Adapting Audiology Procedures During the Pandemic: Validity and Efficacy of Testing Outside a Sound Booth

This investigation aims to provide outcomes from a clinical perspective on the validity and efficacy of a wireless automated audiometer system that could be used in multiple settings when a sound booth is not accessible. Testing was conducted in a clinical setting under modified protocols meeting safety precautions during the COVID-19 pandemic. Four doctoral students in audiology served as examiners. Participants were 69 adults between the ages of 20 and 69 years, with normal hearing (≤ 25 dB HL; = 110 ears) or hearing loss (> 25 dB HL; = 25 ears). Two versions of a pure-tone air-conduction threshold test following a modified Hughson-Westlake approach were performed and compared at 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz (a) in a sound-treated test booth using standard manual audiometry and (b) in a quiet, nonsound-treated clinical room (sound booth free) using automated KUDUwave audiometry. Participants were asked to complete a five-item feedback questionnaire, and examiners were interviewed to report on their experience. Clinical validity to within ±10 dB of standard audiometry was demonstrated for 94.5% of the total thresholds ( = 937) measured with the sound booth-free approach. Less accuracy (73.3%) was observed using a ±5 dB comparison. When comparing the mean thresholds, there were significant differences ( < .01) between the mean thresholds at most frequencies, with mean sound booth thresholds being higher than the sound booth-free mean thresholds. A strong threshold correlation (.91-.98) was found between the methods across frequencies. Participant and examiner feedback supported the efficacy of the sound booth-free technology. Findings support sound booth-free, automated software-controlled audiometry with active noise monitoring as a valid and efficient procedure for pure-tone hearing threshold assessment. This method offers an effective alternative when circumstances require more transportable hearing assessment technology or do not allow for standard manual audiometry in a sound booth.