Soundproof Booth Research Articles

Evaluating the accuracy of a self-administered smartphone hearing test application in a geriatric population.

As the global population ages, hearing loss becomes increasingly prevalent, and is associated with neurocognitive and psychiatric comorbidities, impacting quality of life. Early screening and timely intervention might prevent or delay cognitive decline, a gap in care that can potentially be addressed by self-administered smartphone hearing tests. This study aims to evaluate the accuracy of Mimi™ (Berlin, Germany), a commercially available self-administered smartphone hearing test compared to pure tone audiogram (PTA) in terms of both hearing levels and hearing thresholds in our local geriatric population > 65 years-old. Fifty-two participants above 65 years of age requiring conventional audiograms were recruited from a National Referral University Hospital Otolaryngology clinic from March to June 2022. All participants were administered the conventional PTA tests in a sound-proof booth conducted by audiology technicians followed by Mimi™ Hearing Test in a quiet clinic room. Comparisons between the hearing levels of both tests were analyzed using Spearman's rank correlation coefficient, Bland-Altman plots and Gwet's Kappa which looked at concordance. Hearing thresholds were then analysed using the Wilcoxon signed rank (SR) test. Mimi™ showed strong to very strong correlation with good agreement compared to readings obtained from formal PTA. Concordance in determining hearing loss also showed substantial to almost perfect agreement at each individual frequency, with values of kappa falling between 0.735-0.857. In terms of thresholds, there were no significant differences in thresholds given by both tests except for 2.0 kHz, HFPTA and 4FPTA (p < 0.05). Mimi™ serves as a good screening tool for detection of moderate hearing loss for early pickup and treatment except at higher frequencies. The smartphone hearing test is also less accurate in determining the extent of hearing loss and formal PTA after hearing loss is detected on screening should still be standard of care.

Combined effect of anemia and chronic rhinitis on hearing loss in Korean adults: a nationwide observational study.

Studies have suggested an association between hearing loss and anemia. Hearing loss has also been linked to rhinitis, which is characterized by inflammation of the nasal mucous membranes and sinus mucosa. Few studies have concurrently explored the relationships between hearing loss, anemia, and rhinitis. This study was conducted to investigate the association between hearing loss and anemia and to further analyze the potential role of rhinitis in this relationship. Data were collected from the 2020 Korea National Health and Nutrition Examination Survey. Hearing loss was measured with an audiometer in a soundproof booth and was defined as at least moderate impairment (as indicated by a pure-tone average of ≥41 dB in the better-hearing ear). The association between hearing loss and anemia was analyzed using multivariable logistic regression. The combined effect of anemia and rhinitis on hearing loss was assessed with an interaction term. Among the 2,772 participants, 477 (17.2%) exhibited hearing loss. Participants with anemia were more likely to experience hearing loss than those without anemia (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.33). Furthermore, the odds of hearing loss were greater in participants with both anemia and rhinitis (OR, 3.79; 95% CI, 1.93 to 7.43) relative to those without either condition. Anemia was associated with hearing loss in individuals aged 40 years and older. Based on the analysis of combined effects, participants with anemia and chronic rhinitis were more likely to experience hearing loss than individuals without these conditions.

Cross-linguistic variability in audiovisual enhancement of coronal consonants

The role of auditory perceptibility in phonological contrast is uncontroversial. In clear speech, speakers increase acoustic distance between contrastive phones, thereby improving perception. Although visual cues are also known to improve perception, it is unclear whether speakers actively enhance their speech for visual perceptibility. 20 native English and 20 native Mandarin speakers participated in a two-part production experiment. Words containing /l d n s r/ (and English /θ/) were elicited, with vowels balanced for height, backness, and rounding. Speakers first recited each word while alone in a soundproof booth. Words were then spoken for a native listener (who attempted to guess the word) over Zoom with heavily degraded audio. Audio and high-speed video were recorded. English speakers showed a significant increase in visually exaggerated articulations for /l, θ/ (but not /n, d, s, r/), including interdental and linguolabial productions with external lingual protrusion. Mandarin speakers increased their use of interdental articulation for /n, l, t, s/ (but not /r/), although lingual protrusion was limited. These results demonstrate that speakers may enhance their speech for visual over auditory perceptibility but suggest that enhancement is mediated by language-specific factors including phonological contrast and the articulatory characteristics of sounds in normal speech.

