The Effect of Stimulus Audibility on the Relationship between Pure-Tone Average and Speech Recognition in Noise Ability

Abstract

Background:

The literature presents conflicting reports on the relationship between pure-tone threshold average and speech recognition in noise ability.

Purpose:

The purpose of this retrospective study and meta-analysis was to determine the effect of stimulus audibility on the relationship between speech recognition in noise ability and bilateral pure-tone average (BPTA).

Research Design:

Pure-tone threshold and Hearing in Noise Test (HINT) data from two data sets were evaluated. The HINT data from both data sets were divided into groups with complete and partial audibility of the HINT stimuli delivered at 65 dBA.

Study Sample:

Normal and hearing-impaired participants were included in this retrospective study. For data set 1 (n = 215), a relatively weak relationship had been found between HINT thresholds and BPTA. For data set 2 (n = 55), a relatively strong relationship had been found between HINT thresholds and BPTA. For data set 1, only 10% of the participants had partial audibility of the HINT stimuli. For data set 2, 16% of the participants had partial audibility of the HINT stimuli.

Data Collection and Analysis:

Pure-tone thresholds and HINT data were obtained from published and unpublished studies. HINT data were collected in a simulated soundfield environment under headphones using the standard HINT protocol. Statistical analyses included descriptive statistics, correlations, and a two-way analysis of variance (ANOVA), and multiple regression.

Results:

A two-way ANOVA followed by post hoc analyses revealed a greater difference between the data sets for the Noise Front thresholds obtained with partial rather than complete audibility of the stimuli. A weak and nonsignificant relationship was found between BPTA_{(0.5, 1.0, 2.0, 3.0, 6.0 kHz)} versus HINT Noise Front thresholds for complete audibility data (r = 0.060, p = 0.356) and a strong relationship was found for the partial audibility data (r = 0.863, p < 0.001).

Conclusions:

The proportion of partial audibility data in a given data set may influence the relative strength of the relationship between BPTA and HINT Noise Front thresholds. This brings into question the convention of using pure-tone average as a predictor of speech recognition in noise ability.

Key Words

gold-standard - pure-tone thresholds - speech recognition in noise ability

• REFERENCES

• AAO-ACO 1979; Guide for the evaluation of hearing handicap. JAMA 241: 2055-2059
• AMA 2008. In: Rondinelli RD. Guides to the Evaluation of Permanent Impairment. 6th ed. Chicago, IL: American Medical Association;
• Demorest ME, Erdman SA. 1987; Development of the communication profile for the hearing impaired. J Speech Hear Disord 52 (02) 129-143
• Dobie RA. 2011; The AMA method of estimation of hearing disability: a validation study. Ear Hear 32 (06) 732-740
• Killion MC, Niquette PA, Gudmundsen GI, Revit LJ, Banerjee S. 2004; Development of a quick speech-in-noise test for measuring signal-to-noise ratio loss in normal-hearing and hearing-impaired listeners. J Acoust Soc Am 116 (4 Pt 1) 2395-2405
• Lierle DM. 1959; (For the subcommittee on noise of the AAOO committee on conservation of hearing). Guide for the evaluation of hearing impairment. Trans Am Acad Ophthalmol Otolaryngol 63: 236-238
• Lyregaard PE. 1982; Frequency selectivity and speech intelligibility in noise. Scand Audiol Suppl 15: 113-122
• Mathers C, Smith A, Concha M. 2000; Global burden of hearing loss in the year 2000. Glob Burden Dis 18: 1-30
• Nilsson M, Soli SD, Sullivan JA. 1994; Development of the hearing in noise test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 95 (02) 1085-1099
• Niquette P, Arcaroli J, Revit L, Parkinson A, Staller S, Skinner M, Killion M. 2003 Development of the BKB-SIN Test. Paper presented at the American Auditory Socitey, Scottsdale, AZ.
• Plomp R, Mimpen AM. 1979; Improving the reliability of testing the speech reception threshold for sentences. Audiology 18 (01) 43-52
• Saunders GH, Forsline A, Fausti SA. 2004; The performance-perceptual test and its relationship to unaided reported handicap. Ear Hear 25 (02) 117-126
• Smits C, Kapteyn TS, Houtgast T. 2004; Development and validation of an automatic speech-in-noise screening test by telephone. Int J Audiol 43 (01) 15-28
• Smoorenburg GF. 1992; Speech reception in quiet and in noisy conditions by individuals with noise-induced hearing loss in relation to their tone audiogram. J Acoust Soc Am 91 (01) 421-437
• Stevens G, Flaxman S, Brunskill E, Mascarenhas M, Mathers CD, Finucane M. Global Burden of Disease Hearing Loss Expert Group 2013; Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. Eur J Public Health 23 (01) 146-152
• Tschopp K, Zust H. 1994; Performance of normally hearing and hearing-impaired listeners using a German version of the SPIN test. Scand Audiol 23 (04) 241-247
• Vermiglio AJ. 2007 Speech Recogniton in Noise. (AuD Doctoral Project), Central Michigan University
• Vermiglio AJ. 2008; The American English hearing in noise test. Int J Audiol 47 (06) 386-387
• Vermiglio AJ, Soli S. 2008. Is there a relationship between pure tone thresholds and speech recognition in noise ability?. Research Poster Presented at the International Hearing Aid Research Conference (IHCON) Lake Tahoe, CA:
• Vermiglio AJ, Soli SD, Freed DJ, Fisher LM. 2012; The relationship between high-frequency pure-tone hearing loss, hearing in noise test (HINT) thresholds, and the articulation index. J Am Acad Audiol 23 (10) 779-788
• Wilson RH, Carnell CS, Cleghorn AL. 2007; The words-in-noise (WIN) test with multitalker babble and speech-spectrum noise maskers. J Am Acad Audiol 18 (06) 522-529
• Wilson RH, McArdle RA, Smith SL. 2007; An evaluation of the BKB-SIN, HINT, QuickSIN, and WIN materials on listeners with normal hearing and listeners with hearing loss. J Speech Lang Hear Res 50 (04) 844-856
• Zust H, Tschopp K. 1993; Influence of context on speech understanding ability using German sentence test materials. Scand Audiol 22 (04) 251-255