Multi-dimensional evaluation of user-operated audible contrast sensitivity tests towards efficient hearing healthcare services

The user-operated audiometry (UAud) project aims at introducing an automated system for user-operated audiometric testing into everyday clinical practice. Here, we focus on the Audible Contrast Threshold (ACT) test, which has been proposed as a language-independent alternative to aided speech-in-noise tests. Five distinct user-operated ACT (U-ACT) test candidates were evaluated in terms of performance, reliability, and usability against two established test benchmarks. The study involved 28 participants with diverse hearing and cognitive abilities. The results demonstrated that the primary factor influencing the reliability of test results was the type of task. In terms of usability, the participants reported positive experience with all test candidates, with the Yes/No task resulting in the lowest perceived difficulty and the best understanding. Overall, a test candidate with a custom adaptive procedure inspired by audiologists’ experiences with ACT was chosen for the UAud protocol as a user-operated test of hearing-in-noise perception.