Test prep activities II - Biological verification – SHOEBOX Support Center

Biological verification is a confirmation step in which the test examiner uses their own hearing levels to ensure there has been no damage to the audiometer hardware components that could impact the sound output. The intent of this verification is not to evaluate the test examiner's hearing. Present day results are compared to the baseline test on file to confirm that there have been no significant changes. This system check works best when the examiner has stable hearing.

Note: Individuals with hearing loss still qualify to perform this verification, as long as their hearing is stable.

OSHA states: “1910.95(h)(5)(i) The functional operation of the audiometer shall be checked before each day's use by testing a person with known, stable hearing thresholds, and by listening to the audiometer's output to make sure that the output is free from distorted or unwanted sounds. Deviations of 10 decibels or greater require an acoustic calibration.”

If you will be testing offline, ensure the examiner that will be performing the biological verification is logged into the app before going offline. If the examiner is in a situation where they need to perform a biological verification offline, but the app is logged in under another examiner's profile, one solution is to create a hotspot using a mobile device with data access and connecting through that in order to switch accounts. For more information on how to do this, check out this quick, simple guide from cnet.com on how to tether using a personal hotspot on an iPhone or Android.
If the test examiner whose baseline is set on the app is unavailable to perform the daily biological verification (sick, took the day off, etc.) another test examiner may log in to the PureTest app and perform their own biological verification instead. Baselines for each examiner are recorded and used separately.

Warning: Admin users can block testing with expired headphones across the entire organization. This is done to maintain regulatory compliance and prevent the misdiagnosis of test subjects. If your organization is blocked from using expired headphones, you will not be able to perform the biological verification. Install new headphones to complete the verification. Contact the admin user if you do not have the new headphones.

A screenshot of the warning that is displayed during a biological verification when the user's headphones calibration has expired.

Performing your first biological verification and setting a baseline

Tap on the Biological Verification button to begin your biological verification.
You will first be asked to confirm whether you are logged in under the correct account to prevent erroneous results. Tap Yes, Continue if your name appears onscreen.
You will then be prompted to allow PureTest to store your baseline in the secure SHOEBOX cloud. This is done so that you can perform rapid tests for your future biological verifications. Tap Allow to proceed while allowing PureTest to save your baseline to the secure SHOEBOX portal.
- Note: If you select Don't Allow, you will need to set your baseline every time you perform the test, and will not be able to use rapid testing.
You will then be asked to verify if the correct headphones are plugged in. Compare the serial number displayed on screen to the serial number on your headphones. If they match, tap Start Check to proceed. If they are different, tap My Serial is Different to troubleshoot the issue.
The app will then prompt you to put on the headphones and to place the iPad in the provided iPad stand. Once that's done, tap Start the Test! to begin
The test screen will then appear and you will be prompted to complete it. This is done to ensure that all tones are presenting correctly at all frequencies.
- Note: Biological verification uses Assisted Mode instead of Classic Mode as the test theme. A test examiner performing biological verification is confirming whether or not they can hear a sound, and viewing the presentation level on screen will not impact the usefulness of the exercise.
  
  Using Assisted Mode is similar to how audiologists perform biological verification in a clinical setting and is not cheating the test. They are not blinded to the test and are also able to see the presentation level when testing their own hearing.

To perform your first biological verification

See the video below for a visual guide on how to complete your first biological verification in PureTest using assisted mode.

Biological verification is one of the 3 Test Prep activities in the PureTest app, it should take approximately 10-15 minutes for all three activities in total.
The test is done in Assisted Mode, which is the most efficient method.
Biological verification is required by OSHA and should be performed on any testing day. A pass is needed to proceed with testing for the day.
- The test includes the following frequencies: 500 Hz, 1000 Hz, 2000 Hz, 3000 Hz, 4000 Hz, 6000 Hz. The frequencies are presented from lowest to highest, except if 1000 Hz is present, in which case 1000 Hz is presented first, then the remaining frequencies are presented from lowest to highest.
Potential reasons the test may fail:
- You are logged in under someone else’s username.
- Someone else has run a test under your username.
- A baseline reset may be required if your temporary hearing has changed due to noise exposure, congestion, wax, etc.
If the software detects a significant change at any frequency, causing the test to fail, please contact our Customer Support Team for next steps. In rare instances a full acoustic calibration may be required.

Upon completion, you will be prompted to remove the headphones and will be shown the results from your biological verification. These results will serve as your baseline, and future biological verification results will be compared against this baseline. Until you set your first baseline, you will be blocked from testing patients if biological verification is required.

Tap on Set Baseline to proceed, then tap on Done to finish your first biological verification. You will then be able to proceed with your testing workflows for the day.

A screenshot of the prompt to set a user's first biological verification as their baseline. A screenshot of a successful biological verification after it is set as the user's baseline.

Note: Biological verification results are displayed in tabular format only. Biological verification results are saved in the app's cache storage until synced with the web portal, and are currently not viewable in the portal. The baseline value is tied to your account and stored as a part of your account data, unless it is reset by an admin user.

Important: Contact an admin user if you have had a change in hearing and cannot complete future biological verification checks. An admin user can reset your baseline in the portal, which will force you to set a new baseline in the app the next time you perform a biological verification.

Performing regular biological verifications using the rapid test feature

After setting a baseline, your future biological verifications are completed using a rapid test for efficiency.

Tap the Biological Verification button to begin.
You will be asked that you are logged in under your account, and you will also be asked to confirm when your baseline was set. If the information on screen is accurate, tap Yes, continue.
Your baseline will be displayed on screen. Tap Start Check if it looks correct.
You will then be asked to verify if the correct headphones are plugged in. Compare the serial number displayed on screen to the serial number on your headphones. If they match, tap Start Check to proceed. If they are different, tap My Serial is Different to troubleshoot the issue.
Instructions for the rapid test will be displayed on screen. Tap Next and Done once you have read and understood the instructions.

A screenshot of the rapid test's instructions.

The app will then prompt you to put on the headphones, and to place the iPad in the provided iPad stand. Once that's done, tap Start the Test! to begin.
The rapid test will begin, starting with the right ear. Follow the onscreen instructions to complete the test.

Note: If you respond with No to any frequency, you will be given a warning message, and an option to retry the frequency or end the test. If you end the test, you will need to start from the beginning. If you retry the frequency, and you answer No again, the biological verification will fail and you will be given some troubleshooting tips. You will always have the option to recheck.
Once you have passed every frequency, you will be taken to the results screen. Tap Done to complete the biological verification. You will then be able to proceed with your testing workflows for the day.