title: Audiometric Thresholds: Stimulus Considerations in Sound Field and Under Earphones.
abstract: OBJECTIVE
  This study evaluates a new stimulus, FREquency Specific Hearing assessment (FRESH) noise, to obtain hearing thresholds and reviews the potential pitfalls of using narrow band noise.
  
  
  METHODS
  Twelve adults with simulated gradually sloping hearing loss and 12 adults with steeply sloping hearing loss participated. Hearing thresholds were measured in sound field and under a supraaural earphone for FRESH noise, warbled tones, and narrowband noise. Pure-tone thresholds were also measured under the supraaural earphone.
  
  
  RESULTS
  FRESH noise thresholds were similar to pure-tone and warbled-tone thresholds regardless of audiometric configuration. For the group with gradually sloping hearing loss, thresholds obtained with narrowband noise were approximately 4 dB better than those obtained with the other test stimuli. For the group with steeply sloping hearing loss, narrowband noise significantly underestimated hearing thresholds-the steeper the hearing loss, the greater the underestimation.
  
  
  CONCLUSIONS
  When hearing loss is suspected, FRESH noise is appropriate for accurately determining audiometric thresholds in sound field and under earphones. A wider band, attention-getting stimulus such as narrowband noise can result in thresholds that are inaccurate. Clinical decision making regarding choice of test stimulus is discussed.
authors.forename: Linda W
authors.initials: LW
authors.lastname: Norrix
authors.forename: Alora
authors.initials: A
authors.lastname: Anderson
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000368:Aged; D001288:Attention; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D000066491:Clinical Decision-Making; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D055815:Young Adult