Authors: Michael Finkelstein¹
¹Shamir Medical Center
Purpose: The Audiometric Weber Test was designed to verify BC hearing thresholds when they are suspected of being artificially low due to central masking. This study aimed to evaluate the intra-rater reliability and clinical validity of the Audiometric Weber Test. Additionally, the study investigated the impact of tympanic membrane perforation on test outcomes.
Method: Seventy-eight patients with asymmetric conductive hearing loss were included in the data analysis. Each underwent a comprehensive behavioral hearing test followed by the Audiometric Weber Test by placing the bone conduction oscillator on the forehead. To assess intra-rater reliability, the test was repeated three times at each frequency (500, 1000, 2000, and 4000 Hz). Machine learning analysis was conducted to find a more valid formula.
Results: Although the intra-rater reliability was found to be very good, its validity was only moderate (46.2%–58.7%). The results were similar when patients with greater asymmetry were analyzed. The Audiometric Weber Test was found to be more accurate in patients with perforated tympanic membrane at 2000 Hz and 4000 Hz.
Conclusion: Although reliable, the current clinical validity of the Audiometric Weber Test is limited for identifying asymmetric conductive hearing loss. Furthermore, while machine learning models achieved higher accuracy, their complexity renders them impractical for routine clinical use, suggesting that objective audiological measures remain superior for verifying thresholds.
