Are hearing tests reliable?

Oh MDB how kind of you! THANK YOU so much! I guess they either changed the spot or I don’t remember it but…why so secretly hidden??? lol! I’ll try it and hopefully I won’t have to disturb you in this thread again. :o)

Not sure at this point in the discussion how valuable this information is, but there is in the US and many countries an established standard on how to perform an audiological pure-tone assessment. In the US, it falls under ANSI/ASA Standard 3.21 - Methods for Manual Pure-Tone Threshold Audiometry with the great majority, or at least plurality, of every automated system being derived from this standard to be able to provide that in their literature when selling the equipment.

What wasn’t entirely clear is who was providing the instructions in the initial message of the thread creator - “If you hear the beep or think you hear it” is usually an instruction by a person, not an automated system, but there are certainly many out there that could provide this set of test instructions. As such, most individuals who are doing regular pure-tone audiometric testing (not fresh-faced at the testing) are easily able to vary pitch/duration to make the testing reliable within the repeatable/validity measure of tolerance level.

Which is not to say that it isn’t impossible to over-respond or track a person’s testing paradigm, but it should be rather difficult barring any presupposition by the test performer on how your hearing ‘should’ look.

Thanks for input @AuDacious. The article I quote is from ASHA which states as part of Instructions a bit different wording than what you state (If you hear the beep or think you hear it); but both are a bit ambiguous by which I mean they clearly indicate that one responds even if you are not certain you heard it, but leaves to the subject how much uncertainty is OK. At a practical level those individual differences in how instructions are interpreted probably have little impact on test results (if someone is not faking it) especially since threshold is determined from several presentations at the same frequency and level.
" Instructions . The test instructions should be presented in a language or manner appropriate for the participant. Interpreters (oral or manual) should be used when necessary. Supplemental instructions may be provided to enhance understanding, such as written directives, gestures, and demonstrations. Test instructions shall accomplish the following:

• Indicate the purpose of the test, that is, to find the faintest tone that can be heard.
• Indicate that the participant is to respond whenever the tone is heard, no matter how faint it may be.
  *Etc."

Hello,

The ASHA guideline is based off of the ANSI Standards, but written for the public- facing nature of the ASHA guidelines.

You are, on a large scale, correct that, from a psychometric perspective, the way that tones are presented to the user (the Houghston-Westlake process to obtain threshold) helps significantly to increase reliability. All automated systems use this method electronically, and so it is mostly up to the manufacturer whether the validity is maintained by alternating rate of presentation/gauging latency. The less intensive the microprocessor, the more likely it is ‘trackable’/predictable as people have mentioned.

This is usually acceptable risk in an Occupational setting because there will eventually be an assessment by an actual person at ‘some point’.

The reason that ‘even if you are unsure, still respond’ is stressed is because the volume/tone increases used should not be heard 100% of the time (floor effect), but 50%. If you are unsure, but still respond, it may be right at threshold or not-the end result should be the ‘proof’ even though there will always be exceptions.

Hope this increased uncertainty pulls back the curtain a bit!

Those are two different tests. The pure tone test measures hearing ability and there is also a word recognition test which measures word recognition. Although even those have their issues. My word rec is fairly good - 100% r, 80% l and yet my word rec in conversation, particularly on my left, is really not great. I can’t measure it per se but I am not thrilled with it. However I’m learning to live with it and be a bit more proactive…

Thanks for that, I wasn’t given a word rec test at the hospital, only what must have been pure tone. I have taken word rec tests online and they also show mild NIHL (I have a long history of loud machinery without sufficiently protecting my ears that I’m paying for).

This is NHS (UK National Health Service), which I’m a big advocate of, but think I’ll get tested at a private high street place where they do just this all day long.

As you say, I’m also trying to be proactive and adding a TV soundbar and over-ear headphones helps at home.

There is a soundbar by the company zvox that says it enhances sounds for voice to make it easier to understand. I keep considering it…

I.never had a test like that, even in the bootcamp , and my mustering out hearing test was with a human.

@janofh said:

There is a soundbar by the company zvox that says it enhances sounds for voice to make it easier to understand. I keep considering it…

I have had Zvox soundbar for about 2 years and find it to be quite helpful. It processes the raw sound so that the speaker output emphasizes speech. It has I believe 5 levels of how strong this focus is which you can quickly adjust on the fly with the remote. It isn’t magic (nor are HAs in focusing on voice), but for me very useful. However if one were watching with someone else with normal hearing the processed sound with deemphasis on music and sound effects might make their movie watching enjoyment less. I usually watch alone so not issue for me. I purchased from their website where they sometimes have 2nds or returned units that make cost much better.

I had sent email to them before purchase with some fairly technical ? on the interaction in their sound processing, and got a very detailed and thoughtful response - most of which was not canned info. While website provides quite a bit of information they have even more and it seems that they have been quite thoughtful in creating their product.

Thanks for the info! I’ve been considering it for a while. They have ones that range from $90 to about $400 although I’m considering the cheaper end