Development of a smartphone-based Turkish digits in noise test

BackgroundPure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing.MethodsThe digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss.ResultsThe Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p < .01). In addition, the results of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with conductive hearing loss (36.88 ± 6.31) (p < .01).ConclusionAn easy and accessible Turkish Digit in Noise Test mobile application has been developed using which one can assess his/her hearing.

Relationship between speech intelligibility and comprehension in the presence of poor acoustics and poor voice quality

Noisy classrooms with poor acoustics decrease children’s speech understanding and comprehension. The signal quality is also often degraded by voice disorders that have a prevalence of 60% among teachers. Emerging evidence demonstrates that cognitive factors such as working memory (WM), attention, and inhibitory control (IC) also mediate children’s ability to recognize speech in noise. Speech intelligibility and comprehension tests were performed in a sound-proof booth with xx normal-hearing elementary students. The vocal material was recorded by an actor with normal and mimicked dysphonic voice. Babble noise was added to obtain 2 signal-to-noise (SNR) ratios at 0 and −12 dB. The test was administered using Qualtrics to collect intelligibility and comprehension scores, and measure response time to evaluate listening effort. Children’s WM and IC were also evaluated to explain individual differences. Results showed a statistically significant decrease in performance and increase in response time for the highest SNR and the dysphonic voice with a more detrimental effect on comprehension. This research determined how listening comprehension interacts with speech recognition and cognitive factors in children, providing pilot data to examine the variability of students' learning experience in classrooms when auditory input is degraded by poor acoustics and poor voice quality.

Hearing screening using the uHear™ smartphone-based app: reproducibility of results from two response modes.

Estimate the reproducibility of hearing screening results using the uHear™ smartphone-based app in two response modes: self-test response and test-operator. Reliability study conducted with 65 individuals aged ≥18 years assisted at the Speech-language and Hearing Therapy clinic of a public higher-education institution. Hearing screening was conducted by a single researcher using the uHear app and earbud headphones in a soundproof booth. Participants responded to sound stimuli in both self-test response mode and test-operator mode. The order in which these two uHear test modes were applied was altered according to the entrance of each participant in the study. The correspondence between the hearing thresholds obtained from each response mode was analyzed and their Intraclass Correlation Coefficient (ICC) was estimated. A correspondence of ±5 dBHL >75% was observed between these hearing thresholds. The ICC values showed excellent agreement between the two response modes at all frequencies >40 dBHL tested. The two hearing screening response modes using the uHear app presented high reproducibility, suggesting that the test-operator mode is a viable alternative when the self-test response mode is not recommended.

Influence of sound spatial reproduction method on the detectability of reversing alarms in laboratory conditions

This paper investigates the ability of binaural recording and reproduction to be used for measuring the detectability of reversing alarms in laboratory experiments. A complex and repeatible scenario was created using a wave-field synthesis system (WFS), and in-situ recordings in a lime mine. The reproduced sound field was further recorded with a dummy-head. Participants were asked to achieve a visual task (target tracking) while detecting two types of reversing alarms (tonal and broadband), mimicking an approaching vehicle. The experiment was conducted twice : at the center of a WFS array and in a sound-proof booth, using binaural recordings presented with headphones. Results showed that the detection times measured using binaural listening were significantly different from those measured in a fully immersive sound field reproduction. These differences were also greater with tonal sounds compared to broadband sounds. This study shows the limitations of the binaural technique to be used for such applications.

Effect of Realistic Test Conditions on Perception of Speech, Music, and Binaural Cues in Normal-Hearing Listeners.

The purpose of this study was to determine the feasibility of online testing in a quiet room for three auditory perception experiments in normal-hearing listeners: speech, music, and binaural cue. Under Experiment 1, sentence perception was measured using fixed signal-to-noise ratios (SNRs: +10 dB, 0 dB, and -10 dB) and using adaptive speech reception threshold (SRT) procedures. The correct scores were compared between quiet room and soundproof booth listening environments. Experiment 2 was designed to compare melodic contour identification between the two listening environments. Melodic contour identification was assessed with 1, 2, and 4 semitone spacings. Under Experiment 3, interaural level difference (ILD) and interaural time differences (ITD) were measured as a function of carrier frequency. For both measures, two modulated tones (400-ms duration and 100-Hz modulation rate) were sequentially presented through headphones to both ears, and subjects were asked to indicate whether the sound moved to the left or right ear. The measured ITD and ILD were then compared between the two listening environments. There were no significant differences in any outcome measures (SNR- and SRT-based speech perception, melodic contour identification, and ITD/ILD) between the two listening environments. These results suggest that normal-hearing listeners may not require a controlled listening environment in any of the three auditory assessments. As comparable data can be obtained via the online testing tool, using the online auditory experiments is recommended.

