Using Thresholds in Noise to Identify Hidden Hearing Loss in Humans.
Courtney L Ridley, Judy G Kopun, Stephen T Neely and 2 others
PMID 29337760WHAT IT FOUND
A statistical model predicted hearing difficulties in noise using standard tests and brainstem responses, but this was a small exploratory study.
No clinical diagnostic tool is available yet, and current interventions for this condition do not exist.
Key findings
01A multiple linear regression model significantly predicted the variance in hearing thresholds in noise that was not explained by quiet thresholds, with correlation coefficients of 0.78 at 1 kHz and 0.69 at 4 kHz.
02The model explained 61% of the variance at 1 kHz and 48% at 4 kHz, but the authors note this predictive power is limited by the small sample size and lack of a gold standard for the condition.
03Self-reported noise exposure history did not correlate with the physiological measures of nerve damage or the predicted hearing deficits, contradicting some previous findings.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was exploratory with a very small sample size (33 participants) relative to the number of variables analyzed, requiring complex statistical reduction methods. There is no 'gold standard' for hidden hearing loss in humans, so the model was validated against a proxy measure (the residual of noise thresholds) rather than a confirmed diagnosis. The noise exposure questionnaire was subjective and did not correlate with the physiological findings, raising questions about its reliability. The model was not tested on an independent group of participants, so its generalizability is unknown. The study excluded individuals with significant hearing loss or conductive components, limiting applicability to the broader population.
Declared interests
The work was supported by the National Institute on Deafness and Other Communication Disorders (N.I.H.). No commercial conflicts of interest were declared.
The easy way to misread this
Do not interpret the model's statistical success as a validated clinical diagnostic test. The study used a proxy definition for hidden hearing loss, had a very small sample size, and did not validate the model on independent patients. Furthermore, the lack of correlation with noise exposure history means this model cannot currently be used to attribute hearing difficulties to specific noise events.