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Hearing aid ramble--bone conduction testing

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Went to Costco recently and got retested. Was referred to an for worsening hearing and an increasing air/bone gap. I need to get some more testing (acoustic reflexes) but ENT said it was most likely arthritis in the middle ear. (I guess technically arthritis in the joints connecting the bones in the middle ear–I think referred to as the "ossicular chain:)
Costco always has done bone conduction testing with me. When I’ve gone to private audiologist they often do not. I’m curious what others experiences are. Do they usually do bone conduction testing? For the professionals out there, are there indicators that you need to do bone conduction testing and when you don’t?

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Has poor testing been ruled out? Did they retest at the ent or just look at the Costco test? Where is this apparently widening air bone gap?

So if looks ok, skip bone? Pretty sure the people that didn’t do bone also didn’t do tympanometry. My gut impression was that they’d decided my loss was sensorineural and I didn’t need bone.

Standard practice here in the UK @MDB… I don’t believe I have ever, not had a bone conduction test done, either with the NHS, or indeed with any private audiologist, although the flip side of that is, I have never had a , in 30 odd years, well apart from one, I assume I got, for a preliminary assessment, although they declined to tell me my score! Cheers Kev :wink:

I think there are two competing approaches. One is kind of a mindless checklist approach that has the advantage of consistency but may result in doing some things that don’t make sense versus a “use your professional judgement” approach which if done thoughtfully is great, but if one is pressed for time or one is feeling lackadaisical may result in less than optimal outcomes. Likely some sort of combination is desirable.

In reply to @kevels55

BAA standard requires Bone Condition testing with all tests, with at least 4 points established and masked accordingly. Half octave values are only usually measured when there’s 20dB or greater difference between adjacent values, but I like having 1.5 & 3KHz for programming/.

If I had a stab at the rules, I’d ban most headsets in use today and handwritten test records.

In reply to @MDB

Since I get my hearing care through the I can only speak to that. Every time I have had my hearing tested since 2000, when I first got hearing aids, they have done a bone conduction test as part of their normal battery of tests.

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