Audiologic practices What is popular versus what is supported by evidence Letter to the Editor
Letter to the Editor  |   November 01, 1995
Audiologic practices
 
Author Affiliations & Notes
  • Otto J. Menzel
    Bristol, TN
Article Information
Hearing & Speech Perception / Letters to the Editor
Letter to the Editor   |   November 01, 1995
Audiologic practices
American Journal of Audiology, November 1995, Vol. 4, 87-88. doi:10.1044/1059-0889.0403.87
 
American Journal of Audiology, November 1995, Vol. 4, 87-88. doi:10.1044/1059-0889.0403.87
It was refreshing to learn that more than a few audiologists are still using common sense in their choice of specific test procedures for the diagnostic battery. I agree with many of the authors’ comments on both the speech reception threshold test (SRT) and the various tone decay tests. Among the points of agreement are principally these: (a) that a test that contributes little information is perhaps best omitted, and (b) shortcuts that diminish the sensitivity of a test should be avoided.
I agree emphatically that “abbreviated” tone decay tests are worse than useless. Here is an area where I have never taken a shortcut, not being willing to fail to detect important information. To do a quickie tone decay test with false negative results could be a very serious matter. But the compleat audiologist can secure much information without wasting time. Example: In plotting a pure tone audiogram, it is ever a challenge to avoid rhythmic presentation of test tones. The novice is notorious in this, causing many errors in this most basic of tests. Suppose every once in a while, the test tone (near threshold) is left on considerably longer than most presentations. This has the salutary effect of keeping the patient on his toes, even while the clinician is breaking up any tendency toward rhythmic presentation. But if the tone on such occasion stays on for perhaps several seconds and the patient’s hand comes down too soon, this may signal either failure to follow instructions or the presence of abnormal tone decay. It should not take long to determine which is the cause. If it is failure to adhere to instructions about keeping the hand up for the duration of an audible tone, here is a useful reminder. If indeed the threshold has slipped away while the tone remains, the clinician is alerted to the need to do a careful and complete tone decay test—sans shortcuts!
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