Audiogram explanation advice?


Below is a shot of my audiogram. I understand the frequency response section, but I’m a little unsure what the graph at the bottom is telling me. i know SRT is Speech Response Threshold, but why do my result actually indicate? My Audi did briefly mention them after the test, but didn’t go into detail so I didn’t think about it at the time. I see the 5dB left and 7dB right cross the line at 50%. Does that mean I recognise 50% of the words at 5/7 db volume level? Is that good or bad? When she did the test, I could barely make out any of the words.

Also, the PTA section above, what do the numbers represent? I have tried googling but haven’t found a meaningful explanation that help me interpret the numbers.




Pure tone average (PTA) is the average decibel loss at 500hz, 1000hz and 2000hz). 25dB is considered pretty mild. I’ve never seen SRT presented quite that way. Percentage correct is on the vertical (up/down) axis and decibels is on the horizontal. The numbers in the middle from 0 to 100 seem to be decibels beyond "normal’ hearing, which goes up to a 20 dB loss. Both ears (X and O) are very similar and you understand 50% of the words at 5-7 dB and 100% at 40dB. That is quite good. It suggets that with just a little bit of amplification you should be able to understand speech more easily. Oops. Correction. 50% of the words correct at 25-27dB. Easy to get confused with 2 scales.

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Great, thanks for that.

So why is PTA only done up to 2Khz? Doesn’t normal speech go up to 4Khz? Or is there not enough significant sounds above 2Khz to influence the average needed to understand speech enough?



I don’t think PTA is used for much of anything, but it’s easy to calculate so it’s done. I think some states use it to determine eligibility for hearing aids for Medicaid. There are also different variations that use different frequencies. Normal speech goes to at least 6Khz for female “s” sounds, but up to 2Khz covers the bulk of speech.



in india PTA on 500hz 1k hz 2k hz and 4k hz determined and its called speech frequencies(main) and used for eligiblity for disablity certificate if have avg 60 HOH andif 70 and up you are deaf. hence low frequency loss / cookiebite loss candidate nither eligible for certificate and related benefit nor able to talk like normal skie slope loss people. also they are not checking speech score just pta is criteria



So, that’s basically an SRT of 25 bilaterally. I’ve never seen it presented that way either. Bizarre. Maybe it’s an efficiency thing. If I had to guess from the graph, I’d think they presented 8 words in the left and 10 in the right. That doesn’t seem faster than the traditional staircase method, really.



All I remember is that I heard the first 3 or 4 words OK, guessed at the next 3 or 4, then pretty much said “no idea” for the rest. I thought I was doing terrible. Maybe my guesses were right after all.



I have personally never had much use for the SRT test. It is required to be done in some states but I have always felt it pretty much useless. It is suppose to weed out malingerers, but unless litigation is involved, who would want to fake a hearing loss??? You did not mention if hearing aids were recommended or not. I always looked at 2Khz, if it was below 30 and the patient was experiencing difficulty, then trying hearing aids would be worth it. If the patient was not experiencing any difficulty, it was probably not worth even trying. The key word is “trial” if you don’t notice enough improvement to justify the expense, you have no business keeping the hearing aids.

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I think that I’ll be an interesting trial case when I get my Quattro’s. In everyday life, I don’t notice much hearing loss. I can understand male speakers and moderate-to-low voice female speakers just fine almost all the time. My wife, though, has a soft relatively higher-pitched voice and as she ages, suffers from allergies and perhaps being a non-native English speaker tends to slur her words a bit on top of my hearing loss.

But even if I could get by pretty well without HA’s for almost all human speech, the thing that I notice most (besides not hearing turn signals or high-pitched security system buzzers, etc.) is that the “Golden Oldies” no longer sound the way that I remember them. So I don’t know if it’s worth real expensive hearing aids just to restore my listening pleasure but I’m looking forward to finding out what HA’s can do for me in that department.



