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Validity and efficacy of testing outside a sound booth
Serpanos, Y. C., Hobbs, M., Nunez, K., Gambino, L., & Butler, J. (2022). Adapting audiology procedures during the pandemic: Validity and efficacy of testing outside a sound booth. American Journal of Audiology, 31(1), 91-100. https://doi.org/10.1044/2021_AJA-21-00108
PURPOSE: This investigation aims to provide outcomes from a clinical perspective on the validity and efficacy of a wireless automated audiometer system that could be used in multiple settings when a sound booth is not accessible. Testing was conducted in a clinical setting under modified protocols meeting safety precautions during the COVID-19 pandemic.
METHOD: Four doctoral students in audiology served as examiners. Participants were 69 adults between the ages of 20 and 69 years, with normal hearing (≤ 25 dB HL; n = 110 ears) or hearing loss (> 25 dB HL; n = 25 ears). Two versions of a pure-tone air-conduction threshold test following a modified Hughson-Westlake approach were performed and compared at 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz (a) in a sound-treated test booth using standard manual audiometry and (b) in a quiet, nonsound-treated clinical room (sound booth free) using automated KUDUwave audiometry. Participants were asked to complete a five-item feedback questionnaire, and examiners were interviewed to report on their experience.
RESULTS: Clinical validity to within ±10 dB of standard audiometry was demonstrated for 94.5% of the total thresholds (n = 937) measured with the sound booth-free approach. Less accuracy (73.3%) was observed using a ±5 dB comparison. When comparing the mean thresholds, there were significant differences (p < .01) between the mean thresholds at most frequencies, with mean sound booth thresholds being higher than the sound booth-free mean thresholds. A strong threshold correlation (.91-.98) was found between the methods across frequencies. Participant and examiner feedback supported the efficacy of the sound booth-free technology.
CONCLUSIONS: Findings support sound booth-free, automated software-controlled audiometry with active noise monitoring as a valid and efficient procedure for pure-tone hearing threshold assessment. This method offers an effective alternative when circumstances require more transportable hearing assessment technology or do not allow for standard manual audiometry in a sound booth.
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