Equivalent threshold sound pressure levels (ETSPLs) for RadioEar DD65v2 circumaural audiometric headphones.

Objective: Equivalent threshold sound pressure levels (ETSPLs) were determined for RadioEar DD65v2 audiometric headphones.Design: The pure-tone hearing threshold levels were measured for 11 audiometric frequencies between 0.125 and 8 kHz, according to the conditions specified in ISO 389-9. ETSPLs are provided for an ear simulator according to IEC 60318-1, complemented by a comprehensive uncertainty budget.Study sample: The study was based on 25 otologically normal test subjects.Results: ETSPL values are provided with expanded measurement uncertainty. The data are compared for left/right ears as well as male/female test subjects.Conclusions: The results of both studies may be used to update ISO 389-8, the RETSPL standard for circumaural audiometric headphones.

Screening for hearing loss in the Hong Kong Cantonese-speaking elderly using tablet-based pure-tone and word-in-noise test.

Objective: The present study aimed to establish the test-retest reliability and validity of a tablet-based automated pure-tone screening test and a word-in-noise test as hearing screening tools for older Hong Kong Cantonese-speaking adults.Design and study sample: It was a cross-sectional within-subject study. One hundred and thirty-two older adults participated in this study, and 112 of them completed the automated pure-tone screening test, word-in-noise test, and conventional pure-tone audiometry. Pure-tone threshold of 40 dB HL at each of the tested frequencies including 500, 1000, 2000 and 4000 Hz, obtained with conventional pure-tone audiometry was set as the pass/refer criterion, for the calculation of sensitivity and specificity of the tablet-based screening tools.Results: The tablet-based automated pure-tone screening test yielded a sensitivity of 0.93 and specificity of 0.82, while the word-in-noise test yielded a sensitivity of 0.81 and specificity of 0.70 with the cut-off chosen as a speech reception threshold of -3.5 dB signal-to-noise ratio. Both tests require around 3 minutes to be completed on both ears.Conclusions: The tablet-based pure-tone test and word-in-noise test are reliable and valid to be used as screening tools for hearing loss in the Hong Kong Cantonese-speaking elderly.

Validity of correction factors applied to auditory steady-state responses (ASSRs) in normal hearing adults in chartr EP system.

OBJECTIVES: Even though many patients undergoing auditory steady-state response (ASSR) testing have some degree of hearing loss, some have normal hearing and ASSR often overestimates the behavioral thresholds in this group. In most commercial ASSR systems such as Chartr EP, a default correction factor is applied to compensate for this difference. Little is known, however, as how the correction factor compensates for the difference between ASSR and pure tone audiometry (PTA) thresholds as a function of carrier or modulation frequency (MF) in a commercial ASSR system. Our goal is to evaluate this relationship. METHODS: Twenty-four normal hearing adults were examined for both PTA and ASSR (Chartr EP system, GN Otometrics). ASSR thresholds were obtained at three MFs (20, 40, and 80 Hz). The difference scores were obtained by subtracting PTA from ASSR thresholds at each frequency for each subject. The corrected ASSR thresholds, then, were compared with the PTA thresholds across MFs and carrier frequencies. RESULTS: The default correction factors in the ASSR equipment differed significantly from the difference scores at all MFs and carrier frequencies (n = 24, p < 0.005). The correlation between corrected ASSR and PTA thresholds at most MFs and carrier frequencies were medium to poor. CONCLUSIONS: At most MFs and carrier frequencies, the default correction factors defined by the manufacturer do not compensate for the difference between ASSR and PTA thresholds in normal hearing adults. The use of the default correction factors in Chartr EP system for the normal hearing adults needs special considerations.

Development and evaluation of a tablet-based diagnostic audiometer.

