral sensorineural hearing loss (SNHL), and neither diotic nor monaural presentation sensitively detects conductive hearing loss (CHL). Following an earlier finding of enhanced sensitivity in normally hearing listeners, this study tested the hypothesis that interaural antiphasic digit presentation (NoSπ) would improve sensitivity to hearing loss caused by unilateral or asymmetric SNHL, symmetric SNHL, or CHL. Design:This cross-sectional study, recruited adults (18-84 years) with various levels of hearing, based on a four-frequency pure tone average (PTA) at 0.5, 1, 2 and 4kHz.The study sample was comprised of listeners with normal hearing (n=41; PTA ≤ 25 dB HL in both ears), symmetric SNHL (n=57; PTA > 25 dB HL), unilateral or asymmetric SNHL (n=24; PTA > 25 dB HL in the poorer ear) and CHL (n=23; PTA > 25 dB HL and PTA air-bone gap ≥ 20 dB HL in the poorer ear). Antiphasic and diotic speech reception thresholds (SRTs) were compared using a repeated-measures design.Results: Antiphasic DIN was significantly more sensitive to all three forms of hearing loss than the diotic DIN. SRT test-retest reliability was high for all tests (ICC r > 0.89).Area under the receiver operating characteristics (ROC) curve for detection of hearing loss (> 25 dB HL) was higher for antiphasic DIN (0.94) than for diotic DIN (0.77) presentation. After correcting for age, PTA of listeners with normal hearing or symmetric SNHL was more strongly correlated with antiphasic (rpartial[96]=0.69) than diotic (rpartial=0.54) SRTs. Slope of fitted regression lines predicting SRT from PTA was significantly steeper for antiphasic than diotic DIN. For listeners with normal hearing or CHL, antiphasic SRTs were more strongly correlated with PTA (rpartial[62]=0.92) than diotic SRTs (rpartial[62]=0.64). Slope of regression line with PTA was also significantly steeper for antiphasic than diotic DIN. Severity of asymmetric hearing loss (poorer ear PTA) was unrelated to SRT. No effect of self-reported English competence on either antiphasic or diotic DIN among the mixed first-language participants was observed 3 Conclusions: Antiphasic digit presentation markedly improved the sensitivity of the DIN test to detect SNHL, either symmetric or asymmetric, while keeping test duration to a minimum by testing binaurally. In addition, the antiphasic DIN was able to detect CHL, a shortcoming of previous monaural or binaurally diotic DIN versions. The antiphasic DIN is thus a powerful tool for population-based screening. This enhanced functionality combined with smartphone delivery could make the antiphasic DIN suitable as a primary screen that is accessible to a large global audience.

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“…The results indicated a high sensitivity (91%) as well as a high specificity (93%) [63]. A recent trial by Vercammen et al (2017) reported that a Flemish version of the digit triplet test, which was used with broadband noise, had a high sensitivity and high specificity to detect high-frequency hearing impairment in middle-aged persons [64]. Although SPIN tests are commonly used to assess patients’ speech intelligibility, there are only a few eHealth applications available that include SPIN tests.…”

Section: Screening Methods For Age-related Hearing Loss In Older Pmentioning

confidence: 99%

Screening Methods for Age-Related Hearing Loss in Older Patients with Cancer: A Review of the Literature

et al. 2018

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As people grow older, they may experience loss in hearing sensitivity. Age-related hearing loss may negatively affect the patient’s quality of life as it may lead to social isolation. In older patients with cancer, hearing loss can seriously interfere with the patient’s ability to deal properly with all aspects of their disease, and may have a cumulative effect on their already decreased quality of life. Therefore, the proper screening of those conditions is essential in order to optimise the patient’s comfort during and after treatment. This review article aims at providing a concise image of the nature of age-related hearing loss, and provides an overview of the screening methods that could be used in older patients with cancer.

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Digit Triplet Test Hearing Screening With Broadband and Low-Pass Filtered Noise in a Middle-Aged Population

Abstract: The Flemish DTT with broadband noise had high sensitivity and specificity to detect high-frequency hearing impairment in middle age. Similar results were obtained for low-pass filtered noise when cutoff values for referral were age adjusted.

Cited by 16 publications

References 15 publications

Language-Independent Hearing Screening Based on Masked Recognition of Ecological Sounds

Language-Independent Hearing Screening Based on Masked Recognition of Ecological Sounds

Improving Sensitivity of the Digits-in-Noise Test using Antiphasic Stimuli

Screening Methods for Age-Related Hearing Loss in Older Patients with Cancer: A Review of the Literature

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