The evaluation of internet-based speech-in-noise tests for noise-induced hearing loss screening

Speech-in-noise testing provides a sensitive approach for screening for noise-induced hearing loss (NIHL), as one of the first symptoms of NIHL is a difficulty in understanding speech in background noise. It’s possibility for internet presentation offers easily and broadly accessible hearing screening. The main theme of this thesis is the evaluation of internet-based speech-in-noise hearing screening tests for NIHL in two distinct populations: the working-age population exposed to occupational noise on the one hand, and the general teenage population exposed to recreational noise on the other. The main objectives were to evaluate and improve the existing tests in order to obtain valid, reliable, and suitable hearing screening tests. The first part of this thesis focusses on the evaluation of a test for NIHL screening in adults exposed to occupational noise. The test accuracy and precision were investigated by means of a phased approach: in a well-controlled laboratory setting, and subsequently in more realistic and less-controlled occupational settings in representative noise-exposed populations. The second part of this thesis focusses on the application and the suitability of internet-based screening tests in young people. The main approach was to explore online test results, focusing on the effects of age, test-retest reliability, and type of test presentation. To conclude, several test improvements have been proposed and implemented, resulting in appropriate screening tests for occupational and recreational NIHL. However, there is still room for further improvement and fine-tuning