At first glance, this title may seem like a redundant statement, but, in reality, these are vastly different concepts and the sooner we address them the better. Let us first remind ourselves of what a soundbooth is actually for.
There is little consensus among standards for sound booths globally, there are also many countries where standards don't exist and where they do, they can differ from state to state and may never actually be enforced at all. With that said, there is one overarching concept that I am sure we can all agree on.
“Any test environment, whether screening or diagnostic, should be quiet enough to ensure that ambient noise levels do not interfere with the patient's ability to hear the tones being presented“
Audiometry without a booth.
Testing without a sound booth is not as rare as some might think. In fact, when it comes to “portable audiometers” the fact that most audiometers still need a sound booth or at least a test environment so quiet that a soundbooth would not be necessary is never really discussed.
Just because you can move an audiometer does not make it portable in the sense that its use still requires a soundbooth which, in my books, is about as portable as your fridge. Sure, you could move it, but, ice boxes and cooler bags exist so that you never arrive at a picnic with your fridge strapped on your back.
That being said, of course it is possible to test without a soundbooth. But, whether you should or not, will depend on whether the test space is quiet enough.
So how can you tell if your environment is quiet enough?
The easiest way to do this is to purchase a sound level meter. This will measure the ambient noise in the space and if this is in line with MPANL then you should be able to test.
But this has its own problems, not dissimilar to the problem with room certifications.
Obtaining a reading that shows the room is quiet enough is simple enough, but, not actually very helpful. Unless the space surrounding that room is under control and remains at that way, which is highly unlikely, testing without a soundbooth is simply not a reliable option for quality audiometry.
The soundbooth provides much needed attenuation which is an imperative when it comes to audiometry. The keyword here is ATTENUATION.
Boothless audiometry removes the need for a soundbooth but does not remove the key element of attenuation. Instead, boothless audiometry only alters the method of attenuation. This means that you are able to test outside a soundbooth but still retain the ability to attenuate sounds at the same level as a standard booth would.
Much like the problems faced with room certification, sound booths, quiet spaces and our own innate inability to subjectively monitor ambient noise correctly, we still need to account for intermittent sound that may penetrate and interfere with the test tones presented.
This not only needs to be accurate and objective but also needs to happen in real-time.
The main reason anyone would be interested in boothless audiometry is for the benefits it provides in portability that traditional equipment lacks.
While there are many “portable” audiometers on the market, one cannot ignore the fact that these audiometers do not perform any role in providing sound attenuation. In almost every case, these “portable” devices would still require a soundbooth or, at least, a controlled test environment that is so quiet a soundbooth would not be necessary. This almost completely negates the proposed benefit of portability.
Another misconception is that in order to achieve the portability that boothless audiometry offers one would need to compromise by losing some of the features available in traditional audiometer/booth combinations. .
This is no longer true.
The KUDUwave offers an all-in-one, fully featured, portable solution that offers truly boothless audiometry. It attenuates to the same level as a standard soundbooth and includes active noise monitoring which protects from ambient noise peaks in real-time. The KUDUwave can either automatically retest the affected frequency or report on affected frequencies for retesting.
In terms of features, the KUDUwave offers AC, BC, High-frequencies, speech testing, tele-audiology, automatic and manual testing, calibration verification, cloud storage, assistive interpretation tools, patient management, and very soon, built-in tympanometry too.
This makes the KUDUwave the first of its kind and only audiological device that offers unflinching quality and uncompromised boothless portability.
Practices can now rely on a single device for all their testing needs. The future is truly here.