# Arabic Digits-in-Noise Tests: Relations to Hearing Loss and Comparison of Diotic and Antiphasic Versions

## TL;DR

This study validates an Arabic version of a hearing test using browser-based software and finds that a specific test format better predicts hearing loss.

## Contribution

The study introduces antiphasic DIN testing as a more effective method for predicting hearing loss in Arabic speakers.

## Key findings

- Antiphasic DIN thresholds correlate more strongly with poorer-ear hearing loss than diotic thresholds.
- Antiphasic testing is a better binary classifier for hearing loss.
- Browser-based Arabic DIN tests may be effective for remote hearing screening.

## Abstract

The study set out to acquire validation data for Arabic versions of the Digits-in-Noise (DIN) test, measured using browser-based software suitable for home hearing screening. DIN and pure-tone audiometric (PTA) thresholds were obtained from a sample of 155 Arabic-speaking participants, varying widely in age and in degree and type of hearing loss. DIN thresholds were measured using both diotic and antiphasic stimuli, with the goal of determining whether antiphasic testing provides superior prediction of poorer-ear hearing loss. A comprehensive study protocol was publicly pre-registered via the Open Science Framework. Both types of DIN threshold correlate with poorer-ear PTA thresholds after controlling for age, but the correlation is significantly stronger for antiphasic than diotic stimuli. Antiphasic DIN thresholds increase more steeply than diotic DIN thresholds as poorer-ear PTA thresholds increase, and are superior binary classifiers of hearing loss. Combined with previous results based on DIN data measured in participants’ homes, the present findings suggest that the browser-based Arabic DIN test may be effective in remote hearing screening, when combined with antiphasic digit presentation.