PP323 - Understanding Variability in Speech-in-Noise Scores Across Similar Hearing Losses

Abstract:
In general, as hearing loss increases, speech recognition performance in noise decreases. However, there is often variability in speech-in-noise scores across individuals with similar degrees of hearing loss. The purpose of the present study was to determine if objective (hearing thresholds at specific frequencies) and/or subjective measures (self-reported difficulty hearing in noise) can explain some of this variability. Preliminary results demonstrated that self-reported difficulty in noise and performance on the QuickSIN were not significantly correlated, but cutoff thresholds at certain high frequencies can separate individuals with normal performance from those with a SNR loss on the QuickSIN.

Summary:
It has been shown that there is a strong relationship between pure-tone averages (PTAs) and performance on the QuickSIN test (e.g., Davidson, et al., 2022). The QuickSIN is the only speech-in noise test to provide some clinical recommendations on how to set hearing aid features such as directionality and hearing assistive technology (HAT) (Duncan & Aarts, 2006; Wilson et al.,2007). In the Davidson et. al.(2022) study, the QuickSIN scores varied across individuals with similar degrees of hearing loss. For example, the variation in QuickSIN scores for individuals with a 60 dB PTA ranged from 2 (normal SNR loss) to 23 (severe SNR loss). Therefore, these two individuals may have the same hearing loss, yet experience very different levels of difficulty communicating in noisy settings. The purpose of the present study was to investigate if this type of variability in QuickSIN scores is correlated with thresholds at specific frequencies, not the PTAs used in most studies and/or the individuals self-reported difficult hearing in noise.

Participants were patients from the Gebbie Clinic at Syracuse University. Fifty-four of the targeted n size of 70 patients have participated in the study. Their average age was 68.2 (range 42.7-89.3 years). There were 32 males and 22 females with bilateral hearing thresholds that ranged from clinically normal to profound sensorineural hearing loss. Seventeen of the participants used hearing aids. Participants' hearing thresholds and QuickSIN scores were obtained during their audiological evaluation in the Gebbie Clinic by an audiology graduate student supervised by a certified audiologist. Patients were also asked if they have difficulty hearing in background noise.

Preliminary data analysis demonstrated that there was not a significant (p < .05) relationship between participants’ self-reported difficulty hearing in noise and their QuickSIN scores. This inconsistency in subjective and objective measures indicates that individuals’ perceptions of their hearing difficulties do not always align with their measurable ability to process speech in noise. Although participants’ age had a negative effect on the QuickSIN scores, it did not account for the variability observed across individuals with similar degrees of hearing loss. A Pearson correlation was performed between the threshold at each individual frequency and the QuickSIN scores. Preliminary results indicate that there is a cutoff threshold for the individual frequencies at 2k, 4k, and 8k that can separate participants who have normal/near normal QuickSIN scores from those who have mild/moderate/severe SNR loss. In other words, patients with hearing thresholds poorer than the cutoff level at that frequency are more likely to demonstrate an SNR loss than those with thresholds better than the cutoff. The cutoff thresholds were different for each of the three frequencies. Thus, this has the potential to serve as a clinical marker to identify individuals at risk for speech-in-noise difficulties.