ORIGINAL ARTICLE
COMPARISON OF A BOOTH-FREE AUDIOMETER WITH A CONVENTIONAL DEVICE IN TERMS OF IMMUNITY TO NOISE AND SUBJECTIVE COMFORT
,
 
Saransh Jain 1, A,C-E
,
 
,
 
Sandeep Maruthy 1, A,C-F
 
 
 
More details
Hide details
1
All India Institute of Speech and Hearing, Mysore, India
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2025-08-18
 
 
Final revision date: 2026-07-15
 
 
Acceptance date: 2026-07-16
 
 
Online publication date: 2026-08-12
 
 
Publication date: 2026-08-12
 
 
Corresponding author
Sandeep Maruthy   

All India Institute of Speech and Hearing, Manasagangothri, 570006, Mysore, India
 
 
J Hear Sci 2026;16(2):23-34
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study aimed to evaluate the noise immunity level (NIL) of the booth-free KUDUwave™ audiometer and compare the subjective comfort of its headphones against a conventional screening audiometer under simulated noise conditions, in order to determine its suitability for hearing screening in resource-limited settings.

Material and methods:
30 normal-hearing adults (aged 20–25 years) participated in a repeated-measures crossover study. Pure-tone airand bone-conduction thresholds were obtained under quiet and background noise conditions using the KUDUwave audiometer and a conventional audiometer from Interacoustics. Three types of noise were presented: broadband noise (BBN), speech-shaped noise (SSN), and eight-talker babble (8-TB). In addition, the subjective comfort associated with each audiometer’s headset was evaluated.

Results:
Baseline air-conduction (AC) thresholds were comparable between the two audiometers, whereas bone-conduction (BC) thresholds were significantly lower with the KUDUwave, likely due to the occlusion effect. Across all noise conditions, the KUDUwave demonstrated higher NILs than the conventional audiometer, indicating greater resistance to ambient noise. In AC testing, NILs were lowest at low frequencies and highest at mid frequencies, with 8-TB producing greater masking effects than BBN and SSN. However, participants reported lower comfort with the KUDUwave headset compared to the conventional audiometer.

Conclusions:
The KUDUwave audiometer demonstrated greater noise immunity than the conventional device, indicating enhanced resistance to ambient noise. These findings suggest its potential suitability for hearing screening in non–sound-treated, community-based environments. However, its real-world utility and practical advantages in such settings need to be further validated through field-based studies.
ACKNOWLEDGEMENTS
The authors thank the Director, AIISH, Mysuru, and all the participants for their support and cooperation.
FUNDING
This research and article did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
REFERENCES (28)
1.
World Health Organization. Deafness and Hearing Loss [Internet]. Geneva: WHO; 2021. Available from: https://www.who.int/health-top....
 
2.
Joint Committee on Infant Hearing. 2019 Joint Committee on Infant Hearing (JCIH) Position Statement Released [Internet]. Audiology; 2019. Available from: https://www.audiology.org/news....
 
3.
Sheffield B, Edwards B, Swanepoel DW. Increasing hearing readiness using boothless audiometry. Mil Med, 2023; 188 (Suppl 6): 529–35. https://doi.org/10.1093/milmed....
 
4.
Renda L, Selcuk OT, Eyigor H, Osma U, Yilmaz MD. Smartphone-based audiometric test for confirming the level of hearing: Is it usable in underserved areas? J Int Adv Otol, 2016; 12(1): 61–6. https://doi.org/10.5152/iao.20....
 
5.
Chua KWD, Yuen HW, Kamath S. Boothless aided audiometry: a pilot study. Proc Singapore Healthcare, 2022; 31: 20101058211040585. https://doi.org/10.1177/201010....
 
6.
Swanepoel DW, Matthysen C, Eikelboom RH, Clark JL, Hall JW. Pure-tone audiometry outside a sound booth using earphone attenuation, integrated noise monitoring, and automation. Int J Audiol, 2015; 54(11): 777–85. https://doi.org/10.3109/149920....
 
7.
Behar A. Audiometric tests without booths. Int J Environ Res Public Health, 2021; 18(6): 3073. https://doi.org/10.3390/ijerph....
 
8.
Meinke DK, Norris JA, Flynn BP, Clavier OH. Going wireless and booth-less for hearing testing in industry. Int J Audiol, 2017; 56 (Sup1): 41–51. https://doi.org/10.1080/149920....
 
9.
Serpanos YC, Hobbs M, Nunez K, Gambino L, Butler J. Adapting audiology procedures during the pandemic: validity and efficacy of testing outside a sound booth. Am J Audiol, 2022; 31(1): 91–100. https://doi.org/10.1044/2021_A....
 