A study on the IOS application "uHear" as a screening tool for hearing loss in Bangkok.

This study was designed to compare the results of hearing tests performed using the uHear application with those of standard audiometry in Thai people in Bangkok. From December 2018 to November 2019, a prospective observational study was conducted involving Thai participants aged between 18 and 80 years. All participants were tested using standard audiometry and the uHear application in a soundproof booth and in a typical hearing environment. This study included 52 participants (12 males and 40 females). The Bland-Altman plot with the Minimal Clinical Meaningful Difference of 10dB between standard audiometry and the uHear in a soundproof booth found agreement at 2000 Hz. The uHear in a soundproof booth showed high sensitivity at all frequencies (82.5%-98.9%) and high specificity at 500 and 1000 Hz (85.7%-100%). uHear in a typical hearing environment showed high sensitivity at 4000 and 6000 Hz (97.6%) and high specificity at 500 and 1000 Hz (100%). When considering the pure-tone average, uHear in a soundproof booth showed high sensitivity (94.7%) and specificity (90.7%), whereas, in a typical hearing environment, uHear showed poor sensitivity (34%) and high specificity (100%). uHear was accurate for hearing loss screening at 2000 Hz in a soundproof booth. However, uHear in a typical hearing environment lacked accuracy. The uHear application in a soundproof booth can be used to screen hearing loss in some situations where standard audiometry is impossible. II.

The Effects of Laboratory Environment Type on Intermittent Sound Localization

Virtual reality (VR) and augmented reality (AR) are gaining commercial popularity. 3D sound guidelines for AR and VR are derived from psychoacoustic experiments performed in contrived, sterile laboratory settings. Often, these settings are expensive, inaccessible, and unattainable for researchers. The feasibility of conducting psychoacoustic experiments outside the laboratory remains unclear. To investigate, we explore 3D sound localization experiments in-lab (IL) and out-of-the lab (OL). The IL study condition was conducted as a traditional psychoacoustic experiment in a soundproof booth. The OL condition occurred in a quiet environment of the participants' choosing, using commercial-grade headphones. Localization performance did not vary significantly for OL participants compared to the IL participants, with larger variation observed in the IL condition. Participants needed significantly more time to complete the experiment IL than OL. The results suggest that conducting headphone-based psychoacoustic experiments outside the laboratory is feasible if completion time is negligible.

Puretone Hearing Threshold Of Patients With Sickle Cell Disease In Kaduna, Nigeria

Background: Sickle Cell Disease (SCD) is characterised by the vaso-occlusive crisis, which can cause progressive cochlea damage resulting in hearing loss. Objective: This study aimed to determine the prevalence of hearing loss and establish the hearing threshold of patients with sickle cell disease at the study centre. Methods: We conducted a prospective cross-sectional study on participants with sickle cell disease and normal controls between 5-50 years of age. Otolaryngological examination and Pure tone audiometry were carried out on all participants in a soundproof booth at the National Ear Care Centre, Kaduna. The Sickle cell patients were randomly selected from the Sickle cell patient promotion centre Kaduna and Barau Dikko Teaching Hospital Kaduna. The collated data were analysed descriptively with the Statistical Package of Social Sciences. (SPSS version 25). Result: Sixty-two subjects with Sickle cell disease and 62 with normal (HbAA) controls were assessed. The ages of subjects ranged between 6-41 years, while the HbAA was 5–49 years, with mean ages of 14.8 ± 8.1 years for SCD and 20.8 ± 13.3 years for HbAA controls. The mean Puretone threshold of the adult with SCD in the right and left ears were 25.5dB and 25.15dB, while that of Paediatrics with SCD were 21.5dB and 21.4dB, respectively, and it is consistently higher in those with SCD than the controls but the difference was not statistically significant. The prevalence of hearing loss in SCD was 30.6% and 16.1% in the control group (χ2=3.65 and P=0.056). The prevalence of hearing loss in those &lt;15 years was 27%, and in those ≥15 years was 36% in the subjects with HbSS/HbSC. Among those with hearing losses, the majority had mild SNHL (89.7%) in the HbSS/HBSc and 94.4% in the HbAA group. Also, ten patients had bilateral affectation in HbSS/HbSC group compared to eight in the HbAA (χ2=3.94, P=0.021). Conclusion: The prevalence of hearing loss in patients with SCD is 30.6% and it is higher in those ≥15 years. Many cases are asymptomatic, hence the need for SCD patients in our environment to have their hearing checked regularly.

