What!!! Hearing tests are not perfect, goodbye cruel world!!
You haven’t posted in 7 months and that’s the best response you could come up with?
Some “patients”, or persons, are predisposed to preferring certainty. With tinnitus too, such persons (likely including myself!) cannot be reliably or precisely tested, IMHO.
Ambiguity that is introduced by “if you think you hear it” conditions is expected to increased, probably massively.
Just my $0.02, FWIW. Best, Bob.
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I completely agree with you, but that isn’t cheating, to be honest the time of the day will affect my hearing loss which will affect the results of my hearing test.
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On a more serious note though, I was playing around with my jabras today trying to do an in situ test and use the built in hearing test. It is very interesting to take the test when I know the sound is playing as I hit the button 
I had too much cat distraction and will try again later but should be an interesting experiment. In this case I am definitely trying to see what I can and cannot hear. As I seemed to hedge on the ‘if I’m not sure say no’ side so will see how that affects things.
Easy for me. I hear nothing
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Me too Chuck, I hear way worse in the evening than in the morning…
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I’ve thought about this several times over the years. When I was younger and my hearing was much better I was always thrown by the sounds I could hear form outside the booth…people walking down the hallway…and the booth was in a closed door room. I think this is silly, no way can this test be meaningful if people making noise way out there can make me miss one of the low level beeps…
and then the tinnitus, etc…
I’ve come to accept that “good enough” is probably the key phrase. No doubt the audiologists can cull through the noise and mistakes of the test…or at least much of it.
+
it doesn’t really matter of the REAL result is an 2 dB loss vs a 2.2 dB loss. Well I’m an Engineer so it does to me…but not for any practical reason
whatever…it’s all about good enough and tweaking the aids for “decent” understanding of speech (or hearing of sounds)
Most booths or at least the ones that I get tested in now are sound proof. But there will always variables. But I look at my test results over 30 years and I would have to conclude that the tests are pretty reliable. My first hearing test that showed a discrepancy happened in a school nursing office. Good enough to spot a problem
Would a kind soul please tell me how to post a message? Thank you so much! Rosedala
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Click on your avatar (symbol that you created (flags in your instance) in upper right hand corner. Menu opens, click on name at far left, then click on messages. Under your audiogram, there should be “New Message” highlighted in blue. I think it’s self explanatory after that, but if not, let us know.
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Oh MDB how kind of you! THANK YOU so much! I guess they either changed the spot or I don’t remember it but…why so secretly hidden??? lol! I’ll try it and hopefully I won’t have to disturb you in this thread again. :o)
Not sure at this point in the discussion how valuable this information is, but there is in the US and many countries an established standard on how to perform an audiological pure-tone assessment. In the US, it falls under ANSI/ASA Standard 3.21 - Methods for Manual Pure-Tone Threshold Audiometry with the great majority, or at least plurality, of every automated system being derived from this standard to be able to provide that in their literature when selling the equipment.
What wasn’t entirely clear is who was providing the instructions in the initial message of the thread creator - “If you hear the beep or think you hear it” is usually an instruction by a person, not an automated system, but there are certainly many out there that could provide this set of test instructions. As such, most individuals who are doing regular pure-tone audiometric testing (not fresh-faced at the testing) are easily able to vary pitch/duration to make the testing reliable within the repeatable/validity measure of tolerance level.
Which is not to say that it isn’t impossible to over-respond or track a person’s testing paradigm, but it should be rather difficult barring any presupposition by the test performer on how your hearing ‘should’ look.
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Thanks for input @AuDacious. The article I quote is from ASHA which states as part of Instructions a bit different wording than what you state (If you hear the beep or think you hear it); but both are a bit ambiguous by which I mean they clearly indicate that one responds even if you are not certain you heard it, but leaves to the subject how much uncertainty is OK. At a practical level those individual differences in how instructions are interpreted probably have little impact on test results (if someone is not faking it) especially since threshold is determined from several presentations at the same frequency and level.
" Instructions . The test instructions should be presented in a language or manner appropriate for the participant. Interpreters (oral or manual) should be used when necessary. Supplemental instructions may be provided to enhance understanding, such as written directives, gestures, and demonstrations. Test instructions shall accomplish the following:
- Indicate the purpose of the test, that is, to find the faintest tone that can be heard.
-
Indicate that the participant is to respond whenever the tone is heard, no matter how faint it may be.
*Etc."
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Hello,
The ASHA guideline is based off of the ANSI Standards, but written for the public- facing nature of the ASHA guidelines.
You are, on a large scale, correct that, from a psychometric perspective, the way that tones are presented to the user (the Houghston-Westlake process to obtain threshold) helps significantly to increase reliability. All automated systems use this method electronically, and so it is mostly up to the manufacturer whether the validity is maintained by alternating rate of presentation/gauging latency. The less intensive the microprocessor, the more likely it is ‘trackable’/predictable as people have mentioned.
This is usually acceptable risk in an Occupational setting because there will eventually be an assessment by an actual person at ‘some point’.
The reason that ‘even if you are unsure, still respond’ is stressed is because the volume/tone increases used should not be heard 100% of the time (floor effect), but 50%. If you are unsure, but still respond, it may be right at threshold or not-the end result should be the ‘proof’ even though there will always be exceptions.
Hope this increased uncertainty pulls back the curtain a bit!
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Excellent and clarifies important part of testing and scoring rationale to arrive at a threshold determination. Thanks for making me more knowledgeable.
Thanks, I found these posts really useful.
I’ve been diagnosed with mild hearing loss; during my last test (I’m in the UK), I was in a REALLY quiet room, the tones were in a predictable pattern and the nurse told me “even if you just think you might have heard anything at all, press the button”. I was literally sat with tightly shut eyes desperately trying to concentrate to pick up tones (lots of guesswork tbh), then afterward couldn’t help thinking how the test I took didn’t translate to the real world where I do hear voice but really struggle to filter out ambient noise/other voices to know what’s being said.
Sounds like maybe next time I should only press if I’m sure I’ve definitively heard a tone.
Those are two different tests. The pure tone test measures hearing ability and there is also a word recognition test which measures word recognition. Although even those have their issues. My word rec is fairly good - 100% r, 80% l and yet my word rec in conversation, particularly on my left, is really not great. I can’t measure it per se but I am not thrilled with it. However I’m learning to live with it and be a bit more proactive…
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Thanks for that, I wasn’t given a word rec test at the hospital, only what must have been pure tone. I have taken word rec tests online and they also show mild NIHL (I have a long history of loud machinery without sufficiently protecting my ears that I’m paying for).
This is NHS (UK National Health Service), which I’m a big advocate of, but think I’ll get tested at a private high street place where they do just this all day long.
As you say, I’m also trying to be proactive and adding a TV soundbar and over-ear headphones helps at home.
There is a soundbar by the company zvox that says it enhances sounds for voice to make it easier to understand. I keep considering it…
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