THESIS PRESENTATION. The Reference Equivalent Threshold Sound Pressure Level (RETSPL) values of the Creare headphones

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THESIS PRESENTATION The Reference Equivalent Threshold Sound Pressure Level (RETSPL) values of the Creare headphones by Lee Shi Yuan (A0100011U / E0012334)

Purpose Determine the RETSPL values of the Creare headphones across audiometric test frequencies 125Hz, 250Hz, 500Hz, 750Hz, 1kHz, 1.5kHz, 2kHz, 3kHz, 4kHz, 6kHz, 8kHz, 9kHz, 10kHz, 11.2kHz, 12.5kHz, 14kHz, 16kHz, 18kHz and 20kHz.

The Hearing Evaluation System Creare => engineering company => hearing evaluation system Comprises of tablet and headphones Hearing tests run on a proprietary application Protocols for different purposes are uploaded and installed Headphones are designed to provide significant noise attenuation Potential test tool in under-equipped clinics and outside of sound booths However, little RETSPL data available

Reference Equivalent Threshold Sound Pressure Level Varying hearing abilities at different frequencies Normal hearing individuals hear each frequency at different SPLs Recall: audibility curve Physical properties of different transducers Different output SPLs with a fixed input SPL The BIG question is: What is the input SPL that a normal hearing individual can hear without the participation of any audiometers settings for this particular transducer at each audiometric frequency *RETSPL is essential for the calibration of audiometers

: Subjects Tympanometry Type A and 50daPa 47 people signed up, aged 18 25 24 males 23 females Hearing history questionnaire (ISO 389-9) No active ear diseases, recent cold/flu, and significant history of noise exposure 19 males 20 females 8 excluded 39 recruited

: Protocol Baseline hearing test (Siemens Unity 2 & Sennheiser HDA 200) 125Hz to 16kHz 39 subjects 19 males 20 females Actual study (Creare hearing evaluation system) Training @ 1kHz, 2kHz, 4kHz Conducted in a room that meets ANSI standards for ambient noise levels (measured prior to study) Reference for discrepancies Hearing test (125Hz to 20kHz) - modified Hughson Westlake - threshold: 2/3 on ascending - thresholds measured in db SPL

db SPL Purpose 120 100 80 60 40 20 0 0.12 0.25 0.5 0.75 1 1.5 2 3 4 6 8 9 10 11.2 12.5 14 16 18 20 5 Mean (± 1 SD) 35.1 23.9 21.9 18.1 17.3 14.8 14.1 9.3 9.1 20.7 20.2 29.5 22.5 22.1 24.5 34.5 63.9 84.7 94.4 Median 35 25 20 20 15 15 15 10 10 20 20 30 20 20 20 30 60 90 95 Frequency (khz) Mean (± 1 SD) Median

RETSPL is determined as the median of the data because median is less affected by outliers as compared to mean. The effects of gender and laterality had p-values that were generally below 0.05, showing that differences in results due to laterality and gender are insignificant. Deviation is seen only at 6kHz with gender, possibly a result of noise exposure during the two years of military training in males.

RETSPL Purpose 120 100 80 60 40 20 0-20 0.12 5 0.25 0.5 0.75 1 1.5 2 3 4 6 8 9 10 11.2 12.5 14 16 18 20 Study 35 25 20 20 15 15 15 10 10 20 20 30 20 20 20 30 60 90 95 Creare 30 20 15 10 10 10 10 10 10 20 25 25 35 25 25 30 53 70 75 Difference 5 5 5 10 5 5 5 0 0 0-5 5-15 -5-5 0 7 20 20 Frequency (khz)

Subjectivity of the hearing history questionnaire Open ended questions => no guided definitions Subjected to tester bias Decide, at his/her discretion, whether to accept the participant Draw the line between at risk and not at risk for hearing loss Criteria decided may differ in other studies => not published Difficult to decide which set of criteria is relevant and ideal to follow Defined the exclusion criteria and justified for questions that may be controversial. Mainly investigated the participants frequency, duration and intensity of noise exposure to determine if the participants are eligible for the study.

Limitations Calibration Ideal: calibrate before and many times during the study Susceptible to temperature, pressure and equipment handling Lack of equipment and budget Software inflexibility Unable to retest at a particular frequency Valuable for unattainable or outlying results Repeating: time consuming and exhausting Maximum output levels Reduced from the previous study Due to distortions caused by physical limitations of transducer Prevent false positives Less data attainable at 18kHz and 20kHz

Limitations Calibration Ideal: calibrate before and many times during the study Susceptible to temperature, pressure and equipment handling Lack of equipment and budget Software inflexibility Unable to retest at a particular frequency Valuable for unattainable or outlying results Repeating: time consuming and exhausting Maximum output levels Reduced from the previous study Due to distortions caused by physical limitations of transducer Prevent false positives Less data attainable at 18kHz and 20kHz

Limitations Calibration Ideal: calibrate before and many times during the study Susceptible to temperature, pressure and equipment handling Lack of equipment and budget Software inflexibility Unable to retest at a particular frequency Valuable for non-converging or outlying results Repeating: time consuming and exhausting Maximum output levels Reduced from the previous study Due to distortions caused by physical limitations of transducer Prevent false positives Less data attainable at 18kHz and 20kHz

Gender and laterality did not have significant effects on the thresholds obtained. RETSPL values obtained were generally elevated as compared to Creare s values. Greatest deviations were seen at 18kHz and 20kHz. Although limited by the lack of recalibration and elevated results, data from this study are still valuable as this is only the second study of its kind.

: Suggestions More RETSPL studies Ensure that repeated calibration is feasible Improve the credibility and reliability of the results obtained. Research using different populations Differing cultures, practices, genetic disposition => differing standards of normal hearing Correlation between different populations and RETSPL values Research on effectiveness of the ISO 389-9 standard and suggest recommendations to reduce the subjectivity of the participant selection process.

THANK YOU

References ASHA. (1994). Audiologic management of individuals receiving cochleotoxic drug therapy [Guidelines]. Retrieved 11 March 2017 from http://www.asha.org/policy/gl1994-00003/#ap1 Frank, T. (2001). High-Frequency (8 to 16 khz) Reference Thresholds and Intrasubject Threshold Variability Relative to Ototoxicity Criteria Using a Sennheiser HDA 200 Earphone. Ear and Hearing, 22(2), 161-168. ISO. (2009). Acoustics: Reference Zero for the Calibration of Audiometric Equipment: Part 9: Preferred test conditions for the determination of reference hearing threshold levels. International Standard. ISO 389-9. Valiente, A. R., Trinidad, A., Berrocal, J. R. G., Górriz, C., & Camacho, R. R. (2014). Extended high-frequency (9-20kHz) audiometry reference thresholds in 645 healthy subjects. International Journal of Audiology, 53(8), 531-545. doi:10.3109/14992027.2014.893375