Home Hearing Test: Within-Subjects Threshold Variability

Background: The Home Hearing Test (HHT) is an automated pure-tone threshold test that obtains an air conduction audiogram at five test frequencies. It was developed to provide increased access to hearing testing and support home telehealth programs. Purpose: Test and retest thresholds for 1000-Hz stimuli were analyzed to determine intrasubject variability from two independent data sets. Research Design: Prospective, repeated measures. Study Sample: In the Veterans Affairs (VA) study, results from 26 subjects 44 to 88 years of age (mean = 65) recruited from the Nashville VA audiology clinic were analyzed. Subjects were required to have a Windows PC in the home and were self-reported to be comfortable with using computers. Two subjects had normal hearing, and 24 had hearing losses of various severities and configurations. The National Center for Rehabilitative Auditory Research (NCRAR) sample included 100 subjects (68 males; 32 females) with a complaint of hearing difficulty recruited from the local community and Veteran population. Subjects ranged in age from 32 to 87 years (mean = 63.7 years). They were tested in a quiet room at the NCRAR. Data Collection and Analysis: Subjects in the VA study were provided kits for installing HHT on their home computers. HHT was installed on a computer at NCRAR to test subjects in the NCRAR study. HHT obtains a five-frequency air conduction audiogram with a retest of 1000 Hz in both ears. Only the 1000-Hz test–retest results are analyzed in this report. Six statistical measures of test–retest variability are reported. Results: Test and retest thresholds were highly correlated in both studies (r ≥ 0.96). Test–retest differences were within ±5 dB ≥92% of the time in the two studies. Standard deviations of absolute test–retest difference were ≤3.5 dB in the two studies. Conclusions: Intrasubject variability is comparable to that obtained with manual testing by audiologists in sound-treated test rooms. ACKNOWLEDGMENTS: The authors thank Drs. Josephine Helmbrecht, Rachel Tomasek, and Jay Vachhani for their valuable assistance. R.H.M., M.C.K., and G.L.S. have commercial interests in the Home Hearing Test. This work was supported by contract nos. VA-14-0005253 and VA118-12-C-0029 from the U.S. Department of Veterans Affairs and grant nos. R33DC011769 and 4R33DC011769 from the National Institute on Deafness and Other Communication Disorders. The Home Hearing Test was developed in response to the recommendations from the Workshop on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Loss, Bethesda, Maryland, August 25–27, 2009, sponsored by the National Institute on Deafness and Other Communications Disorders. See Donahue et al. (2010) for a report of the workshop. The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs. Address for correspondence: Robert H. Margolis, Audiology Incorporated, 4410 Dellwood Street, Arden Hills, MN 55112, USA. E-mail: rhmargo001@gmail.com Received August 22, 2017; accepted November 29, 2017. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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