Accuracy of Hearing Test (Audiogram)?

[Gemini81]

Hi,

My question is how accurate are hearing tests?

The reason I ask is because I made a stupid decision to not wear earplugs when a bar was playing loud music for a few hours. I went to the audiologist almost 3 weeks after because my tinnitus is louder and I can't hear as well. She said that my hearing tests results are the same as the results of a previous hearing exam I had done years ago. She told me I have a temporary threshold shift.

At this point, it has been almost 2 months since my night out at the bar and I still can't hear as well.

 

[Brian P]

Audiograms are almost useless. Your brain is the best judge. It knows when your ears are damaged well before it shows up on the audiogram.

 

[Gemini81]

Brian P Oh, that's interesting. That explains why I can't hear as well but my hearing test results show no evidence of a change in my hearing.

 

[trevl]

I had a few audiology tests and both indicate hearing is within normal range for age. I had the tests because I have tinnitus in both ears, with the left ear loudest. I couldn't believe that a hearing test would show nothing wrong.

No hearing specialist I have seen so far, has asked me about any hearing loss, any hearing problems, nothing. I told the second audiologist that I have hearing loss in my left ear at the 7500 Hz range. They omitted that frequency, and so recorded no hearing deficit.

Audiologists will use excuses like "we use a mathematical algorithm to generate the chart." and "I don't know what devices you used."

I have been testing my ears at home with noise-cancelling headphones, and Online Tone Generator. I tested in 250 Hz intervals. I use Sony WH-1000XM4 and also Sennheisser PXC 550-II over-ear headphones. I use Online Tone Generator (website) on my computer and also via tablet. I use headphones wired on my computer, and bluetooth on my tablet. The process takes 30-45 minutes. I expect that my hearing loss is not static (will get worse), so I periodically test my ears using same equipment and protocol.

I have found the Sony headphones better, because the Sennheisser have an active volume amplifier in the headphones, when using both wired or Bluetooth. This amplifier creates some audible noise. The Sony headphones disable the earphone amplifier when used in wired mode, so, better for discriminating tone volumes.

I suspect that I have hearing loss due to several years using earbud speakers which were not matched. Left ear louder than right.

I noticed and payed attention to (increased) tinnitus in Oct/Nov 2021, which coincided with hyperacusis (painful ears when hearing bird noises, wind in trees etc.) which I never had before. I'm confident this was due to excessive workplace noise. I believe that my tinnitus is reactive, so have been reducing/removing any excessive noise in my everyday environment.

An extension we should expect from audiologists testing at only limited frequencies, not finding hearing loss at the frequency it *mostly* occurs, is that, if they do find some hearing loss, and recommend a hearing aid to assist, then they will not be able to properly program hearing aids to amplify frequencies where it is most needed - where most of the hearing loss has occurred. Because they simply haven't measured it.

3x charts uploaded.

1. Audiogram from Hearing Specialist
2. Lowest volume at which tones are heard.
3. Same as 2. but repeated at smaller interval for 7 kHz to 8 kHz range.

 

[dbeats]

I had a few audiology tests and both indicate hearing is within normal range for age. I had the tests because I have tinnitus in both ears, with the left ear loudest. I couldn't believe that a hearing test would show nothing wrong.

No hearing specialist I have seen so far, has asked me about any hearing loss, any hearing problems, nothing. I told the second audiologist that I have hearing loss in my left ear at the 7500 Hz range. They omitted that frequency, and so recorded no hearing deficit.

Audiologists will use excuses like "we use a mathematical algorithm to generate the chart." and "I don't know what devices you used."

I have been testing my ears at home with noise-cancelling headphones, and Online Tone Generator. I tested in 250 Hz intervals. I use Sony WH-1000XM4 and also Sennheisser PXC 550-II over-ear headphones. I use Online Tone Generator (website) on my computer and also via tablet. I use headphones wired on my computer, and bluetooth on my tablet. The process takes 30-45 minutes. I expect that my hearing loss is not static (will get worse), so I periodically test my ears using same equipment and protocol.

