Validation of an In Situ Self-Administered Hearing Test with a Self-Fitting Device for Mild to Moderately Severe Hearing Loss in Various Acoustic Environments.

Objectives: This study compared a simplified in situ self-administered hearing screening test, conducted with a neckband-type self-fitting device, with conventional pure-tone audiometry. It evaluated the maximum speech-shaped noise level for screening (MSNLS), crucial for evaluating the feasibility of this in situ screening test in quiet environments.

Methods: This study included 30 adults with normal hearing and 30 adults with mild to moderately severe hearing impairment. A binaural neckband-type self-fitting device was developed. The results of an in situ hearing screening test conducted using the self-fitting device were compared with those obtained using traditional pure-tone audiometry conducted using TDH-50 earphones. Subsequently, MSNLS was determined by assessing noise-masking effects on screening outcomes. All tests were conducted in an audiometric booth, with the hearing screening test conducted in the booth with the door open.

Results: Strong positive correlations were observed between the results of pure-tone audiometry and those of hearing screening tests across all test frequencies, with the strongest correlation observed at 2000 Hz ( = 0.793,  < .001) and the weakest correlation observed at 500 Hz ( = 0.625,  < .001). Comparisons of screening tests results with pure-tone thresholds across all test frequencies revealed differences of approximately 10 dB HL for 80% of all ears. The sensitivity and specificity of the hearing screening test in detecting candidates with hearing loss (>30 dB HL) who are suitable for this device were 93% and 90%, respectively. The hearing-impaired group exhibited MSNLSs, such as 57 dB SPL at 500 Hz, exceeding ambient noise levels in an empty classroom.

Conclusion: The in situ hearing screening test, conducted using a self-fitting device, exhibited reasonable accuracy for self-fitting scenarios in general quiet environments. This test can be used for monitoring mild to moderate hearing loss or fluctuating hearing loss, such as that associated with Ménière's disease.