{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:25:59Z","timestamp":1789140359188,"version":"build-2803163510"},"reference-count":39,"publisher":"Acoustical Society of America (ASA)","issue":"5","content-domain":{"domain":["pubs.aip.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:p>Air-conduction (AC) and bone-conduction (BC) thresholds were measured to evaluate standard reference thresholds and recommend revisions to audiometer standards. AC and BC thresholds were measured from listeners with normal hearing (NH) and sensorineural hearing loss (SNHL) at three sites. NH participants (n\u2009=\u200953) were selected based on age (18\u201325\u2009years old), normal AC thresholds, tympanometry, otoscopy, and absence of otologic disease. SNHL participants (n\u2009=\u200949) were selected based on AC thresholds, tympanometry, otoscopy, and absence of otologic disease. AC thresholds obtained from NH listeners averaged 3.7\u2009dB hearing level (HL). Air-bone gaps (ABGs) occurred in NH and SNHL listeners above 2000\u2009Hz and in SNHL listeners at 250\u2009Hz. Corrections to standard reference equivalent threshold sound pressure levels are recommended. ABGs in listeners without conductive pathology result from incorrect reference threshold levels for frequencies above 2000\u2009Hz. False ABGs increase with hearing-loss magnitude, probably the result of the effects of ambient and internal noise for low-level BC stimuli. False ABGs place patients at risk for unnecessary medical and surgical intervention. Reference threshold levels should achieve two objectives: (1) AC thresholds from young NH listeners should average 0\u2009dB HL; and (2) ABGs from listeners with normal middle-ear function should average 0\u2009dB.<\/jats:p>","DOI":"10.1121\/10.0034456","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T08:00:39Z","timestamp":1732262439000},"page":"3545-3553","update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["Air-conduction and bone-conduction reference threshold levels\u2014A multicenter study"],"prefix":"10.1121","volume":"156","author":[{"given":"Robert H.","family":"Margolis","sequence":"first","affiliation":[{"name":"Arizona State University College of Health Solutions 1 , Tempe, Arizona 85004,","place":["USA"]},{"name":"Audiology Incorporated 2 , Arden Hills, Minnesota 55112,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-6643","authenticated-orcid":false,"given":"Victoria","family":"Sanchez","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine 3 , Tampa, Florida 33612,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa L.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Cincinnati Childrens Hospital Medical Center 4 , Cincinnati, Ohio 45229,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Rao","sequence":"additional","affiliation":[{"name":"Arizona State University College of Health Solutions 1 , Tempe, Arizona 85004,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzannah","family":"Boyle","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine 3 , Tampa, Florida 33612,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina Motlagh","family":"Zadeh","sequence":"additional","affiliation":[{"name":"Cincinnati Childrens Hospital Medical Center 4 , Cincinnati, Ohio 45229,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia N.","family":"Wong","sequence":"additional","affiliation":[{"name":"Arizona State University College of Health Solutions 1 , Tempe, Arizona 85004,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"231","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"2024112213002574700_c1","volume-title":"Methods for Manual Pure-Tone Threshold Audiometry (R2019)","author":"ANSI","year":"2004"},{"key":"2024112213002574700_c2","volume-title":"Specification for Audiometers","author":"ANSI","year":"2018"},{"key":"2024112213002574700_c3","doi-asserted-by":"publisher","first-page":"381","DOI":"10.3109\/00016487009123382","article-title":"Vibrotactile thresholds in pure tone audiometry","volume":"69","year":"1970","journal-title":"Acta Otolaryngol."},{"key":"2024112213002574700_c4","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1001\/archotol.1950.00700020824003","article-title":"Clinical application of bone conduction audiometry","volume":"51","year":"1950","journal-title":"Arch. Otolaryngol."},{"key":"2024112213002574700_c5","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1097\/AUD.0000000000001216","article-title":"Both-ear method for the analysis of audiometric data","volume":"43","year":"2022","journal-title":"Ear Hear."