Objective: To develop and evaluate a software application capable of conducting Pure-Tone Audiometry tests in clinical practice. Design: We designed and developed a mobile software application for iPad devices that performs Pure-Tone Audiometry according to ANSI and IEC standards. The application is proposed to be operated by a trained audiologist inside a sound booth. No extra equipment is required. Hence, it updates the procedure by showing the versatility of the proposed system. Particularly, it provides manual and automated measurement, including air- and bone-conduction audiometry. Study sample: Twenty-nine participants-patients of Papageorgiou Hospital, Thessaloniki, Greece were tested, with all degrees of hearing sensitivity. Manual air- and bone-conduction Pure-Tone Audiometry was conducted inside a sound booth. Participants were tested with conventional audiometry and the audiometric application, in order to validate the tablet-based audiometer for measuring hearing thresholds. Results: The majority (90.9%) of air-conduction estimated hearing thresholds and (90.8%) of air-bone gaps were within 5 dB, compared to results obtained by conventional audiometry. Thus, threshold differences were not significant. Conclusions: The proposed audiometer is a reliable and valid tool for hearing assessment. Owing to certain limitations, mobile devices can provide a feasible substitute for conventional audiometry in clinical practice.

Pure-Tone Audiometry With Forward Pressure Level Calibration Leads to Clinically-Relevant Improvements in Test-Retest Reliability.

OBJECTIVES: Clinical pure-tone audiometry is conducted using stimuli delivered through supra-aural headphones or insert earphones. The stimuli are calibrated in an acoustic (average ear) coupler. Deviations in individual-ear acoustics from the coupler acoustics affect test validity, and variations in probe insertion and headphone placement affect both test validity and test-retest reliability. Using an insert earphone designed for otoacoustic emission testing, which contains a microphone and loudspeaker, an individualized in-the-ear calibration can be calculated from the ear-canal sound pressure measured at the microphone. However, the total sound pressure level (SPL) measured at the microphone may be affected by standing-wave nulls at higher frequencies, producing errors in stimulus level of up to 20 dB. An alternative is to calibrate using the forward pressure level (FPL) component, which is derived from the total SPL using a wideband acoustic immittance measurement, and represents the pressure wave incident on the eardrum. The objective of this study is to establish test-retest reliability for FPL calibration of pure-tone audiometry stimuli, compared with in-the-ear and coupler sound pressure calibrations. DESIGN: The authors compared standard audiometry using a modern clinical audiometer with TDH-39P supra-aural headphones calibrated in a coupler to a prototype audiometer with an ER10C earphone calibrated three ways: (1) in-the-ear using the total SPL at the microphone, (2) in-the-ear using the FPL at the microphone, and (3) in a coupler (all three are derived from the same measurement). The test procedure was similar to that commonly used in hearing-conservation programs, using pulsed-tone test frequencies at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and an automated modified Hughson-Westlake audiometric procedure. Fifteen adult human participants with normal to mildly-impaired hearing were selected, and one ear from each was tested. Participants completed 10 audiograms on each system, with test-order randomly varied and with headphones and earphones refitted by the tester between tests. RESULTS: Fourteen of 15 ears had standing-wave nulls present between 4 and 8 kHz. The mean intrasubject SD at 6 and 8 kHz was lowest for the FPL calibration, and was comparable with the low-frequency reliability across calibration methods. This decrease in variability translates to statistically-derived significant threshold shift criteria indicating that 15 dB shifts in hearing can be reliably detected at 6 and 8 kHz using FPL-calibrated ER10C earphones, compared with 20 to 25 dB shifts using standard TDH-39P headphones with a coupler calibration. CONCLUSIONS: These results indicate that reliability is better with insert earphones, especially with in-the-ear FPL calibration, compared with a standard clinical audiometer with supra-aural headphones. However, in-the-ear SPL calibration should not be used due to its sensitivity to standing waves. The improvement in reliability is clinically meaningful, potentially allowing hearing-conservation programs to more confidently determine significant threshold shifts at 6 kHz-a key frequency for the early detection of noise-induced hearing loss.

Supra-aural transducer-related artifact contributes to overestimation of noise-induced hearing loss.

This study compared the effects of supra-aural and insert receivers on the prevalence of noise-induced hearing loss (NIHL) in young adults. NIHL prevalence was found to be substantially higher when hearing thresholds were obtained with supra-aural compared to insert receivers on the same subjects. Real-ear sound pressure levels at 4000, 6000, and 8000 Hz were the major predictors of notched-audiograms obtained with supra-aural headphones. Distortion-product otoacoustic emissions were not significantly different between ears with and without notched-audiograms obtained with supra-aural headphones. The results demonstrated that supra-aural transducer-related artifacts can mimic a notch-like pattern leading to overestimation of NIHL prevalence.

