AGREEMENT BETWEEN HEARING SCREENING PROCEDURES WITH THE DIGITS-IN-NOISE TEST (DIN) IN STUDENTS.
Screening; Hearing tests; Digits-in-Noise Test; Hearing loss; Academic institutions.
Introduction: Identifying hearing loss in students is essential to ensure adequate educational and social development. Objective: To assess the agreement between auditory screening procedures and the Hearing-in-Noise Test (HINT) adapted as the Digits-in-Noise Test (DIN) in students. Method: This was a cross-sectional study conducted with 83 students from the Federal Institute of Rio Grande do Norte – Parnamirim Campus (52.2% female; 15 to 45 years old; mean age = 19.79 years), who underwent audiometric screening, transient-evoked otoacoustic emissions (TEOAE) screening, distortion product otoacoustic emissions (DPOAE) screening, tympanometric screening, and the Digits-in-Noise Test (DIN) in diotic and antiphasic modes. The DIN was administered via an online link on a smartphone using headphones, following an automated adaptive procedure, with cut-off points of –6.7 dB SNR (diotic) and –11 dB SNR (antiphasic). Agreement between procedures was analyzed using Fleiss’ Kappa and Cohen’s Kappa indices. Results: The diotic DIN showed the highest pass rate (98.80%), followed by the antiphasic DIN and DPOAEs (91.57%). The highest failure rate occurred in the TEOAEs (42.17%). Overall agreement between procedures was low (Fleiss’ kappa = –0.20), and pairwise agreement ranged from –0.02 to 0.34, indicating minimal to slight agreement among tests, with the highest agreement observed between tympanometry and DPOAEs. Conclusion: The DIN, particularly in the antiphasic mode, shows greater agreement with otoacoustic emissions in failure outcomes. Nevertheless, the sample size and differences in the distribution of outcomes may have limited the results. The DIN is a functional and promising tool for identifying hearing difficulties related to speech-in-noise recognition, although it does not replace traditional methods. The combination of different procedures contributes to a more sensitive hearing screening process among high school students.