AI-Based Prediction of Bone Conduction Thresholds Using Air Conduction Audiometry Data

Background/Objectives: This study evaluated the feasibility of predicting bone conduction (BC) thresholds and classifying air–bone gap (ABG) status using only air conduction (AC) data obtained from pure tone audiometry (PTA). Methods: A total of 60,718 PTA records from five tertiary hospitals in the Republic of Korea were utilized. Input features included AC thresholds (0.25–8 kHz), age, and sex, while outputs were BC thresholds (0.25–4 kHz) and ABG classification based on 10 dB and 15 dB criteria. Five machine learning models—deep neural network (DNN), long short-term memory (LSTM), bidirectional LSTM (BiLSTM), random forest (RF), and extreme gradient boosting (XGB)—were trained using 5-fold cross-validation with Synthetic Minority Over-sampling Technique (SMOTE). Model performance was evaluated based on accuracy, sensitivity, precision, and F1 score under ±5 dB and ±10 dB thresholds for BC prediction. Results: LSTM and BiLSTM outperformed DNN in predicting BC thresholds, achieving ~60% accuracy within ±5 dB and ~80% within ±10 dB. For ABG classification, all models performed better with the 10 dB criterion than the 15 dB. Tree-based models (RF, XGB) achieved the highest classification accuracy (up to 0.512) and precision (up to 0.827). Confidence intervals for all metrics were within ±0.01, indicating stable results. Conclusions: AI models can accurately predict BC thresholds and ABG status using AC data alone. These findings support the integration of AI-driven tools into clinical audiology and telemedicine, particularly for remote screening and diagnosis. Future work should focus on clinical validation and implementation to expand accessibility in hearing care.