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Re: [AUDITORY] National Hearing Test

Thanks for your interest in the telephone-administered National Hearing Test.  Your objection that the test is unlikely to work because of the variability in phone service is not without merit.  It does, of course, assume that US phone service must be much worse than that in the UK, Germany, France, the Netherlands, Australia, and other countries where the same sorts of tests have been functioning quite successfully since 2004.  A data-based counter argument can be found in the validation study run by three hearing centers operated by the US Veterans Administration.  In that study one third of the (over 600) participants took the test at home, using whatever telephone they happened to have (not cell phones).  The correlation between pure-tone audiograms and the telephone test, for those who took the test at home was the same as for those of the same age who took the test with the phones selected for use in the hearing clinics.  This is reported in Watson, 2012 (JAAA) and in more detail in a forthcoming report in JAAA by Williams-Sanchez et al.  One aspect of your criticism is definitely accurate, however.  Like any valid auditory test, there are many ways to perform badly but only one to perform well.  A bad phone connection, a noisy room, a distracted or anxious client can all result in failing a screening test, and thus in a unnecessary recommendation for an evaluation by an audiologist.  But the accuracy of this test, in terms of hit a false alarm rates suggests that if callers fail this test they probably should make that appointment.  
Thanks again for your interest in the NHT.  We are sure the same concerns must have occurred to many others and we are glad you raised them.

Chuck Watson

-----Original Message-----
From: Tom Brennan [mailto:g_brennantg@xxxxxxxxxxxxxxx] 
Sent: Tuesday, October 29, 2013 6:49 AM
To: Watson, Charles S.
Cc: AUDITORY@xxxxxxxxxxxxxxx
Subject: Re: National Hearing Test

While I see this test as a potentially good idea I am also aware of the extreme variability of telephone services in the U.S. depending upon whether one is using a cell, treditional land line, broad band telephone, internet phone, etc.
This alone would seem to invalidate the test results especially when telephones with different receiver attributes are added to the mix.

I would be interested in at least looking at this test but I believe that you might get further with making people aware of it if those of us who are professionals in audiology could actually take the test and perhaps use it on selected clients to gain our own opinions of the test.  Of course, this would likely need to be for no charge but in a case like this we professionals are probably going to want/need more than just journal references.

I wish you the best of luck with this.  It is potentially an excellent idea but the U.S. telephone structure is going to make this pretty difficult.


Tom Brennan  KD5VIJ, CCC-A/SLP
web page http://titan.sfasu.edu/~g_brennantg/sonicpage.html