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Audiogram accuracy / second opinions

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I’ve been wondering these last few days if some of the issues I’ve been having with my hearing aid (excessive volume & noise-floor-type hissing) could be because my Costco could be over-diagnosing my actual loss?

In my profile is the recent Costco one, and here is one I had done at Amplifon only 5 months earlier:

Amplifon Audiogram June 23

I find it hard to believe that both of my ears had changed that much - around 10-20dB in parts - in 5 months, or is that within an acceptable margin for error (particularly if you have tinnitus)? Yes I know of course that is possible, I just don’t believe it has worsened that fast in my case.

Has anyone taken a hearing test at two locations, for a second opinion etc, and then seen a sizable discrepancy in the results when comparing them (not knowing which one to believe)?

9 people in this conversation9 min readJump to latest

OK, to make things easier, I’m posting your profile here.

Screenshot 2024-02-20 at 10.11.42 AM

It is interesting to see the differences in these two audiograms. I wonder how much can be explained by equipment and sound booth? Cuz if one gets such different audiograms depending on where they’re being done, it doesn’t bode well for our confidence levels!

Five months does seem too short a time for the difference. To be a bug, I’d get a THIRD audiogram and see what you get. Seriously, if all 3 are different, something is majorly wrong with the system - and NOT your hearing.

I disagree it could easily by a hearing issue due to allergies, a cold, a stopped up sinus congestion or even stress or as simple as the time of day of the test. I know with me I am much feesher the the first thing in the morning and my hearing is better, and by the end of the day I am mentally exhausted and my hearing is much worse.

@withoutwings There are multiple variables that can affect your hearing temporarily. It’s better to do in-situ [via your hearing devices] or . Some [most?] fitting softwares have option for more accurate measurements, using 1dB increments [instead 5dB as used in yours] 5dB can give a wider margin of error.

Edited

Same sort of thing happened to me.

I had a hearing test done by my new hearing aid specialist.
The test showed my hearing was worse than the dispensing audiologist had shown for almost two years. All of a sudden I had an additional 10 to 20 loss in hearing. My new hearing aid practitioner detected it. I hear better now since he set up my hearing aids.

In reply to @cvkemp

Sounds like my day for some of hte last two years… So I experimented. I increased the volume of my hearing aids from the time I put them on. I found I was less tired.

I also contacted a person at work (school board) and asked what I should do. She helps children with hearing problems in our schools. She said I needed a good hearing test to establish an accurate . My dispensing audiologist had politely suggested that I should find someone who could help me more than he had been able to. He was right.

I agree that finding the right audiologist is more important than the brand of hearing aids most of the time.

In reply to @cvkemp

@cvkemp said:

I disagree it could easily by a hearing issue due to allergies, a cold, a stopped up sinus congestion or even stress or as simple as the time of day of the test.

Good point! My ear canals swell up and go down throughout the day, so it seems that one’s hearing could also waver depending on factors like sinus condition, medication or STRESS. I hope withoutwings gets to the bottom of things and shares the resolution.

Are you wearing Costco aids?
Have you told them what you have told us?
Ask for help.

As far as db changes for each frequency back when I had annual physicals where I worked. If we had a 10 db shift on any frequency we were sent out to an audiologist for testing.

In reply to @1Bluejay

@1Bluejay said:

OK, to make things easier, I’m posting your profile audiogram here.

Thanks!

@1Bluejay said:

I wonder how much can be explained by equipment and sound booth?

One was in a small individual booth, and the other one was the large Costco type of booth with the audiologist sitting right next to me.

@1Bluejay said:

I’d get a THIRD audiogram and see what you get. Seriously, if all 3 are different, something is majorly wrong with the system - and NOT your hearing.

Yep, am going for a third one this morning: simple tone test only this time but that’s all I need for now to compare.

In reply to @cvkemp

@cvkemp said:

it could easily by a hearing issue due to allergies, a cold, a stopped up sinus congestion or even stress or as simple as the time of day of the test. I know with me I am much feesher the the first thing in the morning and my hearing is better, and by the end of the day I am mentally exhausted and my hearing is much worse.

Yes I have considered this possibility also, as I have raging tinnitus in both ears that is sometimes worse than other days, chronic sinusitis, and also patulous eustachian tubes that can play up sometimes & when they do definitely affect my hearing.

However at my request the Costco audiologist did another quick tone test some weeks later to verify and said it was pretty much the same as the original one she’d done.

My hearing will vary due to the time of day, and also I have to be careful as certain foods I eat will make my tinnitus worse.
I have to stay away from wheat, as in bread and desserts, and added sugar even makes it worse.

