Clinical Applicability of Adaptive Speech Testing: A comparison of the administration time, accuracy, efficiency and reliability of adaptive speech tests with conventional speech audiometry
Adaptive procedures are a common method of investigating sensory abilities in research settings; however, their use in clinical settings is more limited. We have investigated the advantages of using both closed-set and open-set adaptive speech tests in the clinical audiology setting, with respect to administration time, accuracy, efficiency and reliability. Preliminary testing of two major adaptive procedures (staircase and maximum-likelihood procedures) was conducted to determine the optimal procedures and parameters for use in clinical speech tests. The maximum-likelihood QUEST procedure showed advantages over the staircase procedures in terms of administration time; however, the reliability of both this test and conventional speech audiometry was poor, indicating that these tests were not as suitable as staircase tests for the clinical setting. Subsequent clinical testing of the optimal adaptive speech tests using participants with varying degrees of hearing loss found that administration time was similar between conventional speech audiometry and the adaptive closed-set staircase tests when optimised termination criteria were employed. Adaptive open-set staircase tests with larger step sizes at the beginning showed the best accuracy of any of the tests when using the pure-tone average as a reference, while the efficiency of all the adaptive staircase tests was similar. Overall, the results highlight some of the potential advantages of adaptive speech testing in the clinical Audiology setting; however, further studies are required to determine the specific parameters that achieve the best results.