Lively's online hearing test

Advances in computer technology along with the ubiquitous presence of smartphones and their applications have taken hearing testing out of the clinic and into the comfort of your home.

How does Lively test hearing and how does it differ from a test I would get in a clinic?

Just like a test you get in the clinic, Lively uses pure tones to measure your thresholds at those frequencies most important for hearing and understanding speech. The frequencies we use for our online test are the very same ones recommended by the World Health Organization.

Just like a test you get in the clinic, Lively uses pure tones to measure your thresholds at those frequencies most important for hearing and understanding speech.

The primary differences between Lively's hearing test and a clinic hearing test are in the types of tests administered and how the results are used.

The tests administered in an audiology clinic, in addition to the pure tone test, might include bone conduction; tympanometry; middle ear muscle reflex; otoacoustic emissions; and speech recognition testing, all of which are designed to determine the health of your hearing system and to determine whether or not your hearing loss is the result of a medical problem requiring further attention.

Lively's online test was designed for one purpose only — to create a personal hearing profile so that we can appropriately program your hearing aids.

Our initial programming, however, is just the first step of a comprehensive process designed to continually work with you through one-on-one consultations to further adjust your hearing aids.

Our initial programming, however, is just the first step of a comprehensive process designed to continually work with you through one-on-one consultations to further adjust your hearing aids, if necessary, and provide you with the necessary counseling, training, and education to ensure that you are getting the most out of our technologically advanced hearing instruments.

What type of sounds are used to test hearing?

The sounds coming through your headphones when taking the Lively test or at an audiology clinic are called pure tones. Pure tones are sounds that contain energy in only one frequency. A frequency represents the number of times a sound vibrates in one second. This is also known as cycles per second (cps) or Hertz (Hz). A 500 Hz pure tone vibrates 500 times a second; a 1000 Hz pure tone vibrates 1000 times a second. The greater the Hz, the higher the frequency or pitch.

To test your hearing, each frequency is isolated to measure the softest sound (the threshold) you can hear at each individual frequency. Your threshold is expressed in decibels or dB which is a measure of sound intensity. This is the same in both Lively testing and audiology clinics.

What frequencies are tested and why?

Hearing tests are designed to measure your thresholds at those frequencies most important for hearing and understanding speech. Young, healthy ears can detect a range of sounds from as low as 20 Hz to as high as 20,000 Hz! But the frequencies we consider important for hearing and understanding conversational speech range between 500 to 4000 Hz.

Frequencies above and below these, however, are still important for hearing and appreciating the sounds of nature and music, for example.

As we assault our ears with noise and get older, the upper range of our hearing decreases and our thresholds increase (get worse). This means that the pure tones need to be more intense in order for us to hear them, particularly in high frequencies. If those thresholds get too high, we will likely experience difficulty understanding speech. How much difficulty depends upon which frequencies are affected and by how much.

How does Lively know I don't have a problem that requires medical attention?

Even though the primary purpose of the Lively test was not designed to diagnose hearing disorders, we still look for "red flags" in your online test results, such as a hearing loss in only one ear, which could signal a problem that requires further examination. Importantly, we ask each client about the physical symptoms of their ear prior to and during their initial consultation with a doctor. This assessment is based on the CEDRA (Consumer Ear Disease Risk Assessment) questionnaire.

The CEDRA questionnaire was developed by researchers at Northwestern University and Mayo Clinic through a grant funded by the National Institutes of Health. The CEDRA consists of 15 questions and the total number of points (based on responses to the questions) indicates the likelihood of otological or otoneurological disease and determines whether or not we will advise you to seek medical care.

How does Lively ensure that their online test results are accurate?

Lively's hearing test is an adaptation of an existing online hearing test developed by Dr. Stephane Pigeon, a Belgium audio engineer. Dr. Pigeon's computer-based test requires an individual to simply click on an image in a column of similar images (similar to Lively's test). When an image, ordered from soft to loud, is clicked, a pure tone is produced. Each column of images represents a different frequency.

We compared individuals' results from Lively's test with a clinical audiometer. We analyzed those differences and set frequency-specific corrections to minimize the differences.

With Dr. Pigeon's permission and encouragement, we used his calibrated sound files and adapted them to build our own, proprietary hearing test. Naturally, it was important for us to determine the extent to which thresholds would vary as a function of different headphones, devices, operating systems and device volume settings.

Through a series of experiments, we compared individuals' results from Lively's test with a clinical audiometer. We analyzed those differences and set frequency-specific corrections to minimize the differences. Because of differences in devices, headphones, and environments, online testing can never be as consistently accurate as a clinical test taken in a controlled, sound-treated booth; however, the high level of satisfaction and benefit reported by Lively's clients indicates that our online hearing test, when taken in a reasonably quiet environment, is more than adequate for the purposes of initially programming your hearing aids.

What does Lively do with my test results?

Lively will provide you with a description of your results, based on the World Health Organization's hearing impairment grading system, and an accompanying video, specific to your test results, explaining the impact of your impairment on speech understanding and the likely benefits that Lively Hearing Aids will provide. If you choose to purchase Lively hearing aids, your test results will be used to program your hearing aids to your exact needs.

If at any time, you have questions about our hearing test, our hearing aids, or our on-demand audiology support program, we're just a phone call away.

Harvey Abrams, Ph.D. Head of Research Audiology, Lively