},{"key":"2024112213002574700_c6","first-page":"53","article-title":"Hearing by bone conduction","volume-title":"Proceedings of the Third International Congress on Acoustics","year":"1961"},{"key":"2024112213002574700_c7","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1044\/jshr.1802.242","article-title":"Bone-vibrator measurements: Physical characteristics and behavioral thresholds","volume":"18","year":"1975","journal-title":"J. Speech Hear. Res."},{"key":"2024112213002574700_c8","doi-asserted-by":"publisher","first-page":"EL96","DOI":"10.1121\/1.4885771","article-title":"Effect of bone-conduction harmonic distortions on hearing thresholds","volume":"136","year":"2014","journal-title":"J. Acoust. Soc. Am."},{"key":"2024112213002574700_c9","doi-asserted-by":"publisher","first-page":"342","DOI":"10.3109\/14992027.2013.769065","article-title":"Clinical validation of the AMTAS automated audiometer","volume":"52","year":"2013","journal-title":"Int. J. Audiol."},{"key":"2024112213002574700_c10","first-page":"1","article-title":"Survey of the current status of audiometric practices in the United States","year":"2012"},{"key":"2024112213002574700_c11","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1097\/AUD.0000000000000456","article-title":"Vibrotactile thresholds on the mastoid and forehead position of deaf patients using Radioear B71 and B81","volume":"38","year":"2017","journal-title":"Ear Hear."},{"key":"2024112213002574700_c12","doi-asserted-by":"publisher","first-page":"e0195233","DOI":"10.1371\/journal.pone.0195233","article-title":"Influence of transducer types on bone conduction hearing thresholds","volume":"13","year":"2018","journal-title":"PLoS One"},{"key":"2024112213002574700_c13","doi-asserted-by":"publisher","first-page":"EL33","DOI":"10.1121\/1.4804944","article-title":"Acoustic method for calibration of audiometric bone vibrators. II. Harmonic distortion","volume":"134","year":"2013","journal-title":"J. Acoust. Soc. Am."},{"key":"2024112213002574700_c14","article-title":"Electroacoustics\u2014Simulators of human head and Ear\u2014Part 1: Ear simulator for the measurement of supra-aural and circumaural earphones","author":"IEC","year":"2009"},{"key":"2024112213002574700_c15","article-title":"Acoustics\u2014Reference zero for the calibration of audiometry equipment\u2014Part 8: Reference equivalent threshold force levels for pure tones and circumaural earphones","author":"ISO","year":"2004"},{"key":"2024112213002574700_c16","article-title":"Reference zero for the calibration of audiometric equipment\u2014Part 9: Preferred test conditions\/or the determination of reference hearing threshold levels","author":"ISO","year":"2009"},{"key":"2024112213002574700_c17","article-title":"Acoustics\u2014Reference zero for the calibration of audiometry equipment\u2014Part 3: Reference equivalent threshold force levels for pure tones and bone vibrators","author":"ISO","year":"2016"},{"key":"2024112213002574700_c18","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1097\/01.aud.0000436255.53747.a4","article-title":"Validity of automated threshold audiometry: A systematic review and meta-analysis","volume":"34","year":"2013","journal-title":"Ear Hear."},{"key":"2024112213002574700_c19","doi-asserted-by":"publisher","first-page":"526","DOI":"10.3109\/14992027.2013.792437","article-title":"False air-bone gaps at 4 kHz in listeners with normal hearing and sensorineural hearing loss","volume":"52","year":"2013","journal-title":"Int. J. Audiol."},{"key":"2024112213002574700_c20","first-page":"14","article-title":"False 4-kHz air-bone gaps\u2014A failure of standards","volume":"31","year":"2019","journal-title":"Audiol. Today"},{"key":"2024112213002574700_c21","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3109\/14992020903092608","article-title":"AMTAS\u00ae\u2014Automated method for testing auditory sensitivity: Validation studies","volume":"49","year":"2010","journal-title":"Int. J. Audiol."},{"key":"2024112213002574700_c22","doi-asserted-by":"publisher","first-page":"416","DOI":"10.3766\/jaaa.15102","article-title":"Validation of the home hearing test","volume":"27","year":"2016","journal-title":"J. Am. Acad. Audiol."},{"key":"2024112213002574700_c23","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1055\/a-1743-5514","article-title":"AMBAND bone conduction headband","volume":"33","year":"2022","journal-title":"J. Am. Acad. Audiol."},{"key":"2024112213002574700_c24","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3109\/14992027.2011.575085","article-title":"Automated method for testing auditory sensitivity: III. Sensorineural hearing loss and air-bone gaps","volume":"50","year":"2011","journal-title":"Int. J. Audiol."