Software Application toward Accessible Hearing Care Assessment: Gap in Noise Test.

Currently, several methods are being applied to assess auditory temporal resolution in a controlled clinical environment via the measurements of gap detection thresholds (GDTs). However, these methods face two issues: the relatively long time required to perform the gap detection test in such settings and the potential of inaccessibility to such facilities. This article proposes a fast, affordable, and reliable application-based method for the determination of GDT either inside or outside the soundproof booth. The proposed test and the acoustic stimuli were both developed using the MATLAB® programming platform. GDT is determined when the subject is able to distinguish the shortest silent gap inserted randomly in one of two segments of white noise. GDTs were obtained from 42 normal-hearing subjects inside and outside the soundproof booth. The results of this study indicated that average GDTs measured inside the booth (5.12 ± 1.02 ms) and outside (4.78 ± 1.16 ms) were not significantly different. The measured GDTs were also comparable to that reported in the literature. In addition, the GDT screening time of the proposed method was approximately 5 minutes, a screening time that is much less than that reported by the literature. Data show that the proposed application was fast and reliable to screen GDT compared to the standard method currently used in clinical settings.

French Version of the Antiphasic Digits-in-Noise Test for Smartphone Hearing Screening.

In France 58% of persons with hearing loss still do not wear hearing aids. Pure-tone audiometry is the traditional gold standard in assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. The antiphasic digits-in-noise (DIN) test does not require calibrated material and can run on a standard headset or earbuds connected to a smartphone or a computer. The DIN test is highly correlated with pure tone audiometry and has already shown to be effective in hearing loss screening in its English version promoted by the WHO. The aim of the present study was to develop and validate a French version of the antiphasic DIN test for implementation on a national screening test offered as a smartphone app. The audio files recorded from a French native female speaker were selected and normalized in intensity according to their recognition probability. The French DIN test application was then tested on normal hearing- and hearing-impaired subjects. Based on the strong correlation between pure tone audiometry (PTA) and DIN SRT, we calculated ROC curves and Z-score. For PTA > 20 dB HL, a SNR cutoff of 12.9 dB corresponds to a sensitivity and specificity of 0.96 and 0.93, respectively. To detect moderate and more severe hearing loss (PTA > 40 dB HL), the SNR cutoff was −10.9 dB, corresponding to a sensitivity and specificity of 0.99 and 0.83, respectively. The Z-score was calculated to define statistical criteria of normality for speech-in-noise evaluation. While a score of 0 roughly corresponds to the normality (DIN SRT = −15.4 dB SNR), a subject with DIN SRT > −12.2 (Z-score > 2) is ranked in the hearing loss population. Next, the French antiphasic DIN test was implemented in the Höra iOS and Android apps. In total, 19,545 Höra tests were completed and analyzed. Three quarters of them were classified as normal (74 %) and one quarter presented mild (9%) or more severe loss (17%). Together, results argue for the use of the French version of antiphasic DIN test in the general population to improve the screening of hearing-impaired individuals.

Diagnostic Accuracy of Smartphone-Based Audiometry for Hearing Loss Detection: Meta-analysis.

