Comparison of ascending and bracketing methods in pure tone audiometry. A multi-laboratory study

Area of Science:

• Audiology
• Hearing Science
• Diagnostic Methods

Background:

• Accurate hearing threshold determination is crucial for diagnosing hearing loss.
• Manual audiometric methods, such as ascending and bracketing, are commonly used.
• Understanding the efficiency and comparability of these methods is important for clinical practice.

Purpose of the Study:

• To compare the ascending and bracketing methods for manual hearing threshold determination.
• To assess differences in mean thresholds, subject variability, and test time.
• To evaluate the consistency of results across multiple laboratories.

Main Methods:

• Four laboratories participated in the study.
• Hearing thresholds were manually determined using attenuators with a 5 dB step.
• Both ascending and bracketing methods were employed.
• A total of 214 ears were measured across various frequencies (0.5-6 kHz).

Main Results:

• No significant difference was found between mean hearing thresholds obtained with ascending and bracketing methods.
• The grand mean difference across all laboratories and frequencies was -0.31 dB.
• Subject variability was comparable between the two methods.
• The bracketing method required a significantly longer test duration compared to the ascending method.

Conclusions:

• Ascending and bracketing methods provide comparable hearing threshold data.
• The ascending method is more time-efficient for manual hearing threshold determination.
• Clinical audiology can utilize either method, with a consideration for testing time.