I have found the Sony headphones better, because the Sennheisser have an active volume amplifier in the headphones, when using both wired or Bluetooth. This amplifier creates some audible noise. The Sony headphones disable the earphone amplifier when used in wired mode, so, better for discriminating tone volumes.

I suspect that I have hearing loss due to several years using earbud speakers which were not matched. Left ear louder than right.

I noticed and payed attention to (increased) tinnitus in Oct/Nov 2021, which coincided with hyperacusis (painful ears when hearing bird noises, wind in trees etc.) which I never had before. I'm confident this was due to excessive workplace noise. I believe that my tinnitus is reactive, so have been reducing/removing any excessive noise in my everyday environment.

An extension we should expect from audiologists testing at only limited frequencies, not finding hearing loss at the frequency it *mostly* occurs, is that, if they do find some hearing loss, and recommend a hearing aid to assist, then they will not be able to properly program hearing aids to amplify frequencies where it is most needed - where most of the hearing loss has occurred. Because they simply haven't measured it.

3x charts uploaded.

1. Audiogram from Hearing Specialist
2. Lowest volume at which tones are heard.
3. Same as 2. but repeated at smaller interval for 7 kHz to 8 kHz range.

View attachment 48433

View attachment 48434

View attachment 48435

If these are the only frequencies you can find any hearing loss, then you have great hearing.

Don't stress it!

 

[trevl]

If these are the only frequencies you can find any hearing loss, then you have great hearing.

Don't stress it!

These are NOT the only frequencies where hearing loss has occurred. Hearing loss is not static. It can get worse. It should be expected to get worse since it is (often) the result of cumulative excessive noise over time. The point is, a 6 point audiology exam will miss out on finding the frequencies where hearing loss has occurred.

 

[Lasse S]

In 2019, a study was conducted on 106 tinnitus patients with a normal audiogram. It showed that if a more accurate hearing test (fine frequency step, 1/24 octave) were carried out, many more tinnitus patients would be diagnosed with hearing loss.

→ Missed hearing loss in tinnitus patients with normal audiograms

 

[RunningMan]

In 2019, a study was conducted on 106 tinnitus patients with a normal audiogram. It showed that if a more accurate hearing test (fine frequency step, 1/24 octave) were carried out, many more tinnitus patients would be diagnosed with hearing loss.

→ Missed hearing loss in tinnitus patients with normal audiograms

They should have done the same test on non-tinnitus participants. More of them probably would have been diagnosed with hearing loss as well.

 

[trevl]

@Lasse S and @RunningMan, you're correct. My audiologists—both of them—measured no more than six frequency points, broadly within the range of human speech. The goal seems to be finding just enough evidence to sell hearing aids, which is frankly embarrassing. When you consider how hearing loss occurs and the variety of tones present in everyday sounds, hearing aids can actually be detrimental. They can even make tinnitus worse if you already have it. Audiologists don't take tinnitus into account in their assessments.

I almost got into an argument with one audiology technician when I asked him to measure at 7500 Hz. He refused. I have since learned that audiology equipment typically measures only a limited range of frequencies, often in 1 kHz intervals, which covers just the human speech range. Standard audiology tests are essentially worthless for anyone who needs more detailed information.

Once I finish assembling my personal chart in a format suitable for upload, I can show you what my hearing loss looks like. Audiology tests also use algorithms to plot their data, and some may use dB-A. One audiologist told me that they use the dB-HL algorithm. dB-A down-weights high and low frequencies, and I expect dB-HL does something similar.

For context, I have had tinnitus since 2021. I experience several pure tones and also white noise, with a high-frequency pure tone at approximately 11,443 Hz. Determining my tinnitus volume is more challenging. In 2024, a researcher raised the high-frequency tone up to 80 dB in my better ear to match the tone in my worse ear. Beyond that point, the equipment begins buzzing to alert the listener of potentially damaging volumes, which interferes with matching the pure tone accurately.