Yes I have been recommended hearing aids. I’m getting Opn 3’s in 10 days. I hope they work because I have a lot of trouble with speech in noise, soft voices and high frequencies.



You and I are on a pretty similar track, except your aids cost twice as much as mine :slight_smile: You seem to have slightly better low frequency and slightly worse high frequency, but still close. I could probably live without aids for quite a while yet, but I’m not sure the people around me can. I don’t think it’s fair everyone has to keep repeating themselves all the time, or that I keep calling Mrs Smith, Mrs Fish when she comes to the front counter.

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I wonder a bit to what degree “please the customer” is factored into such a recommendation. Essentially I went to an audiologist seeking the justification to get hearing aids and discussing my perceived need for them with her before the audiogram. After the audiogram, she announced with a big smile on her face, “I think I can recommend hearing aids for you” - and I understand for FDA requirements or whatever, that HA’s actually have to be medically recommended before they can be fitted. So I was wondering if in “on the fence” situations, an audiologist might be tempted to tip the recommendation in the direction the customer desires or whether audiologists by and large always play things strictly by the book? (not that I have an on-the-fence audiogram but I just remember that the audiologist who did my audiogram seemed to be pleased to deliver the verdict that I let her know that I was hoping for all along).



Oh I always assume that anyone selling me stuff is biased as to whether I need it or not, even if their intentions are good. But I’ve known for years I’ve had hearing problems, because I miss a lot of things that others around me don’t. I just couldn’t afford them, so didn’t follow up. I still can’t afford them, but there comes a point where the potential benefits outweigh the costs, so you sacrifice one thing for another.

I’m grateful I have a lot more choice in this decision than a lot of other people here with severe or profound loss for who hearing aids are essential and they need the best money can buy. But I don’t think that means if I’m only going to get a small improvement, that I shouldn’t bother. Why shouldn’t we all have the best quality of life we can, if we can make it happen without hurting anyone else?

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@gorgeguy I’m curious about a couple of your comments. You mentioned litigation, or people not experiencing problems. Is people unnecessarily seeking hearing aids a big issue where you are? As you mentioned, why would people be getting tested if they weren’t having issues?

Maybe it’s a cost difference thing. In Australia, there are some groups that get government assistance for the cost of basic hearing aids, but apart from that, medical insurance cover for aids far exceeds the costs. $5,000 = $10,000 a year in insurance premiums may get your $500 to $1,000 back on the cost of hearing aids. My Opn 3’s at the best price I could find with local support are $5,000.



Yes, fit the patient not the loss. If someone is in the borderline zone and not reporting any difficulties at all, I tell them to wait. Someone with the same hearing loss coming in with a lot of problems would go ahead with a trial. There’s not a black and white cutt-off for who would benefit, and lifestyle and auditory processing plays into it.

Per georgguy’s comment, most of the malingers I see are between the ages of 8 and 14. Though sometimes with the oldest adults cognitive issues will affect how they are responding to tones despite a lot of re-instruction and I’ll also see a much lower SRT than expected which will guide my fitting a certain way.



When I still owned my practice and was actively practicing, there was very little coverage for hearing aids through insurance or government entities. If the patient was not motivated due to noticeable problems, it was not worth wasting their time or mine (I offer free trials on instruments). The litigation comment comes mainly from employees or former employees trying to sue for work related hearing loss. I avoided those type of cases so it was not a problem for me. I am actually very glad I retired before insurance and other entities started covering hearing aids. The billing hassles and dealing with the third party in a real pain in the backside. From the patient point of view, I think the hearing aid coverage is a great thing. Unfortunately, when a patient has “no skin in the game” some do not have any incentive to make the hearing aid work and will just put them in the drawer. I have seen numerous cases here in the US especially with hearing aids provided by the Veterans Administration. Top of the line instruments not being used, I think it is a waste of time, effort and resources in those cases.

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OK, I see what you mean now.