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Objective The purposes of the study were: (1) To evaluate the intrasession test-retest reliability of pure-tone thresholds measured in the 0.5–16 kHz frequency range for a group of otologically healthy subjects using Sennheiser HDA 200 circumaural and Etymotic Research ER-2 insert earphones and (2) to compare the data with existing criteria of significant threshold shifts related to ototoxicity and noise-induced hearing loss. Design Auditory thresholds in the frequency range from 0.5 to 6 kHz and in the extended high-frequency range from 8 to 16 kHz were measured in one ear of 138 otologically healthy subjects (77 women, 61 men; mean age, 24.4 yr; range, 12–51 yr) using HDA 200 and ER-2 earphones. For each subject, measurements of thresholds were obtained twice for both transducers during the same test session. For analysis, the extended high-frequency range from 8 to 16 kHz was subdivided into 8 to 12.5 and 14 to 16 kHz ranges. Data for each frequency and frequency range were analyzed separately. Results There were no significant differences in repeatability for the two transducer types for all frequency ranges. The intrasession variability increased slightly, but significantly, as frequency increased with the greatest amount of variability in the 14 to 16 kHz range. Analyzing each individual frequency, variability was increased particularly at 16 kHz. At each individual frequency and for both transducer types, intrasession test-retest repeatability from 0.5 to 6 kHz and 8 to 16 kHz was within 10 dB for >99% and >94% of measurements, respectively. The results indicated a false-positive rate of Conclusion Repeatability was similar for both transducer types. Intrasession test-retest repeatability from 0.5 to 12.5 kHz at each individual frequency including the frequency range susceptible to noise-induced hearing loss was excellent for both transducers. Repeatability was slightly, but significantly poorer in the frequency range from 14 to 16 kHz compared with the frequency ranges from 0.5 to 6 or 8 to 12.5 kHz. Measurements in the extended high-frequency range from 8 to 14 kHz, but not up to 16 kHz, may be recommended for monitoring purposes.

Background: For the past 50+ years, audiologists have been taught to measure the pure-tone thresholds at the interoctave frequencies when the thresholds at adjacent octave frequencies differ by 20 dB or more. Although this so-called 20 dB rule is logical when enhanced audiometric resolution is required, the origin of the rule is elusive, and a thorough literature search failed to find supporting scientific data. Purpose: This study purposed to examine whether a 20 dB difference between thresholds at adjacent octave frequencies is the critical value for whether the threshold of the interoctave frequency should be measured. Along this same line of questioning is whether interoctave thresholds can be predicted from the thresholds of the adjacent or bounding octave frequencies instead of measured, thereby saving valuable time. Research Design: Retrospective, descriptive, correlational, and cross-sectional. Study Sample: Audiograms from over a million veterans provided the data, which were archived at the Department of Veterans Affairs, Denver Acquisition and Logistics Center. Data Collection and Analysis: Data from the left and right ears were independently evaluated. For each ear three interoctave frequencies (1500, 3000, and 6000 Hz) were studied. For inclusion, thresholds at the interoctave frequency and the two bounding octave frequencies had to be measurable, which produced unequal numbers of participants in each of the six conditions (2 ears by 3 interoctave frequencies). Age tags were maintained with each of the six conditions. Results: Three areas of analyses were considered. First, relations among the octave-frequency thresholds were examined. About 62% of the 1000-2000 Hz threshold differences were ≥20 dB, whereas about 74% of the 4000-8000 Hz threshold differences were <20 dB. About half of the threshold differences between 2000 and 4000 Hz were <20 dB and half were >20 dB. There was an inverse relation between frequency and the percent of negative slopes between octave-frequency thresholds, ranging from 89% at 1500 Hz to 54% at 6000 Hz. The majority of octave-frequency pairs demonstrated poorer thresholds for the higher frequency of the pair. Second, interoctave frequency thresholds were evaluated using the median metric. As the interoctave frequency increased from 1500 to 6000 Hz, the percent of thresholds at the interoctave frequencies that were not equal to the median threshold increased from ∼9.5% (1500 Hz) to 15.6% (3000 Hz) to 28.2% (6000 Hz). Bivariate plots of the interoctave thresholds and the mean octave-frequency thresholds produced 0.85-0.91 R2 values and 0.79-0.92 dB/dB slopes. Third, the predictability of the interoctave thresholds from the mean thresholds of the bounding octave frequencies was evaluated. As expected, as the disparity between octave-frequency thresholds increased, the predictability of the interoctave threshold decreased; for example, using a ±5 dB criterion at 1500 Hz, 53% of the thresholds were ±5 dB when the octave thresholds differed by ≥20 dB, whereas 77% were ±5 dB when the octave thresholds differed by <20 dB. Conclusions: The current findings support the 20 dB rule for testing interoctave frequency thresholds and suggest the rule could be increased to 25 dB or more with little adverse effect.

Preliminary studies have stirred the hope that sound-field stimulation through auditory steady state evoked potentials can be used to assess aided thresholds in the difficult-to-test population. Before the introduction of ASSEP into the clinical field, as a technique for the prediction of aided thresholds in the difficult-to-test population, a question arises concerning its clinical validation. The application of ASSEP through sound field stimulation, in the determination of aided thresholds and for the evaluation of amplification fittings, is dependent on the determination of unaided responses. Subsequently the estimation of unaided thresholds in the hearing impaired population is dependent on the establishment of normative data from the normal hearing population. The aim of this study was to determine the influence of insert earphones and sound field speaker presentation on threshold estimations using monotic auditory steady state evoked potentials, in a group of normal hearing adults. To achieve the aim of the study, a comparative, within-group experimental design was selected. The results of the current study indicated that the monotic single ASSEP technique under both insert earphone- and sound field conditions provided a reasonable estimation (25-35 dB HL for inset earphones; 20-33 dB HL for sound field speaker presentation) of the behavioural pure tone thresholds. The minimum response levels obtained under insert earphone conditions differed significantly from those obtained under sound field conditions for all the frequencies tested except 2 kHz (p < 0.01). Subsequently, the current study indicates that minimum response levels obtained using a specific transducer should serve as the basis of comparison with behavioural thresholds obtained under the same transducer. Therefore, behavioural pure tone thresholds obtained under insert earphone conditions will not suffice as a basis of comparison for minimum response levels obtained for the ASSEP technique under sound field conditions, and vice versa. This research endeavour concluded that the monotic ASSEP technique under both insert earphone and sound field conditions provide useful information for the estimation of frequency specific thresholds, but that the results are transducer specific and that comparison across transducers should be avoided. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

The Epidemiology of Hearing Loss Study (EHLS) conducted in Beaver Dam, Wisconsin, was a population-based study that focused on the prevalence of hearing loss among 3,753 participants between 1993 and 1995. This article reports the results of several auditory measures from 999 veteran and 590 nonveteran males 48 to 92 years of age included in the EHLS. The auditory measures included pure tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version. Hearing loss in the auditory domains of pure tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and nonveterans. No significant differences were found between participant groups on the HHIE-S; however, regarding hearing aid usage, mixed differences were found.