title: Validity of diagnostic pure-tone audiometry without a sound-treated environment in older adults.
abstract: OBJECTIVE
  To investigate the validity of diagnostic pure-tone audiometry in a natural environment using a computer-operated audiometer with insert earphones covered by circumaural earcups incorporating real-time monitoring of environmental noise.
  
  
  METHODS
  A within-subject repeated measures design was employed to compare air (250 to 8000 Hz) and bone (250 to 4000 Hz) conduction pure-tone thresholds, measured in retirement facilities, with thresholds measured in a sound-treated booth.
  
  
  METHODS
  One hundred and forty-seven adults (average age 76 ± 5.7 years) were evaluated. Pure-tone averages were ≥ 25 dB in 59%, mildly (> 40 dB) elevated in 23%, and moderately (> 55 dB) elevated in 6% of ears.
  
  
  RESULTS
  Air-conduction thresholds (n = 2259) corresponded within 0 to 5 dB in 95% of all comparisons between the two test environments. Bone-conduction thresholds (n = 1669) corresponded within 0 to 5 dB in 86% of comparisons. Average threshold differences (- 0.6 to 1.1) and standard deviations (3.3 to 5.9) were within typical test-retest reliability limits. Thresholds recorded showed no statistically significant differences (paired samples t-test:p > 0.01) except at 8000 Hz in the left ear.
  
  
  CONCLUSIONS
  Valid diagnostic pure-tone audiometry can be performed in a natural environment with recently developed technology, offering the possibility of access to diagnostic audiometry in communities where sound-treated booths are unavailable.
authors.affiliation: Department of Communication Pathology, University of Pretoria, South Africa.
authors.forename: Felicity
authors.initials: F
authors.lastname: Maclennan-Smith
authors.forename: De Wet
authors.initials: de W
authors.lastname: Swanepoel
authors.forename: James W
authors.initials: JW
authors.lastname: Hall
mesh_terms: D000161:Acoustic Stimulation / Q000295:instrumentation / Q000379:methods*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone / Q000295:instrumentation; D001309:Auditory Threshold; D001844:Bone Conduction; D004780:Environment, Controlled; D004784:Environmental Monitoring; D004867:Equipment Design; D005260:Female; D006309:Hearing; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009622:Noise / Q000517:prevention & control; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012179:Retirement