In reply to @Raudrive

@Raudrive said:

Are you wearing Costco aids?
Have you told them what you have told us?
Ask for help.

Yes have a single Philips 9040 aid in my left ear. Right is borderline needing correction but for now I’m happy to leave that unaided.

I actually did give my original to Costco to keep on file when they did their own test for comparison, not sure the audiologist really paid attention to it though; certainly didn’t talk to me about how different it was.

Haven’t suggested to them that I think their testing is inaccurate - yet - as I’ve only just started considering the possibility…

@withoutwings said:

I actually did give my original audiogram to Costco to keep on file when they did their own test for comparison, not sure the audiologist really paid attention to it though;

Honestly if I were fitting aids anywhere I would not go by any other than the one I do. As a fitter I would not have any idea of what or how that audiogram was done.

I do know Costco uses best practices to fit hearing aids. I have a feeling you could go to just about any Costco and get very similar audiogram results. If you didn’t I would expect the difference to be you. You could be ill, tired, anxious or whatever.

Try a different fitter at Costco or try a different Costco. They are human and not all equal at fitting hearing aids. Are you still in the 180 day trial? Give the Rextons a try.

Anyway, good luck with this. Hang in there.

Edited

In reply to @1Bluejay

UPDATE: Today I went to my local Specsavers for a third opinion/test, and guess what - it’s almost exactly like the original (less severe) one!

So to put them all side-by-side, here is the first one 7 or so months ago @ Amplifon:

@withoutwings said:

Amplifon Audiogram June 23

Here is the Costco one two months ago:

@1Bluejay said:

Screenshot 2024-02-20 at 10.11.42 AM

And here is today’s one @ Specsavers, done with a brand new booth & equipment:

image

What was really cool was despite this check supposedly being a “quick” free 15 minute one, the audiologist there was so intrigued by my reason for coming in and bringing a Philips hearing aid with me (which they don’t sell there) that she fired up HearSuite on her system and re-programmed my aid - complete with adjustment - to fit against the new so I can actually try it out for a couple of weeks until my next Costco appointment! Think it must have gone for 40 mins in the end, but she didn’t mind at all.

Anyway, it seems I have some legitimate questions to ask my Costco audiologist next time I see her…

Could be a Calibration/transducer fault on the Costco Kit.

Were they all using inserts? Or Headphones?

The 1KHz R on the Costco result ‘looks’ anomalous, but wouldn’t necessarily show a a faulty test unless you’d been previously been tested there.

Edited
@Um_bongo said:

Could be a Calibration/transducer fault on the Costco Kit.

I was wondering about that.

@Um_bongo said:

Were they all using inserts? Or Headphones?

Original one I can’t remember it was a while ago. Costco I’m pretty sure just headphones, but my memory could be sketchy from back in December. Today was headphones initially but then high frequencies were repeated with inserts.

I will add that for the General program that was configured for me today, I straight away upped the volume by 2.5dB using the app as it was a touch too quiet across the board (despite it being based on the -adult rationale). But since doing that I’m very happy with the sound of the world - it’s comfortable, and it’s well balanced in all environments. A tiny amount of generated mic noise is still audible in a quiet room (somewhere in the higher-frequencies), but it’s much improved compared with before.

In reply to @Um_bongo

You bring up some really valid observations here! If one’s chosen aids are to be programmed per a single , I can see how the outcome would be sub-optimal!

I also seem to do better when the voice-over saying the word comprehension list is FEMALE, for whatever reason. So the nuances of a hearing test are part brain + ear and part equipment used at the hearing test.

Edited

As the famous Dr Cliff is fond of saying ‘ verification etc…’

Unfortunately if you have a duff test, REM isn’t going to provide a ‘catch-all’ for all issues. Especially when your source data is suspect.

Sometimes it comes down to the relative experience of the person doing the testing: having the ‘this doesn’t look quite right?’ question sitting in the back of your brain.

This isn’t quite the answer you are looking for, but may be worth sharing.
Some 40 years ago I noticed that one note on my piano, E6, 1,300 Hz, sounded weak. When eventually I visited a clinic for general hearing loss, the traditional spot frequencies used always missed this dip. A long time later, a different audiologist ran a continuou sweep that immediately found it.

It’s still there, not realistically remediable and not a problem, but perhaps assessments should be
more subtle if only to pick up trouble early and perhaps further alert young folk to the hazards of high spls.

And… it just happens that the old army-tank headphones I used as a kid on my crackly home made radios did peak strongly in that region. Could hurt if I shorted the battery. Maybe blew out specific cochlear hairs… “What did I know in my lamb-white days?”

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