BackgroundHearing loss is one of the most common disabilities worldwide and affects both individual and public health. Pure tone audiometry (PTA) is the gold standard for hearing assessment, but it is often not available in many settings, given its high cost and demand for human resources. Smartphone-based audiometry may be equally effective and can improve access to adequate hearing evaluations.ObjectiveThe aim of this systematic review is to synthesize the current evidence of the role of smartphone-based audiometry in hearing assessments and further explore the factors that influence its diagnostic accuracy.MethodsFive databases—PubMed, Embase, Cochrane Library, Web of Science, and Scopus—were queried to identify original studies that examined the diagnostic accuracy of hearing loss measurement using smartphone-based devices with conventional PTA as a reference test. A bivariate random-effects meta-analysis was performed to estimate the pooled sensitivity and specificity. The factors associated with diagnostic accuracy were identified using a bivariate meta-regression model. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsIn all, 25 studies with a total of 4470 patients were included in the meta-analysis. The overall sensitivity, specificity, and area under the receiver operating characteristic curve for smartphone-based audiometry were 89% (95% CI 83%-93%), 93% (95% CI 87%-97%), and 0.96 (95% CI 0.93-0.97), respectively; the corresponding values for the smartphone-based speech recognition test were 91% (95% CI 86%-94%), 88% (95% CI 75%-94%), and 0.93 (95% CI 0.90-0.95), respectively. Meta-regression analysis revealed that patient age, equipment used, and the presence of soundproof booths were significantly related to diagnostic accuracy.ConclusionsWe have presented comprehensive evidence regarding the effectiveness of smartphone-based tests in diagnosing hearing loss. Smartphone-based audiometry may serve as an accurate and accessible approach to hearing evaluations, especially in settings where conventional PTA is unavailable.

Boothless Aided Audiometry: A Pilot Study

Background Although free-field aided audiometry is not the gold standard of hearing aid verification because of its many limitations, it is still circumstantially needed. The conventional method of sound-field aided audiometry requires a sound-proof booth. However, as clinicians face a high-volume of audiometric tests ordered daily at the otolaryngology clinic, a sound-proof booth may not be always available when needed. This study aims to explore if out-of-booth free-field aided audiometry can be just as reliable as the conventional method. Methods A pilot exploration of 10 patients (20 ears), with at least a moderate degree of bilateral symmetrical sensorineural hearing loss was conducted. Patients were recruited during their follow-up hearing aid appointments with their audiologist. All patients had been fitted with hearing aids for at least 6 months in duration, and their hearing aids were optimized. Results Out-of-booth aided audiometry for the main frequencies of interest was reliable with good correlation between the two methods at primary frequencies (500 Hz–4 KHz). However, results in the high frequencies were less reliable and needs to be interpreted cautiously. Conclusion Out-of-booth sound-field audiometry may be a quick and reliable method that can be used to fulfil its intended purpose with the added advantage of not needing an arguably expensive audiometric booth. However, not all frequencies of interest can be assessed with reliable measurements. Further larger studies are needed to validate the reliability of boothless sound-field audiometry to meet evolving healthcare needs.

Sex differences in noise-induced hearing loss: a cross-sectional study in China

BackgroundSignificant sex differences exist in hearing physiology, while few human studies have investigated sex differences in noise-induced hearing loss (NIHL), and the sex bias in previous studies resulted in inadequate female data. The study aims to investigate sex differences in the characteristics of NIHL to provide insight into sex-specific risk factors, prevention strategies and treatment for NIHL.MethodsThis cross-sectional study included 2280 industrial noise-exposed shipyard workers (1140 males and 1140 females matched for age, job and employment length) in China. Individual noise exposure levels were measured to calculate the cumulative noise exposure (CNE), and an audiometric test was performed by an experienced technician in a soundproof booth. Sex differences in and influencing factors of low-frequency (LFHL) and high-frequency hearing loss (HFHL) were analyzed using logistic regression models stratified by age and CNE.ResultsAt comparable noise exposure levels and ages, the prevalence of HFHL was significantly higher in males (34.4%) than in females (13.8%), and males had a higher prevalence of HFHL (OR = 4.19, 95% CI 3.18 to 5.52) after adjusting for age, CNE, and other covariates. Sex differences were constant and highly remarkable among subjects aged 30 to 40 years and those with a CNE of 80 to 95 dB(A). Alcohol consumption might be a risk factor for HFHL in females (OR = 3.12, 95% CI 1.10 to 8.89).ConclusionsThis study indicates significant sex differences in NIHL. Males are at higher risk of HFHL than females despite equivalent noise exposure and age. The risk factors for NIHL might be different in males and females.

Effect of Realistic Test Conditions on Spectral and Temporal Processing in Normal-Hearing Listeners.

