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Developing a digits in noise screening test with higher sensitivity to high-frequency hearing loss

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2019, PhD, University of Cincinnati, Allied Health Sciences: Communication Sciences and Disorders.
An estimated 466 million people worldwide have some degree of hearing loss. Despite this widespread prevalence, only a minority of cases are identified and receive treatment, especially in low-and-middle-income countries. Technologies such as remote hearing screening can help individuals identify hearing loss before it becomes disabling. The automated digits-in-noise (DIN) test has been used as a reliable self-administered hearing screening test in different languages. This research aimed to improve the sensitivity of the English DIN test to hearing loss using low-pass noise filters (LPNF) with higher cutoff frequencies. Additionally, this study aimed to develop the first Persian DIN test for people in Persian speaking countries who have limited access to audiology services. Standard and extended high-frequency (EHF) audiometry and a hearing-in-noise questionnaire were used to investigate contributions of higher frequency hearing to speech-in-noise perception in 86 normal-hearing (NH) listeners. For developing the English DIN test, recordings of English digits 0-9 were presented to 10 NH listeners at ten different signal-to-noise ratios. Fitted psychometric curves provided threshold and slope estimates for each noise condition (broadband and LPNFs) allowing for the homogenization of digits to achieve 50% intelligibility across all listeners. For 30 NH and 40 hearing impaired (HI) listeners with bilateral mild to moderate sensorineural hearing-loss, separate speech reception thresholds (SRTs) were obtained using broadband and three LPNFs (cut-off at 2, 4, 8 kHz). A total of 30 NH native Persian speakers were recruited for developing the Persian DIN test using the same method. More than two-thirds of the NH listeners had some hearing loss at frequencies above 8 kHz. EHF hearing loss was correlated with self-reported difficulty hearing in noise. Narrower noise bandwidth generally produced better mean SRTs. Surprisingly, even the broadest LPNF (8 kHz-cutoff) produced better SRTs than those using the broadband noise, showing the contribution of signal energy above 8 kHz in speech-in-noise perception. There were weak and nonsignificant correlations between SRT and audiometric pure-tone average (PTA) of NH listeners. These correlations were statistically significant in the HI group. SRTs using 2 kHz filtering had the highest correlation and steepest slope with lower frequency PTA (0.5, 1, 2, 4 kHz). Broader noise filters all had similar, weaker correlations. In contrast, higher frequency PTA (4, 8, 10, 12.5 kHz) correlated best with SRTs obtained from 4 and 8 kHz LPNFs. 4 kHz LPNF had the highest sensitivity (92%) for detecting an average high frequency hearing loss of 20 dB or more. The speech intelligibility function of the Persian DIN test corresponded closely to previously developed DIN tests in other languages. However, our findings also revealed distinct cross-language differences related to phonetic characteristics of the Persian stimuli. Using successively higher cutoff frequency filters, the present study improved sensitivity of the DIN test to higher frequency hearing loss. Our results also showed that sound energy above 8 kHz contributes to speech perception in noise. This research also introduces a convenient and efficient tool for self-hearing screening in Persian speaking countries where there is limited access to audiology services.
Noah Silbert, Ph.D. (Committee Chair)
Lisa Kelchner, Ph.D. (Committee Member)
David Moore (Committee Member)
100 p.

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Citations

  • Motlagh Zadeh, L. (2019). Developing a digits in noise screening test with higher sensitivity to high-frequency hearing loss [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1552378973670023

    APA Style (7th edition)

  • Motlagh Zadeh, Lina. Developing a digits in noise screening test with higher sensitivity to high-frequency hearing loss. 2019. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1552378973670023.

    MLA Style (8th edition)

  • Motlagh Zadeh, Lina. "Developing a digits in noise screening test with higher sensitivity to high-frequency hearing loss." Doctoral dissertation, University of Cincinnati, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1552378973670023

    Chicago Manual of Style (17th edition)