An automated speech-in-noise test for remote testing: development and preliminary evaluation

Purpose: To develop and evaluate a novel, automated speech-in-noise test viable for widespread in situ and remote screening. Method: Vowel-consonant-vowel sounds in a multiple-choice consonant discrimination task were used. Recordings from a professional male native English speaker were used. A novel adaptive staircase procedure was developed, based on the estimated intelligibility of stimuli rather than on theoretical binomial models. Test performance was assessed in a population of 26 normal hearing young adults (YA) and in 72 unscreened adults (UA), including native and non-native English listeners. Results: The proposed test provided accurate estimates of the speech reception threshold (SRT) compared to a conventional adaptive procedure. Consistent outcomes were observed in YA in test/retest and in controlled/uncontrolled conditions and in UA in native and non-native listeners. The SRT increased with increasing age, hearing loss, and self-reported hearing handicap in UA. Test duration was similar in YA and UA irrespective of age and hearing loss. The test-retest repeatability of SRTs was high (Pearson correlation coefficient = 0.84) and the pass/fail outcomes of the test were reliable in repeated measures (Cohen's kappa = 0.8). The test was accurate in identifying ears with pure-tone thresholds >25 dB HL (accuracy = 0.82). Conclusions: This study demonstrated the viability of the proposed test in subjects of varying language in terms of accuracy, reliability, and short test time. Further research is needed to validate the test in a larger population across a wider range of languages and hearing loss, and to identify optimal classification criteria for screening purposes.