Accuracy and time efficiency of an automated commercial audiometer in the evaluation of hearing in quiet and noisy environments.

In this study, we sought to validate the effectiveness of an automated audiometry system in quiet (AA) and noisy environments (AA-N) by comparing the air pure-tone thresholds obtained by AA to those obtained by traditional manual audiometry (MA). In this cross-sectional study, 150 participants with or without hearing loss were tested (age: 11-84 years; female: 57.3%). Air conduction thresholds were assessed by MA, AA, and AA-N in a quiet or noisy sound booth. In participants without hearing loss, 94.5% and 96% of the threshold comparisons differed between MA versus AA and AA versus AA-N within 10 dB HL or less. In participants with hearing loss, there was no statistically significant difference between the three testing conditions at any frequency (p > 0.05). The hearing threshold difference in the poor hearing ear in participants with a bilateral difference ≥40 dB HL was -15 and +15 dB HL; however, this difference was not statistically significant when excluding participants with tinnitus. Automatic audiometry can accurately estimate hearing thresholds and screen for hearing loss even in noisy environments. Nevertheless, the algorithm must be corrected when patients experience tinnitus.