Validating and refining a psychoacoustic test to diagnose hyperacusis
Bibliographic record
Abstract
ABSTRACT Decreased sound tolerance refers to conditions like hyperacusis and misophonia, in which everyday sounds may provoke discomfort or distress. Hyperacusis is characterized by exaggerated loudness perception and aversive reactions to moderate to loud sounds, often leading to significant impairment. Despite its estimated prevalence of 10–15%, no objective clinical test exists. Current assessment relies on interviews, questionnaires, and loudness discomfort levels (LDLs), which lack reliability and ecological validity. Recent work has shown that pleasantness ratings of natural sounds can differentiate individuals with hyperacusis from controls. A subset of seven natural sounds, termed Core Discriminant Sounds (CDS hyper ), was identified post-hoc as particularly effective, yielding 81% sensitivity and 88% specificity in prior lab-based testing. A similar approach for misophonia identified ten distinct trigger sounds (CDS miso ). This study aimed to validate a tablet-based version of the CDS test to diagnose hyperacusis prospectively. Forty-nine participants (20 with hyperacusis, 29 controls) completed the test that presented randomly CDS hyper and CDS miso sounds at 60, 70, and 80 dBA. Participants rated each sound presentation on visual analog scales for pleasantness and loudness. Hyperacusis was defined by clinical complaints, Hyperacusis Questionnaire scores (≥22), and LDLs (≤77 dB HL). Results showed that individuals with hyperacusis rated CDS hyper sounds as significantly less pleasant (means score of 39 vs 25 for hyperacusis vs controls, p = .002, η² = .185) and louder (means score of 71 vs 63 for hyperacusis vs controls, p = .024, η² = .104) than controls. No group differences emerged for misophonia trigger sounds (CDS miso sounds). The sensitivity and specificity for the combined CDS hyper scores of pleasantness and loudness at detecting hyperacusis were 90% and 69%, respectively. These findings validate the tablet-based test as an efficient, ecologically valid tool for diagnosing hyperacusis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".