Phyllis M. Tookey Kerridge and the science of audiometric standardization in Britain.

The provision of standardized hearing aids is now considered to be a crucial part of the UK National Health Service. Yet this is only explicable through reference to the career of a woman who has, until now, been entirely forgotten. Dr Phyllis Margaret Tookey Kerridge (1901-1940) was an authoritative figure in a variety of fields: medicine, physiology, otology and the construction of scientific apparatus. The astounding breadth of her professional qualifications allowed her to combine features of these fields and, later in her career, to position herself as a specialist to shape the discipline of audiometry. Rather than framing Kerridge in the classic 'heroic-woman' narrative, in this article we draw out the complexities of her career by focusing on her pursuit of standardization of hearing tests. Collaboration afforded her the necessary networks to explore the intricacies of accuracy in the measurement of hearing acuity, but her influence was enhanced by her ownership of Britain's first Western Electric (pure-tone) audiometer, which she placed in a specially designed and unique 'silence room'. The room became the centre of Kerridge's hearing aid clinic that, for the first time, allowed people to access free and impartial advice on hearing aid prescription. In becoming the guardian expert and advocate of the audiometer, Kerridge achieved an objectively quantified approach to hearing loss that eventually made the latter an object of technocratic intervention.

Use of noise cancellation earphones in out-of-booth audiometric evaluations.

OBJECTIVE: To assess the utility of noise cancelation earphones (NCE) in audiometric evaluations. DESIGN: Degree of noise reduction of Bose QuietComfort 15 NCE was assessed through probe-microphone measures and sound-field audiometry. Occlusion effects from NCE were assessed for potential effects on bone-conduction thresholds. STUDY SAMPLE: Twenty participants were tested to determine average occlusion effect values during bone-conduction testing with and without NCE. Noise reduction values of the NCE were assessed on a single subject through probe-microphone measures and sound-field testing. RESULTS: NCE sufficiently reduced ambient noise to levels acceptable for air-conduction testing as well as for bone-conduction testing for most patients when adding minimal adjustment to acceptable levels as outlined by the ANSI S3.1-1999 standard. In addition, NCE did not create a clinically significant change in the occlusion effect for bone-conduction testing. CONCLUSION: NCE placed over insert earphones provide a sound pressure level at the tympanic membrane that is below ANSI standards for routine air-conduction testing and result in sufficient ambient noise reduction for bone-conduction testing with most patients. There is no clinically significant occlusion effect from NCE during routine bone-conduction audiometry. These findings support the utility of using NCE for offsite audiometric testing.

Clinical Validity of hearScreen™ Smartphone Hearing Screening for School Children.

OBJECTIVES: The study aimed to determine the validity of a smartphone hearing screening technology (hearScreen™) compared with conventional screening audiometry in terms of (1) sensitivity and specificity, (2) referral rate, and (3) test time. DESIGN: One thousand and seventy school-age children in grades 1 to 3 (8 ± 1.1 average years) were recruited from five public schools. Children were screened twice, once using conventional audiometry and once with the smartphone hearing screening. Screening was conducted in a counterbalanced sequence, alternating initial screen between conventional or smartphone hearing screening. RESULTS: No statistically significant difference in performance between techniques was noted, with smartphone screening demonstrating equivalent sensitivity (75.0%) and specificity (98.5%) to conventional screening audiometry. While referral rates were lower with the smartphone screening (3.2 vs. 4.6%), it was not significantly different (p > 0.05). Smartphone screening (hearScreen™) was 12.3% faster than conventional screening. CONCLUSION: Smartphone hearing screening using the hearScreen™ application is accurate and time efficient.

Smartphone-based audiometric test for screening hearing loss in the elderly.

