High-frequency audiometry: test reliability and procedural considerations.

This study compared the reliability of a recently developed high-frequency audiometer (HFA) [Stevens et al., J. Acoust. Soc. Am. 81, 470-484 (1987)] with a less complicated system that uses supraaural earphones (Koss system). The new approach permits calibration on an individual basis, making it possible to express thresholds at high frequencies in dB SPL. Data obtained from 50 normal-hearing subjects, ranging in age from 10-60 years, were used to evaluate the effects on reliability of threshold variance, earpiece/earphone fitting variance, and the variance associated with the HFA calibration process. Without earpiece/earphone replacement, the reliability of thresholds for the two systems is similar. With replacement, the HFA showed poorer reliability than the Koss system above 11 kHz, largely due to errors in estimating the calibration function. HFA reliability is greater for subjects with valid calibration functions over the entire frequency range. When average correction factors are applied to the Koss data in an effort to convert threshold estimates to dB SPL, individual transfer functions are not represented accurately. Thus the benefit of being able to express thresholds at high frequencies in dB SPL must be weighed against the additional source of variability introduced by the HFA calibration process.