Female uses QuickTest in an office

Overcoming The Challenge of Screening for Hearing Loss in Noisy Conditions

Audiology and ENT Clinics, Hearing Services

We often hear from clients that they have attempted hearing screening in the past, but conventional approaches have yielded poor results. “No one passes,” they say. This is often because they are screening in noisy conditions, and their testing equipment can’t compensate for these environments.

In this article, we explore the flaws of conventional approaches for simple hearing screening and offer a method that is proving to yield accurate results.

SHOEBOX QuickTest is an easy-to-use, self-administered hearing screener that leverages several components from its sister product SHOEBOX Audiometry, a full software-based audiometer that is FDA, CE, and Health Canada-listed and optimized for testing outside of a sound booth. Although QuickTest is not considered a medical device, it was built using many of the same software elements that make SHOEBOX a leader in boothless audiometry. As such, you can be confident that QuickTest will produce accurate results, and you will get qualified leads.

There are a couple of factors that will impact the frequencies you choose for screening and the boundaries for categorizing different types of hearing loss:

  1. The goal of the test
  2. The background noise level of your testing location and how much of that can be managed by the headphones you choose

Let’s explore these in more detail.

What is the goal of QuickTest?

QuickTest is used when you wish to quickly assess if a participant has any hearing loss and accurately segment them into either two or three categories. It is not meant to be used for clinically diagnosing hearing loss but rather to get a general sense of whether the participant has good, reduced, or very reduced hearing ability.

QuickTest Result - Good QuickTest result - reduced

How do you manage background noise when using QuickTest?

The American National Standards Institute (ANSI) S3.1 offers details on how to work out the maximum acceptable background noise per testing frequency for accurate testing.

There are two factors that impact what noise level is acceptable when screening with QuickTest:

  1. How well do the headphones block out background noise(headphone attenuation)?
  2. You need to test down to the lowest level and still guarantee accuracy(no shifting).

QuickTest ships with RadioEar DD450 headphones. We selected these headphones for two reasons. First, the high level of background noise they block, and second, how easy they are to put on for a wide range of participants.

Using the  ANSI S3.1* formula, the graph below shows the maximum allowable background noise at different frequencies when screening with QuickTest and the DD450’s*.

Max background noise allowed when screening hearing

If we then overlay the typical noise level (75 dBA) of a trade show or retail outlet onto this graph, we see that the higher frequencies fall below the maximum background noise allowed.

For simplicity it’s common to use an overall measurement to represent the average noise level across all frequencies; however, to understand how this impacts different frequencies during screening, we must consider the noise level per frequency. When we overlay typical retail background noise on the frequency spectrum, we find the noise at lower frequencies is dominant compared to the higher frequencies.

Max background noise allowed vs 75 dBA of background noise

NOTE: This data uses the published manufacturer attenuation values and calculations from ANSI 3.1* 

To help illustrate the concept of testing in noise, we’ve included an audiogram below for someone with hearing loss. The test was taken in a quiet environment (30dB) and again in a noisy one (80dB). This is an example of real-life hearing loss showing how the lower frequency thresholds are shifted to show hearing loss where there is no loss. However, the higher frequencies are not significantly shifted due to the noise. This audiogram demonstrates the science behind selecting the correct headphones and testing only the higher frequencies when in noise according to the ANSI 3.1 guidelines.

Testing in noise when screening in noise

Using high frequencies to segment participants into categories is more accurate than using lower frequencies for three reasons:

  1. We lose the high frequencies first as we age
  2. There are usually significant gaps between them
  3. Interfering background noise at these frequencies is uncommon

Results breakdown when screening hearing


High background noise is a universal hurdle for conventional hearing screening products. QuickTest is designed to revolutionize how we screen in noisy environments. This is achieved by using the highest attenuation headphones on the market and selecting the higher frequencies to categorize hearing loss accurately. Using this approach, you can generate more qualified leads for your clinic at a fraction of the cost of traditional marketing.

Furthermore, with QuickTest, you’re in the driver’s seat. This simple-to-use, self-administered mobile hearing screener can be placed in any high-traffic area, even if it is noisy. Participants can get an accurate result of their hearing ability in just two minutes, and you’ll have the data you need to identify which are your most qualified leads.

QuickTest is portable, allowing you to offer screenings for participants in locations that are convenient to them, such as retail outlets, fairs and expos, physician offices, optical chains, pharmacies, waiting rooms, and more..

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** DD45