Hearing loss is widespread among the elderly. One of the main obstacles to rehabilitation is identifying individuals with potentially correctable hearing loss. Smartphone-based hearing tests can be administered at home, thus greatly facilitating access to screening. This study evaluates the use of a smartphone application as a screening tool for hearing loss in individuals aged ≥ 65 years. Twenty-six subjects aged 84.4 ± 6.73 years (mean ± SD) were recruited. Pure-tone audiometry was administered by both a smartphone application (uHear for iPhone, v1.0 Unitron, Canada) and a standard portable audiometer by trained personnel. Participants also completed a questionnaire on their hearing. Pure-tone thresholds were compared between the two testing modalities and correlated with the questionnaire results. The cutoff point for failing screening tests was a pure tone average of 40 dB for the frequencies 250-6,000 Hz. The smartphone application's pure tone thresholds were higher (poorer hearing) than the audiometric thresholds, with a significant difference in all frequencies but 2,000 Hz. The application and the audiometric values were in agreement for 24 subjects (92 %). The application had a sensitivity of 100 % and specificity of 60 % for screening compared with the audiometer. The questionnaire was significantly less accurate, having assigned a passing score to three participants who failed both the application and audiometric tests. While a smartphone application may not be able to accurately determine the level of hearing impairment, it is useful as a highly accessible portable audiometer substitute for screening for hearing loss in elderly populations.

Smartphone threshold audiometry in underserved primary health-care contexts.

OBJECTIVE: To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. DESIGN: A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. STUDY SAMPLE: A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. RESULTS: In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. CONCLUSIONS: Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Affordable headphones for accessible screening audiometry: An evaluation of the Sennheiser HD202 II supra-aural headphone.

OBJECTIVE: Evaluation of the Sennheiser HD 202 II supra-aural headphones as an alternative headphone to enable more affordable hearing screening. DESIGN: Study 1 measured the equivalent threshold sound pressure levels (ETSPL) of the Sennheiser HD 202 II. Study 2 evaluated the attenuation of the headphones. Study 3 determined headphone characteristics by analyzing the total harmonic distortion (THD), frequency response and force of the headband. STUDY SAMPLE: Twenty-five participants were included in study 1 and 15 in study 2 with ages ranging between 18 and 25. No participants were involved in study 3. RESULTS: The Sennheiser HD 202 II ETSPLs (250-16000 Hz) showed no significant effects on ETSPL for ear laterality, gender or age. Attenuation was not significantly different (p > 0.01) to TDH 39 except at 8000 Hz (p < 0.01). Maximum permissible ambient noise levels (MPANL) were specified accordingly. The force of the headband was 3.1N. THD measurements showed that between 500 and 8000 Hz intensities of 90 dB HL and higher can be reached without THD >3%. CONCLUSION: Sennheiser HD 202 II supra-aural headphones can be used as an affordable headphone for screening audiometry provided reported MPANLs, maximum intensities and ETSPL values are employed.

Stimulus and transducer effects on threshold.

OBJECTIVE: This study examined differences in thresholds obtained under Sennheiser HDA200 circumaural earphones using pure tone, equivalent rectangular noise bands, and 1/3 octave noise bands relative to thresholds obtained using Telephonics TDH-39P supra-aural earphones. DESIGN: Thresholds were obtained via each transducer and stimulus condition six times within a 10-day period. STUDY SAMPLE: Forty-nine adults were selected from a prior study to represent low, moderate, and high threshold reliability. RESULTS: The results suggested that (1) only small adjustments were needed to reach equivalent TDH-39P thresholds, (2) pure-tone thresholds obtained with HDA200 circumaural earphones had reliability equal to or better than those obtained using TDH-39P earphones, (3) the reliability of noise-band thresholds improved with broader stimulus bandwidth and was either equal to or better than pure-tone thresholds, and (4) frequency-specificity declined with stimulus bandwidths greater than one equivalent rectangular band, which could complicate early detection of hearing changes that occur within a narrow frequency range. CONCLUSIONS: These data suggest that circumaural earphones such as the HDA200 headphones provide better reliability for audiometric testing as compared to the TDH-39P earphones. These data support the use of noise bands, preferably ERB noises, as stimuli for audiometric monitoring.

Ambient noise impact on accuracy of automated hearing assessment.

