Abstract
The Better hEAring Rehabilitation (BEAR) project aims to provide a new clinical profiling tool—a test battery—for hearing loss characterization. Although the loss of sensitivity can be efficiently measured using pure-tone audiometry, the assessment of supra-threshold hearing deficits remains a challenge. In contrast to the classical “attenuation-distortion” model, the proposed BEAR approach is based on the hypothesis that the hearing abilities of a given listener can be characterized along two dimensions, reflecting independent types of perceptual deficits (distortions). A data-driven approach provided evidence for the existence of different auditory profiles with different degrees of distortions. Ten tests were included in a test battery, based on their clinical feasibility, time efficiency, and related evidence from the literature. The tests were divided into six categories: audibility, speech perception, binaural processing abilities, loudness perception, spectro-temporal modulation sensitivity, and spectro-temporal resolution. Seventy-five listeners with symmetric, mild-to-severe sensorineural hearing loss were selected from a clinical population. The analysis of the results showed interrelations among outcomes related to high-frequency processing and outcome measures related to low-frequency processing abilities. The results showed the ability of the tests to reveal differences among individuals and their potential use in clinical settings.
Highlights
In current clinical practice, hearing loss is diagnosed mainly on the basis of pure-tone audiometry (ISO 8253-1, 2010)
If fixed-level frequency threshold (FLFT) is measured at a conversational level (i.e., 65 dB sound pressure level (SPL)), or at frequency-dependant levels corresponding to the speech spectrum, this measure could help to estimate the contribution of audible off-frequency listening to speech intelligibility or loudness perception
This suggests that IPDfmax is a reliable measure of binaural processing abilities that can reveal substantial variability among both NH and hearing-impaired listeners (HI) listeners, which is valuable for highlighting individual differences among patients
Summary
In current clinical practice, hearing loss is diagnosed mainly on the basis of pure-tone audiometry (ISO 8253-1, 2010). Pure-tone audiometry is often complemented by speech audiometry (ISO 8253-3, 2012), which is a test typically performed in the form of word recognition performance in quiet (Anderson et al, 2018). This test can provide information about supra-threshold deficits (Gelfand, 2009), measurements of speech understanding in noise have been found more informative (Nilsson et al, 1994; Killion et al, 2004). A hearing evaluation that goes beyond pure-tone sensitivity and speech intelligibility in quiet would be expected to provide a more accurate characterization of a listener’s hearing deficits
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