Digital speech hearing screening using a quick novel mobile hearing impairment assessment: an observational correlation study

Abstract

By 2050, 1 in 4 people worldwide will be living with hearing impairment. We propose a digital Speech Hearing Screener (dSHS) using short nonsense word recognition to measure speech-hearing ability. The importance of hearing screening is increasing due to the anticipated increase in individuals with hearing impairment globally. We compare dSHS outcomes with standardized pure-tone averages (PTA) and speech-recognition thresholds (SRT). Fifty participants (aged 55 or older underwent pure-tone and speech-recognition thresholding. One-way ANOVA was used to compare differences between hearing impaired and hearing not-impaired groups, by the dSHS, with a clinical threshold of moderately impaired hearing at 35 dB and severe hearing impairment at 50 dB. dSHS results significantly correlated with PTAs/SRTs. ANOVA results revealed the dSHS was significantly different (F(1,47) = 38.1, p < 0.001) between hearing impaired and unimpaired groups. Classification analysis using a 35 dB threshold, yielded accuracy of 85.7% for PTA-based impairment and 81.6% for SRT-based impairment. At a 50 dB threshold, dSHS classification accuracy was 79.6% for PTA-based impairment (Negative Predictive Value (NPV)-93%) and 83.7% (NPV-100%) for SRT-based impairment. The dSHS successfully differentiates between hearing-impaired and unimpaired individuals in under 3 min. This hearing screener offers a time-saving, in-clinic hearing screening to streamline the triage of those with likely hearing impairment to the appropriate follow-up assessment, thereby improving the quality of services. Future work will investigate the ability of the dSHS to help rule out hearing impairment as a cause or confounder in clinical and research applications.

Keywords: Cognition; Digital hearing screening; Pure tone audiometry; Speech recognition.

Figure 1

Workflow of study recruitment and randomization arms. Total study enrollment: 50 participants (28 females, mean age ± SD: 73.64 ± 9.5 years).

Figure 2

Screenshots from the dSHS application showing nonsense vowel–consonant–vowel selection options.

Figure 3

Linear relationship between the dSHS volumes (% of maximum) and Pure Tone Averages in dB (Left) and Speech Recognition Thresholds in dB (Right). Blue lines indicate the line best fitting the data. Red lines indicate the XY unity line. Black dashed lines indicate impairment thresholds of 35 and 50.

Figure 4

Distributions of dSHS volumes for 50 participants grouped by Pure Tone Averages (PTA; top row figures) and Speech Recognition Thresholds (SRT; bottom row figures). Figures on the left (top and bottom) show distributions at a hearing impairment cutoff threshold of 35 dB while figures on the right show distributions at a hearing impairment cutoff threshold of 35 dB. *Gray shaded boxes indicate upper and lower quartiles above and below the bolded median line.

Figure 5

ROC curves of average Audiogram Pure Tones (AudiogramPT) and Speech Recognition Thresholds (SRTaverage) predicted by dSHS 35 dB threshold (left) and Speech Recognition Thresholds (SRTaverage) predicted by dSHS 50 dB threshold (right).