OBJECTIVE: The aim of this study was to determine the effect of ambient noise on the accuracy of thresholds obtained using the KUDUwave portable clinical audiometer as compared to those obtained using a GSI-61 clinical audiometer in a sound booth. DESIGN: Pure-tone air conduction thresholds were obtained in three conditions: (1) with a clinical audiometer in a quiet sound booth, (2) with the KUDUwave in a quiet sound booth, and (3) with the KUDUwave with 40 dBA of background noise. STUDY SAMPLE: A total of 31 individuals ranging in age from 15 to 80 years participated in the study, 21 with normal hearing and ten with hearing loss. RESULTS: Eighty-nine percent of thresholds obtained with the KUDUwave in quiet, and 92% of thresholds obtained with the KUDUwave in background noise were within 5 dB of those obtained with the clinical audiometer. Accuracy was poorer at 250 Hz and 8000 Hz. CONCLUSION: Ambient noise typical of that found in a non-sound-treated room, did not affect the accuracy of air conduction hearing thresholds obtained with the KUDUwave. The KUDUwave may be a viable method of testing when a clinical audiometer and sound booth are not available.

A user-operated audiometry method based on the maximum likelihood principle and the two-alternative forced-choice paradigm.

OBJECTIVE: To create a user-operated pure-tone audiometry method based on the method of maximum likelihood (MML) and the two-alternative forced-choice (2AFC) paradigm with high test-retest reliability without the need of an external operator and with minimal influence of subjects' fluctuating response criteria. User-operated audiometry was developed as an alternative to traditional audiometry for research purposes among musicians. DESIGN: Test-retest reliability of the user-operated audiometry system was evaluated and the user-operated audiometry system was compared with traditional audiometry. STUDY SAMPLE: Test-retest reliability of user-operated 2AFC audiometry was tested with 38 naïve listeners. User-operated 2AFC audiometry was compared to traditional audiometry in 41 subjects. RESULTS: The repeatability of user-operated 2AFC audiometry was comparable to traditional audiometry with standard deviation of differences from 3.9 dB to 5.2 dB in the frequency range of 250-8000 Hz. User-operated 2AFC audiometry gave thresholds 1-2 dB lower at most frequencies compared to traditional audiometry. CONCLUSIONS: User-operated 2AFC audiometry does not require specific operating skills and the repeatability is acceptable and similar to traditional audiometry. User operated 2AFC audiometry is a reliable alternative to traditional audiometry.

Earphones in extended high-frequency audiometry and ISO 389-5.

OBJECTIVE: To determine common reference equivalent threshold sound pressure levels (RETSPL) for the earphones used in the extended high-frequency (EHF) range, as different earphones are commercially available, but there are not RETSPLs for each model. DESIGN: Hearing threshold sound pressure levels were measured up to 20 kHz for the Sennheiser HDA 200 audiometric earphone, and were compared to the ISO 389-5 (2006) norm and other investigations using that earphone and different ones. STUDY SAMPLE: A total of 223 otologically-normal subjects (aged 5-25 years old) participated in the hearing determination. RESULTS: The results are in good agreement with previous studies of hearing thresholds using the same and other earphones. CONCLUSIONS: The results of the present investigation are relevant for the international standard for the calibration of audiometric equipment in the 8 to 16 kHz frequency range, ISO 389-5. The data may be used for a future update of the RETSPL for circumaural and insert audiometric earphones.

Smartphone hearing screening with integrated quality control and data management.

OBJECTIVE: To determine if a smartphone application could be used as a calibrated screening audiometer with real-time noise monitoring for school screening using automated test sequences. DESIGN: The investigation comprised three studies. Study 1 evaluated calibration accuracy across four Samsung S5301 smartphones (Android v4.0.4) using commercial Sennheiser HD202 headphones. Study 2 involved referencing smartphone microphone sensitivity to narrowband noise intensity as measured in octave bands by a sound-level meter between 30 and 75 dB SPL (5 dB increments). Study 3 compared screening outcomes of smartphone based and conventional hearing screening. STUDY SAMPLE: Study 2: 15 normal-hearing subjects (age range, 18-22 years; all female). Study 3: 162 children (324 ears) aged 5 to 7 years. RESULTS: Smartphone calibration at 20, 30, and 40 dB was within 1 dB of recommended reference equivalent thresholds levels. Microphone calibration for noise monitoring had maximum variability across phones of 0.9, 0.6, and 2.9 dB at 1, 2, and 4 kHz, respectively, from reference intensities (30 to 75 dB SPL). Screening outcomes demonstrated no significant difference between smartphone and conventional audiometry with an overall referral rate of 4.3% and 3.7%, respectively. CONCLUSIONS: The newly developed smartphone application can be accurately calibrated for audiometry with valid real-time noise monitoring, and clinical results are comparable to conventional screening.