Purpose To measure the effect of testing conditions (in the soundproof booth vs. quiet room), test order, and number of test sessions on spectral and temporal processing in normal-hearing (NH) listeners. Method Thirty-two adult NH listeners participated in the three experiments. For all three experiments, the stimuli were presented to the left ear at the subjects' most comfortable level through headphones. All tests were administered in an adaptive three-alternative forced-choice paradigm. Experiment 1 was designed to compare the effect of soundproof booth and quiet room test conditions on amplitude modulation detection threshold and modulation frequency discrimination threshold with each of the five modulation frequencies. Experiment 2 was designed to compare the effect of two test orders on the frequency discrimination thresholds under the quiet room test conditions. The thresholds were first measured in the ascending and descending order of four pure tones, and then with counterbalanced order. For Experiment 3, the amplitude discrimination threshold under the quiet room testing condition was assessed 3 times to determine the effect of the number of test sessions. Then the thresholds were compared over the sessions. Results Results showed no significant effect of test environment. The test order is an important variable for frequency discrimination, particularly between piano tunes and pure tones. Results also show no significant difference across test sessions. Conclusions These results suggest that a controlled test environment may not be required in spectral and temporal assessment for NH listeners. Under the quiet test environment, a single outcome measure is sufficient, but test orders should be counterbalanced.

“It's an emotional rollercoaster” the spatial and temporal structuring of affect in diagnosing childhood hearing loss

Despite well-established screening for hearing problems, and objective, diagnostic techniques aimed at dispelling uncertainty, some parents spend months waiting for clear diagnosis of their child's hearing loss. In the clinical setting, providers use international best-practice policies in diagnosing and managing childhood deafness, yet limited attention is given to the role of emotion in this context. Drawing on socio-spatial and temporal theories we conceptualise the clinical waiting room and soundproof booth of a paediatric hearing clinic as affective spacio-temporal places that both constrain and evoke emotion. Tensions between parents and professionals grew, and emotion and affect were problematised in the clinical setting where temporal notions held significance. We consider contentious or difficult areas in the management of childhood deafness through a number of cases of parents experiencing uncertainty as they grapple with decisions for their children. Alternative spaces and experiences in non-medical settings that hold value for parents are discussed in considering new approaches to managing childhood deafness.

Do we need two ears to perceive the distance of a virtual frontal sound source?

The present study investigated whether the perception of virtual auditory distance is binaural, monaural, or both. Listeners evaluated the distance of a frontal source of pink noise simulated in a room via headphones. Experiment 1 was performed with eyes closed in a soundproof booth. Experiment 2 was performed with eyes open in the room used to create the stimuli. Individualized and non-individualized stimuli were compared. Different conditions for controlling sound level were tested. The amount of binaural information in the stimuli was varied by mixing the left and right ear signals in different proportions. Results showed that the use of non-individualized stimuli did not impair distance perception. Binaural information was not used by naive listeners to evaluate distance, both with and without visual information available. However, for some listeners, a complete absence of binaural information could disrupt distance evaluation with headphones. Sound level was a dominant cue used by listeners to judge for distance, and some listeners could also reliably use reverberation-related changes in spectral content. In the absence of specific training, artificial manipulation of sound level greatly altered distance judgments.

The Use of Artificial Intelligence to Program Cochlear Implants.

Cochlear implant (CI) technology and techniques have advanced over the years. There has not been the same degree of change in programming and there remains a lack of standardization techniques. The purpose of this study is to compare performance in cochlear implant subjects using experienced clinician (EC) standard programming methods versus an Artificial Intelligence, FOX based algorithm for programming. Prospective, nonrandomized, multicenter study using within-subject experimental design SETTING:: Tertiary referral centers. Fifty-five adult patients with ≥ 3 months experience with a Nucleus 5, 6, Kanso, or 7 series sound processor. Therapeutic Main Outcome Measures: CNC words and AzBio sentences in noise (+10 dB SNR) tests were administered in a soundproof booth followed by a direct connect psychoacoustic battery using the EC program. Tests were repeated 1 month later using the optimized FOX program. Subjective measures of patient satisfaction were also measured. Performance for the EC program was compared to the FOX program for both measures. Group mean results revealed equivalent performance (Kruskal-Wallis ANOVA p = 0.934) with both programming methods. While some patients had better performance with the FOX method and some performed more poorly, the majority had equivalent performance and preferred the FOX system. The study demonstrated that on average, FOX outcomes are equivalent to those using traditional programming techniques. In addition, the FOX programming method can effect standardization across centers and increase access for many individuals who could benefit.