title: Speech-in-noise screening tests by internet, part 2: improving test sensitivity for noise-induced hearing loss.
abstract: OBJECTIVE
  An easily accessible screening test can be valuable in the prevention of noise-induced hearing loss (NIHL). The Dutch National Hearing Foundation developed 'Earcheck', an internet-based speech-in-noise test, presenting CVC-words in stationary broadband noise. However, its sensitivity to detect NIHL appeared to be low, 51% ( Leensen et al, 2011 , part 1). The aim of the current study is to examine ways to improve Earcheck's sensitivity for (early) NIHL using different forms of noise filtering.
  
  
  METHODS
  The test's stationary broadband masking noise is replaced by six alternatives, including noises that have been temporally modulated, spectrally filtered by high-pass or low-pass filters, and combinations of temporal modulation and spectral filtering.
  
  
  METHODS
  In this multi-centre study, 49 normal-hearing and 49 subjects with different degrees of NIHL participated.
  
  
  RESULTS
  Hearing-impaired subjects deviated more clearly from normal performance when executing the test with alternative masking noises, except for the high-pass filtered conditions. Earcheck with low-pass filtered noise made the best distinction between normal hearing and NIHL, without reducing test reliability. The use of this noise condition improved the sensitivity of Earcheck to 95%.
  
  
  CONCLUSIONS
  The use of low-pass filtered masking noise makes speech-in-noise tests more sensitive to detect NIHL in an early stage.
authors.affiliation: Clinical and Experimental Audiology, ENT Department, Academic Medical Centre (AMC), Amsterdam, The Netherlands. m.c.leensen@amc.nl
authors.forename: Monique C J
authors.initials: MC
authors.lastname: Leensen
authors.forename: Jan A P M
authors.initials: JA
authors.lastname: de Laat
authors.forename: Ad F M
authors.initials: AF
authors.lastname: Snik
authors.forename: Wouter A
authors.initials: WA
authors.lastname: Dreschler
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech / Q000379:methods*; D001309:Auditory Threshold; D016022:Case-Control Studies; D059026:Diagnostic Self Evaluation; D042241:Early Diagnosis; D005260:Female; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009622:Noise / Q000009:adverse effects*; D010470:Perceptual Masking; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013065:Speech Intelligibility; D013067:Speech Perception; D013069:Speech Reception Threshold Test; D055815:Young Adult