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The digits-in-noise test (DIN) is a popular self-test measure that has traditionally been used to screen for hearing loss by only providing either a pass or refer result. Standard approaches tested either monaurally or used a binaural diotic version where identical digits and noise were presented simultaneously to each ear. Recently, an antiphasic version was developed, increasing sensitivity of the DIN to unilateral or asymmetric sensorineural hearing loss (SNHL) and conductive hearing loss (CHL). We evaluated whether a combination of diotic and antiphasic DIN could accurately classify hearing as (a) normal, (b) bilateral SNHL, or (c) unilateral SNHL or CHL. The sample consisted of bilateral normal hearing (n=293), bilateral sensorineural hearing loss (SNHL; n=172), unilateral SNHL (n=42) and CHL (n=32). Each (n=489) participant first completed an antiphasic DIN (digit stimuli 180o out-of-phase between ears), while 393 of the sample also completed a diotic DIN. Two procedures were assessed for their ability to categorize hearing into one of the three hearing groups. The first used fixed antiphasic and diotic DIN SRT cut-offs, while the second used a variable, diotic DIN SRT cut-off, to maximize the percentage of correctly categorized participants. The first fixed SRT cut-off procedure could correctly categorize 75% of all participants, while the second procedure increased correct categorization to 79%. False negative rates for both procedures were below 10%. A sequential antiphasic and diotic DIN could categorize hearing into three groups of (a) normal hearing, (b) bilateral SNHL, and (c) unilateral asymmetric SNHL or CHL to a reasonable degree. This type of approach could optimize care pathways using remote and contactless testing, by identifying unilateral SNHL and CHL as cases requiring medical referral. In contrast, bilateral SNHL cases could be referred directly to an audiologist, or non-traditional models like OTC hearing aids. Karina De Sousa Audiologist & Project Coordinator | University of Pretoria, Speech-Language Pathology and Audiology Room 3-16, Level 3, Communication Pathology Building Cell: +27 (0)82 556 5431 Email: <> -- This message and attachments are subject to a disclaimer. Please refer to <> for full details.
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