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: <mailto:karina.swanepoel@up.ac.za> karina.swanepoel@up.ac.za
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