Short-term variability of pure-tone thresholds obtained with TDH-39P earphones.

OBJECTIVE: To estimate the short-term variability and correlates of variability in pure-tone thresholds obtained using audiometric equipment designed for occupational use, and to examine the justification for excluding 8 kHz as a mandatory threshold in occupational hearing conservation programs. METHOD: Pure-tone thresholds and other hearing-related tests (e.g. noise dosimetry, otoscopy, middle-ear assessment) were conducted with a group of 527 adults between 20 and 69 years of age. Five measurement visits were completed by participants within 14 days. RESULTS: The 50% critical difference boundaries were - 5 and 0 dB at 4 kHz and below and - 5 and 5 dB at 6 and 8 kHz. The likelihood of spurious notches due to test-retest variability was substantially lower than the likelihood of failing to detect a notched configuration when present. Correlates of variability included stimulus frequency, baseline threshold, acoustic reflectance of the ear, average noise exposure during the previous eight hours, age, and the tester's level of education in audiology. CONCLUSION: The short-term variability in 8-kHz pure-tone thresholds obtained with the TDH-39P earphone was slightly greater than at other frequencies, but this difference was not large enough to justify the disadvantages stemming from the inability to detect a 6-kHz notch.

Amplitude variation in calibrated audiometer systems in clinical simulations.

Manual pure tone audiometry is considered to be the gold standard for the assessment of hearing thresholds and has been in consistent use for a long period of time. An increased legislative requirement to monitor and screen workers, and an increasing amount of legislation relating to hearing loss is putting greater reliance on this as a tool. There are a number of questions regarding the degree of accuracy of pure tone audiometry when undertaken in field conditions, particularly relating to the difference in conditions between laboratory calibration and clinical or industrial screening use. This study analyzed the output sound pressure level of four different commercial audiometers, all using TDH39 headphones and each of which had recently undergone calibration at an appropriate laboratory. Levels were measured using a Bruël and Kjaer Head and Torso simulator, which accurately replicates the size and shape of a human head, including the ears. A clinical environment was simulated by a trained audiometrist replacing the headphones for each test. Tests were undertaken at three presentation levels, and at the frequencies of 250 Hz, 500 Hz, 1 kHz, 2 kHz, 4 kHz and 6 kHz. The results showed a high level of test-retest variability, both between different audiometers and within the same audiometer. Maximum variation of sound pressure level at the ear for the same tone presentation was 21 decibels, with a particularly high level of variation at 6 kHz for all meters. An audiometer with attenuating cups exhibited significantly higher variation than ones using supral-aural headphones. Overall the variation exhibited suggests that there is a higher degree of potential error with screening pure tone audiometry than is commonly assumed and that results particularly at the 6 kHz frequency need to be assessed carefully alongside other methods such as speech audiometry.

Description of a new low-cost and open-source audiometer and its validation with normal-hearing listeners: The Aupiometer.

Hearing loss is a major public health problem. In 2050, it could affect 2.5 billion people. It has therefore become necessary to prevent and diagnose them as early and as widely as possible. However, the costs of clinical equipment dedicated to the functional exploration of hearing remain high and hamper their distribution, while the technologies used are relatively basic. For example, the gold-standard pure-tone audiometry (PTA) essentially consists of emitting pure sounds. In addition, clinical audiometers are generally limited to PTA or few audiological tests, while hearing loss induce multiple functional deficits. Here, we present the Aupiometer, a low-cost audiometer implemented on a modular open-source system based on Raspberry Pi, and which integrates the entire technical framework necessary to carry out audiological measurements. Several hearing tests are already implemented (e.g. PTA, speech audiometry, questionnaires), while the clinical validity of the Aupiometer was verified on a panel of participants (N = 16) for an automated test of standard and extended high-frequency PTA, from 0.125 to 16 kHz, in comparison with a clinical audiometer. For this comparison between the two devices and over this wide frequency range, the difference is evaluated as less than ±10 dB for a 90% confidence interval, of the same order of magnitude as on test-retest differences on a single device. The interest of this device also extends to academic research as it should encourage the prototyping of innovative hearing tests by the community, in order to better understand the diversity of hearing problems in the population.