Are False-Positive Rates Leading to an Overestimation of Noise-Induced Hearing Loss? PurposeTo estimate false-positive rates for rules proposed to identify early noise-induced hearing loss (NIHL) using the presence of notches in audiograms.MethodAudiograms collected from school-age children in a national survey of health and nutrition (the Third National Health and Nutrition Examination Survey [NHANES III]; National Center for Health Statistics, 1994) were ... Article
Article  |   April 2011
Are False-Positive Rates Leading to an Overestimation of Noise-Induced Hearing Loss?
 
Author Affiliations & Notes
  • Robert S. Schlauch
    University of Minnesota, Minneapolis
  • Edward Carney
    University of Minnesota, Minneapolis
  • Correspondence to Robert S. Schlauch: schla001@umn.edu
  • Editor: Anne Smith
    Editor: Anne Smith×
  • Associate Editor: Sheila Pratt
    Associate Editor: Sheila Pratt×
  • © 2011 American Speech-Language-Hearing Association
Article Information
Hearing Disorders / Hearing
Article   |   April 2011
Are False-Positive Rates Leading to an Overestimation of Noise-Induced Hearing Loss?
Journal of Speech, Language, and Hearing Research, April 2011, Vol. 54, 679-692. doi:10.1044/1092-4388(2010/09-0132)
History: Received July 6, 2009 , Accepted August 30, 2010
 
Journal of Speech, Language, and Hearing Research, April 2011, Vol. 54, 679-692. doi:10.1044/1092-4388(2010/09-0132)
History: Received July 6, 2009; Accepted August 30, 2010
Web of Science® Times Cited: 14

PurposeTo estimate false-positive rates for rules proposed to identify early noise-induced hearing loss (NIHL) using the presence of notches in audiograms.

MethodAudiograms collected from school-age children in a national survey of health and nutrition (the Third National Health and Nutrition Examination Survey [NHANES III]; National Center for Health Statistics, 1994) were examined using published rules for identifying noise notches at various pass–fail criteria. These results were compared with computer-simulated “flat” audiograms. The proportion of these identified as having a noise notch is an estimate of the false-positive rate for a particular rule.

ResultsAudiograms from the NHANES III for children 6–11 years of age yielded notched audiograms at rates consistent with simulations, suggesting that this group does not have significant NIHL. Further, pass–fail criteria for rules suggested by expert clinicians, applied to NHANES III audiometric data, yielded unacceptably high false-positive rates.

ConclusionsComputer simulations provide an effective method for estimating false-positive rates for protocols used to identify notched audiograms. Audiometric precision could possibly be improved by (a) eliminating systematic calibration errors, including a possible problem with reference levels for TDH-style earphones; (b) repeating and averaging threshold measurements; and (c) using earphones that yield lower variability for 6.0 and 8.0 kHz—2 frequencies critical for identifying noise notches.

Acknowledgments
We wish to acknowledge the helpful comments offered by Robert Dobie, including the implications for clinicians listed among the conclusions.
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