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, participants reporting the Yes/No task as having the lowest perceived difficulty and 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.

The three authors are listed as co-inventors of the preliminary patent application EP4371480A1, and the patents EP4094685, EP4005474 which have been granted to Interacoustics A/S. Both patents are partially related to the test described in these studies. SL own stocks in Demant A/S, which owns Interacoustics A/S and Oticon A/S. The Audible Contrast Threshold test as described above is commercially available in instrumentation from Interacoustics A/S and other Demant A/S brands. The authors declare that the research was conducted in the absence of any other commercial or financial relationships that could be construed as a potential conflict of interest.

This study is not a clinical trial

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study was carried out in accordance with the ethical approval of the Danish Science-Ethics Committee granted by the Capital Region Committee (H-16036391). All participants gave written informed consent and were offered an economic compensation for their participation.

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The data and code used in the analyses of this manuscript is available in the Zenodo repository https://doi.org/10.5281/zenodo.15730189. Most additional data can be made available on request.