Are hearing tests reliable?

Many years ago, as I walked into the building for my first hearing test, I passed under a ventilation fan that had a bad bearing. The squeal suddenly increased the tinnitus in one ear. Naturally, I scored poorly in the test.

The technician was concerned that I might have a tumor, despite my description of the sudden increase in tinnitus. He insisted on my undergoing an MRI scan on my head, which was negative. Or as my wife teased “They didn’t find anything.”

A re-test the next year was normal, showing mild/moderate loss essentially equal in the two ears (which got much greater 10 years later following chemo).

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Took my physical in Fort Hamilton in Brooklyn NY . It was like an assembly line . About 10 of us were marched into a big green box sat down in what I guess you could call booths but basically a metal chair with plastic dividers and ordered to put the headphones on. We all finished together and ordered to leave the booth and the next 10 were shuffled in. And God forbid you failed. This was preinduction. Took that on 2 seperate occasions. Took a third test in great lakes illinois during A school for submarine duty. Similar set up but the booth was smaller holding only one person but fully automated. I guess a bad result would have warranted a more thorough examination but like a said I had been trained by my recruiter how to pass the test. But my first bad test came back to haunt me because I didn’t get submarine duty Also at 20 years old my progressive loss wasn’t that bad at that point. I wasn’t wearing hearing aids and wouldn’t get my first pair for another 8 years. So chuck thank you for your service. Something you didn’t hear back in those days. Nixon Vietnam Watergate power to the people. A military uniform was frowned upon. But then again the big apple was a world of it own. Still is. Which is why I don’t live there anymore

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I always note to the audiologist that a) I have tinnitus and b) I’m concerned about skewing the results. In a few instances cases they’ve adapted the tone to be a short ‘tremelo’ note rather than a beep as it stands out from the tinnitus. All my tests seem to be consistent - I’ve been a cookie bite across the tests I have results for (10 years worth).

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Just to add, all tests have an acceptable margin of error. I think I’ve read that it’s in range of 5-10 dB for audiograms. I think we have a tendency to think these tests are more precise than they are.

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My Audiologist says 10db , but it depends on the loss too.

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That’s for sure. When you get a reading of 110db ten decibels either way means nothing

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I served for 6 years, then got out. A couple years later I decided to go back in. I failed the hearing test. The examiner told me if I wanted to re enlist, that I would go back into the booth and do whatever it took to pass the test…Well…The booth had 10 patients with headphones on and facing each other. Sooooo I just watched the guy in front of me, and pushed the button each time he did…I passed and went on to serve 5 more years. After the fifth year the military forced me to retire due to bad knees and (you guessed it) bad ears…so, there are reasons to skew the test…
Dan

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Back in my day we didn’t have that option, there wasn’t such a setup.

Dan thank you for verifying what I was saying all along. CVS I don’t know when your day was but my day was early 70s. Obviously everyones experience was different. But it existed whether an individual esprienced it or not

As to the general veracity of tests, there’s a couple of things that are important.

Testing with headphones is usually less accurate than testing with inserts; peripheral leakage, external noise, differences in residual canal volume, fully collapsing the EAM etc.

Levels; 5dB steps are greater than a doubling of the sound energy (though apparent doubling is about 10dB). This might only seem like a small thing, but geometric progression actually means you’re very likely to be within one step of your actual threshold.

Fakery; yes people do try this. Poor testing technique and auto tests are subject to more errors, however once you’ve spent a few weeks doing industrial noise claims, you can spot the fakers with bells on. The lawyers hate it; they’ve usually got some time/effort invested in that client already.
It’s the simple stuff that gives it away; answering background questions from me facing the other way while I get up to close the door (with a supposed flat 70dB loss), the BC not matching the AC, reflexing to sounds they ‘can’t hear’, repeat test variability, over exertion during the test. All sorts really. I’d give them one chance to repeat the test with real values, then bounce them.

So, to answer the original question, testing is pretty reliable. The calibration of electronic kit is unlikely to wander these days (except BC vibrators) that have a habit of decaying slowly. Your Audiologist is likely to have a previous record for you; so can spot if things are ‘off’ pretty quickly.
I did have a transducer lead that had an occasional fault once; which was fun to find.

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You sound like you go into each review assuming people are lying

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My Audiologist uses plugs in my ear canals for tone test and headphones for the word recognition test. And he will lock down the sound booth and test my word recognition with my aids on, while pumping in noise like a restaurant.

Actually, no, virtually every normal hearing test that we use as the basis for hearing aid fittings is genuine.

The bit about people faking tests was in response to the above discussion about testing accuracy and people swinging the lead over assessments. It never comes into daily practice unless the client has other issues. However if you are involved in an industrial insurance assessment, the way you approach testing changes.

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The bottom line was are automated test used. The answer obviously was yes because the op experienced it and others confirmed it. The next part was can they distort results and again the answer obviously is yes and should never be used on someone with a loss who is considering hearing aids. As far as speech with noise mine is done in the booth with the headphones jacked up . I score 20 percent . How do you think I’ll do if they add noise. I’ll be there all day

Thanks @Um_bongo for offering comments of professional with substantial experience in the field.

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Bongo I think you made the difference very clear

I may be weird, but the only reason I get my hearing tested is to have my hearing aids adjusted, and I do my best, but never push the button until I hear the tone.

I want my hearing aids adjusted properly. If I fake a tone, she will not turn that frequency up enough, and won’t hear as well with my aids as I should.

I wouldn’t fake it to join the armed forces. I tried to join when I was 18 but rejected. It was before Nam when they were being very picky, and I had a case of bronchitis when they scheduled my physical.

Then Nam broke out, and I realized that I was actually very lucky.

I make my living as a musician, and almost every summer our duo goes to the nursing home at the VA hospital - wheelchair division, and we give the vets an afternoon of music (free concert). It’s our way of saying “Thank you for your service”. We’ve met some very nice and very interesting people there.

Many have hearing problems due to their time in combat. We can relate on that level and have a few laughs.

Bob

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I’m not sure what your point is Bob. No one here said they try to fake their hearing test when they go to get to get their aids adjusted. Why would anybody do such a thing. This thread was about automated hearing tests and the fact that results because they are automated can be distorted. And whether you understand it not there are a lot of people out there that want to to serve in the military and do so voluntary. It’s been a long time since the draft so somebody is signing up. And they don’t seem to worry about whether there’s a military action going on at the time to decide what they do. Anyway this thread questioned the accuracy of automated hearing tests and their validity. Not weather you wanted to serve in Vietnam or not

Good points hass.

But I still don’t understand why to cheat to get into the military. If you end up in combat, and you don’t have the skills you cheated and said you had, you might end up not only in a dangerous position for yourself, but for those military people around you. You could get yourself and your buddies killed.

Hearing tests are simple, when you hear the tone, react appropriately. That’s the way to get the most accurate test you can.

Bob

If you don’t understand then you don’t understand. And it’s better that you failed the hearing test and Vietnam came along. But please enjoy your freedoms that are allowed in this country and that others put their lives on the line to make sure those freedoms are available for you to enjoy. You would have been a big hit right after pearl harbor