Establishing New Pediatric Thresholds for Digits-In-Noise Testing
Morgan McBride1, Allyson Dunlap1, Siva Chinnadurai2,3
1University of Minnesota Medical School Minneapolis Minnesota USA.
Laryngoscope Investigative Otolaryngology
|November 17, 2025
Summary
Tablet-based digits in noise (DIN) testing shows potential for identifying pediatric conductive hearing loss (CHL). However, current sensitivity requires improvement before widespread clinical use as a screening tool.
Area of Science:
- Pediatric Audiology
- Hearing Diagnostics
- Mobile Health Technology
Background:
- Conductive hearing loss (CHL) in children requires accurate and accessible diagnostic methods.
- Traditional audiometric evaluations can be time-consuming and require specialized equipment.
- Tablet-based hearing tests offer a potential alternative for screening and diagnosis.
Purpose of the Study:
- To evaluate the efficacy of tablet-based digits in noise (DIN) testing for identifying CHL in children.
- To determine if specific pediatric diagnostic criteria can be established using DIN testing.
Main Methods:
- 149 children (aged 3-18) underwent conventional audiometry and tablet-based DIN testing.
- DIN testing included diotic and antiphasic stimuli presented via a Samsung Galaxy tablet.
- Results were correlated with audiometric diagnoses of CHL versus normal hearing (NH).
Main Results:
- Two parameters identified CHL with high positive predictive value (76%, 95%) and good specificity (81%, 98%).
- Sensitivity for detecting CHL was poor (39%, 22%).
- Pediatric DIN testing did not differentiate CHL from NH as effectively as in adults.
Conclusions:
- Tablet-based DIN testing shows promise but requires significant improvements in sensitivity.
- Further refinement is needed before DIN testing can be reliably used as a pediatric CHL screening tool.
