title: The applicability of a speech-in-noise screening test in occupational hearing conservation.
abstract: OBJECTIVE
  Noise-induced hearing loss (NIHL) is the most reported occupational health disease in the Netherlands. The internet-based speech-in-noise test Earcheck (Albrecht et al, 2005; Leensen et al, 2011b) is designed to detect beginning NIHL and can be a valuable tool in occupational hearing health surveillance. The aim of this study is to investigate the validity of Earcheck compared to regular screening audiometry.
  
  
  METHODS
  Subjects performed online Earcheck tests at home. The results are compared to a pure-tone screening audiogram obtained during regular occupational health examination. A subgroup performed the measurements twice to assess test-retest reliability.
  
  
  METHODS
  Two hundred and forty-nine male construction employees who recently had a periodic occupational health examination participated.
  
  
  RESULTS
  An average learning effect of -1.6 dB was found, that reduced with increasing test number. The test-retest variability was 1.6 dB. Sensitivity to detect beginning NIHL was 68%, with a specificity of 71%.
  
  
  CONCLUSIONS
  Although sensitivity and specificity values are only moderate, the broad internet application still promises a valuable addition to current practice. The relatively high learning effect indicates that more reliable results can be obtained after a longer test session. When this is put into practice some improvement in sensitivity and specificity may be expected as well.
authors.affiliation: Clinical and Experimental Audiology, ENT Department, Academic Medical Centre AMC, 1100 DD Amsterdam, The Netherlands. m.c.leensen@amc.nl
authors.forename: Monique C J
authors.initials: MC
authors.lastname: Leensen
authors.forename: Wouter A
authors.initials: WA
authors.lastname: Dreschler
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D060389:Construction Industry; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D020407:Internet; D059032:Learning Curve; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009622:Noise / Q000009:adverse effects*; D009784:Occupational Diseases / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D010470:Perceptual Masking; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012648:Self Care; D013065:Speech Intelligibility; D013067:Speech Perception; D013069:Speech Reception Threshold Test