Authors: Robert Eikelboom¹, David Sly¹, Christo Bester¹, Sebastian Ryan¹, Sandra Bellekom¹, Rebecca Bennett²
¹Ear Science Institute Australia
²National Acoustic Laboratories
Background: One of the challenges facing audiologists is how to manage clients attending audiology appointments, who in many cases report hearing difficulties, but have audiometrically normal thresholds. This study examined the demographic and hearing-related factors of those with subjective hearing loss.
Methods: Features included: age, sex, best ear three-frequency average thresholds and asymmetry, ABWord and QuickSin scores, tinnitus (reporting, bothersome, awareness), aspects of psychosocial health, and 0-10 scales for self-reported hearing ability, and effect of hearing loss on quality of life, impact on daily life, and motivation to do something about their hearing loss. The hearing ability of ~43,000 audiology clients were classified as (i) subjective hearing loss if thresholds in both ears were <=20 dBHL or hearing loss (all others), and (ii) low (lowest quartile) or high (highest quartile) hearing ability. Machine learning (XGBOOST) and SHAP values were used to identify key classification features.
Results: Data from 4,271 with subjective hearing loss (1068 had a high hearing ability and 1297 had a low hearing ability) and 38,810 hearing loss adults were included. Better QuickSIN scores, being female, lower asymmetry of hearing thresholds, and lower age were the most important differentiating features for those with subjective hearing loss. Those with low hearing ability were more willing to take action, and their hearing loss had a greater impact on quality of life, on daily life and on psychosocial health.
Conclusion: About 10% of clients attending had normal thresholds, with many reporting significant impacts listening in noise, on their daily life and psychosocial health. Most of these clients are motivated to take action. Clinicians should make themselves aware of the difficulties faced by clients who have normal thresholds, and consider options other than traditional hearing aids.
