Out-of-clinic diagnostics of hearing impairment

The potential benefits of out-of-clinic diagnostics are manifold: it may be used to alleviate clinically trained personnel where resources are scarce, it may reduce the need for travel and it allows for increased privacy and discretion for the potentially hearing impaired, who may see a self-administered hearing test as the first step toward accepting the need for a hearing aid. However, one of the inherent problems of such test situations is the lack of control over the user behavior and the test environment. With respect to the latter, the exact characteristics of the equipment used may not be known or available for routine checks and calibration. Background noise levels may pose a problem in some environments, and be a problem for subjects with audiometric thresholds near normal hearing level at some frequencies. Several strategies can be applied to overcome these challenges. Some types of hearing impairment can be characterized using supra-threshold methods that are more robust to background noise and calibration issues. The background noise level may be passively or actively suppressed, or monitored and applied to discard or repeat unreliable measurements. The purpose of present study is to examine the feasibility of selected out-of-clinic test strategies, and in a first evaluation the effect of each is quantified in laboratory assessments, where the key variables can be controlled. A platform consisting of a tablet-based automated paradigm using commercially available active noise cancelling headphones will be used. The accuracy of the procedures in real-life scenarios are determined by comparing the outcome with clinically determined audiometric measures. How well the test subjects manage the test will also be assessed, and data from a usability point of view will be collected.