Objectives: Diagnostic
criteria for noise-induced hearing loss include the audiometric
notch, yet no standardized definition exists. This study tested
whether objective notch metrics could match the clinical judgments
of an expert panel.
Design: A panel of
occupational physicians, otolaryngologists, and audiologists
reviewed audiograms of noise-exposed workers. In a two-sample
process, the panel judged whether a notch was present and whether
hearing loss had progressed in a notch pattern. Quantitative notch
metrics were compared against expert decisions.
Results: At least five
of six experts agreed about notch identification in 71 and 72% of
the cases in the two samples, and agreement about notch progression
was 61 and 67%. Notch depth and professional specialty appeared to
affect notch judgments. Despite this variability, a notch metric
showed excellent agreement with expert notch consensus in each
sample (94.7 and 96.6%; kappa = 0.88 and 0.92).
Conclusions: Audiogram
notch metrics can agree with expert clinical consensus and assist
in the surveillance of noise-exposed workers.