Accuracy and time efficiency of an automated commercial audiometer in the evaluation of hearing in quiet and noisy environments.

Introduction: In this study, we sought to validate the effectiveness of an automated audiometry system in quiet (AA) and noisy environments (AA-N) by comparing the air pure-tone thresholds obtained by AA to those obtained by traditional manual audiometry (MA).

Methods: In this cross-sectional study, 150 participants with or without hearing loss were tested (age: 11-84 years; female: 57.3%). Air conduction thresholds were assessed by MA, AA, and AA-N in a quiet or noisy sound booth.

Results: In participants without hearing loss, 94.5% and 96% of the threshold comparisons differed between MA versus AA and AA versus AA-N within 10 dB HL or less. In participants with hearing loss, there was no statistically significant difference between the three testing conditions at any frequency (p > 0.05). The hearing threshold difference in the poor hearing ear in participants with a bilateral difference ≥40 dB HL was -15 and +15 dB HL; however, this difference was not statistically significant when excluding participants with tinnitus.

Conclusions: Automatic audiometry can accurately estimate hearing thresholds and screen for hearing loss even in noisy environments. Nevertheless, the algorithm must be corrected when patients experience tinnitus.