Developing an Evidence-Based Military Auditory Fitness-for-Duty Standard Based on the 80-Word Modified Rhyme Test

Objectives: One important function of military audiology is to conduct evaluations of service members (SMs) with hearing loss to ensure they are fit for deployment in dangerous operational environments. The objective of this study was to establish evidence-based auditory fitness-for-duty criteria based on speech-in-noise performance on the 80- and 160-word clinical versions of the Modified Rhyme Test (MRT₈₀and MRT₁₆₀). Design: Approximately 2400 SMs with various levels of hearing loss were recruited to complete the MRT₈₀in conjunction with their annual hearing conservation evaluations. These SMs were also asked to perform one or more operationally-relevant listening tasks based on audio recordings made in highly realistic military training environments. The scores on these tests were compared to determine how well a proposed cutoff criterion for the MRT₈₀was able to identify individuals who are hard of hearing with an exceptionally high risk of abnormally poor performance on operationally-relevant hearing tasks. Results: The results show that a cutoff criterion that combines the percent correct score on two lists of the MRT₈₀(i.e. MRT₁₆₀) with information about the better-ear threshold at 2 kHz is generally able to separate listeners with hearing loss into those who are likely to perform relatively well on operational listening tests and those who are likely to perform poorly on these tasks. This is consistent with current military acquisition standards, which identify the MRT as the preferred test for evaluating speech intelligibility for radios, headsets, and other communication equipment. It is also consistent with prior studies conducted in high-fidelity military simulations which have shown a significant correlation between MRT performance and operational outcomes. Conclusions: The proposed selection criteria, along with the new hearing profile standards that were recently adopted by the US Army, appear to provide an effective evidence-based methodology for identifying those SMs with hearing loss who are most at risk for poor performance on hearing-critical military tasks.