Improved Sensitivity of Digits-in-Noise Test to High-Frequency Hearing Loss.
Lina Motlagh Zadeh, Noah H Silbert, De Wet Swanepoel and 1 others
PMID 33928924WHAT IT FOUND
A Digits-in-Noise test using a 4 kHz low-pass noise filter detected high-frequency hearing loss with 92% sensitivity.
This filter outperformed standard broadband noise, offering a more accurate screening tool for identifying subtle high-frequency deficits that standard tests might miss.
Key findings
01The 4 kHz low-pass filtered DIN test achieved the highest area under the ROC curve (0.97) and 92% sensitivity for detecting high-frequency hearing loss.
02Speech reception thresholds for the 4 kHz filtered noise showed the strongest correlation with extended high-frequency pure tone averages (r = 0.81).
03Low-pass filtering improved sensitivity to hearing loss across the spectrum compared to broadband noise, with the 2 kHz filter being most specific for lower-frequency losses.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The hearing-impaired group had relatively mild hearing losses, so the results may not generalize to patients with severe or profound hearing loss. The study focused on adults; while the authors suggest potential for children, the data here is from participants with a mean age of 29.4 for the normal-hearing group and 54.2 for the hearing-impaired group. The test was delivered via headphones in a sound booth; the authors note that sound-field versions are being developed but were not tested here.
Declared interests
The research was supported by the National Institute on Deafness and Other Communication Disorders (N.I.H., Extramural) and Non-U.S. Government sources. No commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume this test replaces standard pure-tone audiometry for all patients. The study showed the 4 kHz filter was superior for high-frequency loss, but the 2 kHz filter was better for lower-frequency loss. A single filtered test may miss specific types of hearing deficits depending on the cutoff frequency chosen.