10.
Storey KK, Muñoz K, Nelson L, Larsen J, White K. Ambient noise impact on accuracy of automated hearing assessment. Int J Audiol, 2014; 53(10): 730–6. https://doi.org/10.3109/149920....
 
11.
Swanepoel DW, Koekemoer D, Clark J. Intercontinental hearing assessment: a study in tele-audiology. J Telemed Telecare, 2010; 16(5): 248–52. https://doi.org/10.1258/jtt.20....
 
12.
Maclennan-Smith F, Swanepoel DW, Hall JW. Validity of diagnostic pure-tone audiometry without a sound-treated environment in older adults. Int J Audiol, 2013; 52(2): 66–73. https://doi.org/10.3109/149920...
 
13.
Brungart DS, Simpson BD, Ericson MA, Scott KR. Informational and energetic masking effects in the perception of multiple simultaneous talkers. J Acoust Soc Am, 2001; 110(5 Pt 1): 2527–38. https://doi.org/10.1121/1.1345....
 
14.
Festen JM, Plomp R. Effects of fluctuating noise and interfering speech on the speech-reception threshold for impaired and normal hearing. J Acoust Soc Am, 1990; 88(4): 1725–36. https://doi.org/10.1121/1.4002....
 
15.
Helfer KS, Chevalier J, Freyman RL. Aging, spatial cues, and single- versus dual-task performance in competing speech perception. J Acoust Soc Am, 2010; 128(6): 3625–33. https://doi.org/10.1121/1.3502....
 
16.
Smith MKP, Wilson RH, Macdonald EN. Word recognition for temporally and spectrally distorted materials: the effects of age and hearing loss. Ear Hear, 2012; 33(3): 349–66. https://doi.org/10.1097/AUD.0b....
 
17.
Kuk F, Keenan D, Korhonen P, Lau CC. Efficacy of linear frequency transposition on consonant identification in quiet and in noise. J Am Acad Audiol, 2009; 20(8): 465–79. https://doi.org/10.3766/jaaa.2....
 
18.
Almeida BP, de Lemos Menezes P, de Andrade KCL, Teixeira CF. Positioning of earphones and variations in auditory thresholds. Braz J Otorhinolaryngol, 2015; 81(6): 642–6. https://doi.org/10.1016/j.bjor....
 
19.
Barcelos FVL, de Paiva KM, Machado MJ, Haas P. Auditory changes in occupational health associated with metabolic diseases in adult workers. Am J Lifestyle Med, 2024. https://doi.org/10.1177/155982....
 
20.
Ergun O, Cakmak E, Alniacik A. Recreational music exposure and hearing health in young adults. Eur Arch Otorhinolaryngol, 2024; 281(8): 4373–8. https://doi.org/10.1007/s00405....
 
21.
Kumar AU, Sandeep M. Auditory Cognitive Training Module. Mysuru: All India Institute of Speech and Hearing; 2013.
 
22.
Carhart R, Jerger JF. Preferred method for clinical determination of pure-tone thresholds. J Speech Hear Disord, 1959; 24(4): 330–45. https://doi.org/10.1044/jshd.2....
 
23.
Jensen R, Lauridsen N, Poulsen A, Tofte C, Christensen F. Analysis of subjective evaluation of user experience with headphones: AES 61st International Conference, 2016. Available from: http://www.aes.org/events/61/.
 
24.
Goldstein DP, Hayes CS. The occlusion effect in bone conduction hearing. J Speech Hear Res, 1965; 8: 137–48. https://doi.org/10.1044/jshr.0....
 
25.
Abraham AK, Jain C, Yashaswini L. Effect of ambient noise on pure tone hearing screening test conducted in Indian rural locations. J Indian Inst Speech Hear, 2016; 35: 58–65.
 
26.
Brennan-Jones CG, Eikelboom RH, Swanepoel DW, Friedland PL, Atlas MD. Clinical validation of automated audiometry with continuous noise-monitoring in a clinically heterogeneous population outside a sound-treated environment. Int J Audiol, 2016; 55(9): 507–13. https://doi.org/10.1080/149920....
 
27.
Frank T, Williams DL. Ambient noise levels in audiometric test rooms used for clinical audiometry. Ear Hear, 1993; 14(6): 414–22. https://doi.org/10.1097/000034....
 
28.
Liu H, Du B, Liu B, Fu X, Wang Y. Clinical comparison of two automated audiometry procedures. Front Neurosci, 2022; 16: 1011016. https://doi.org/10.3389/fnins.....
 
Journals System - logo
Scroll to top