| Autor: |
Brungart DS; Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Building 19, Floor 5, 4954 North Palmer Road, Bethesda, Maryland 20889, USA., Sherlock LP; Hearing Conservation and Readiness Branch, U.S. Army Public Health Center, E1570 8977 Sibert Road, Aberdeen Proving Ground, Maryland 21010, USA., Kuchinsky SE; Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Building 19, Floor 5, 4954 North Palmer Road, Bethesda, Maryland 20889, USA., Perry TT; Hearing Conservation and Readiness Branch, U.S. Army Public Health Center, E1570 8977 Sibert Road, Aberdeen Proving Ground, Maryland 21010, USA., Bieber RE; Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Building 19, Floor 5, 4954 North Palmer Road, Bethesda, Maryland 20889, USA., Grant KW; Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Building 19, Floor 5, 4954 North Palmer Road, Bethesda, Maryland 20889, USA., Bernstein JGW; Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Building 19, Floor 5, 4954 North Palmer Road, Bethesda, Maryland 20889, USA. |
| Abstrakt: |
Although the behavioral pure-tone threshold audiogram is considered the gold standard for quantifying hearing loss, assessment of speech understanding, especially in noise, is more relevant to quality of life but is only partly related to the audiogram. Metrics of speech understanding in noise are therefore an attractive target for assessing hearing over time. However, speech-in-noise assessments have more potential sources of variability than pure-tone threshold measures, making it a challenge to obtain results reliable enough to detect small changes in performance. This review examines the benefits and limitations of speech-understanding metrics and their application to longitudinal hearing assessment, and identifies potential sources of variability, including learning effects, differences in item difficulty, and between- and within-individual variations in effort and motivation. We conclude by recommending the integration of non-speech auditory tests, which provide information about aspects of auditory health that have reduced variability and fewer central influences than speech tests, in parallel with the traditional audiogram and speech-based assessments. |