},{"key":"2024112213002574700_c25","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1055\/s-0041-1735803","article-title":"Ambient noise monitoring during pure-tone audiometry","volume":"33","year":"2022","journal-title":"J. Am. Acad. Audiol."},{"key":"2024112213002574700_c26","article-title":"Air-conduction and bone-conduction reference threshold levels\u2014A multicenter study","year":"2024"},{"key":"2024112213002574700_c27","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1097\/AUD.0000000000000246","article-title":"Distribution characteristics of air-bone  gaps: Evidence of bias in pure-tone audiometry","volume":"37","year":"2016","journal-title":"Ear Hear."},{"key":"2024112213002574700_c28","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1044\/1059-0889.0302.20","article-title":"A survey of audiological practices in the United States","volume":"3","year":"1994","journal-title":"Am. J. Audiol."},{"key":"2024112213002574700_c29","doi-asserted-by":"publisher","first-page":"45","DOI":"10.3109\/01050399609047555","article-title":"Preferred test conditions for determining hearing thresholds for standardization","volume":"25","year":"1996","journal-title":"Scand. Audiol."},{"key":"2024112213002574700_c30","unstructured":"Radioear (2023a). \u201c\nB71 Technical Specifications,\u201d available at http:\/\/www.radioear.us\/products\/bone-transducers (Last viewed November 13, 2024)."},{"key":"2024112213002574700_c31","unstructured":"Radioear (2023b). \u201c\nB81 Technical Specifications,\u201d available at http:\/\/www.radioear.us\/products\/bone-transducers (Last viewed November 13, 2024)."},{"key":"2024112213002574700_c32","doi-asserted-by":"publisher","first-page":"1775","DOI":"10.1097\/AUD.0000000000000873","article-title":"Comparison of thresholds obtained with the Radioear B-71 and B-81 bone-conduction transducers","volume":"41","year":"2020","journal-title":"Ear Hear."},{"key":"2024112213002574700_c33","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1001\/archotol.1956.03830090042009","article-title":"A clinical method for calibrating the bone conduction audiometer","volume":"63","year":"1956","journal-title":"Arch. Otolaryngol."},{"key":"2024112213002574700_c34","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1097\/AUD.0000000000000585","article-title":"Evaluation of two circumaural earphones for audiometry","volume":"40","year":"2018","journal-title":"Ear Hear."},{"key":"2024112213002574700_c35","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1288\/00005537-196705000-00010","article-title":"The standardization of bone-conduction thresholds","volume":"77","year":"1967","journal-title":"Laryngoscope"},{"key":"2024112213002574700_c36","doi-asserted-by":"publisher","first-page":"1962","DOI":"10.1121\/1.1918868","article-title":"Effect of contact area on the vibrotactile threshold","volume":"35","year":"1963","journal-title":"J. Acoust. Soc. Am."},{"key":"2024112213002574700_c37","doi-asserted-by":"publisher","first-page":"57","DOI":"10.4103\/indianjotol.indianjotol_14_23","article-title":"Pseudo air-bone gap in sensorineural hearing loss: Effect of signal frequency and degree of hearing loss\u2014Implications for clinical diagnosis","volume":"29","year":"2023","journal-title":"Indian J. Otol."},{"key":"2024112213002574700_c38","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/0022-460X(65)90110-0","article-title":"A determination of the normal threshold of hearing by bone conduction","volume":"2","year":"1965","journal-title":"J. Sound Vib."},{"key":"2024112213002574700_c39","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1044\/jshr.1003.405","article-title":"Real ear versus artificial mastoid methods of calibration of bone-conduction vibrators","volume":"10","year":"1967","journal-title":"J. Speech Hear. Res."}],"container-title":["The Journal of the Acoustical Society of America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pubs.aip.org\/asa\/jasa\/article-pdf\/156\/5\/3545\/20265053\/3545_1_10.0034456.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/pubs.aip.org\/asa\/jasa\/article-pdf\/156\/5\/3545\/20265053\/3545_1_10.0034456.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T08:00:43Z","timestamp":1732262443000},"score":1,"resource":{"primary":{"URL":"https:\/\/pubs.aip.org\/jasa\/article\/156\/5\/3545\/3321837\/Air-conduction-and-bone-conduction-reference"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":39,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,11,1]]}},"URL":"https:\/\/doi.org\/10.1121\/10.0034456","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.08.01.24311230","asserted-by":"object"}]},"ISSN":["0001-4966"],"issn-type":[{"value":"0001-4966","type":"print"}],"subject":[],"published-other":{"date-parts":[[2024,11]]},"published":{"date-parts":[[2024,11,1]]}}}