Evaluating Random Error in Clinician-Administered Surveys: Theoretical Considerations and Clinical Applications of Interobserver Reliability and Agreement

Purpose

The purpose of this study is to raise awareness of interobserver concordance and the differences between interobserver reliability and agreement when evaluating the responsiveness of a clinician-administered survey and, specifically, to demonstrate the clinical implications of data types (nominal/categorical, ordinal, interval, or ratio) and statistical index selection (for example, Cohen's kappa, Krippendorff's alpha, or interclass correlation).

Methods

In this prospective cohort study, 3 clinical audiologists, who were masked to each other's scores, administered the Practical Hearing Aid Skills Test–Revised to 18 adult owners of hearing aids. Interobserver concordance was examined using a range of reliability and agreement statistical indices.

Results

The importance of selecting statistical measures of concordance was demonstrated with a worked example, wherein the level of interobserver concordance achieved varied from “no agreement” to “almost perfect agreement” depending on data types and statistical index selected.

Conclusions

This study demonstrates that the methodology used to evaluate survey score concordance can influence the statistical results obtained and thus affect clinical interpretations.

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Evaluating Random Error in Clinician-Administered Surveys: Theoretical Considerations and Clinical Applications of Interobserver Reliability and Agreement

Purpose

The purpose of this study is to raise awareness of interobserver concordance and the differences between interobserver reliability and agreement when evaluating the responsiveness of a clinician-administered survey and, specifically, to demonstrate the clinical implications of data types (nominal/categorical, ordinal, interval, or ratio) and statistical index selection (for example, Cohen's kappa, Krippendorff's alpha, or interclass correlation).

Methods

In this prospective cohort study, 3 clinical audiologists, who were masked to each other's scores, administered the Practical Hearing Aid Skills Test–Revised to 18 adult owners of hearing aids. Interobserver concordance was examined using a range of reliability and agreement statistical indices.

Results

The importance of selecting statistical measures of concordance was demonstrated with a worked example, wherein the level of interobserver concordance achieved varied from “no agreement” to “almost perfect agreement” depending on data types and statistical index selected.

Conclusions

This study demonstrates that the methodology used to evaluate survey score concordance can influence the statistical results obtained and thus affect clinical interpretations.

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Evaluating Random Error in Clinician-Administered Surveys: Theoretical Considerations and Clinical Applications of Interobserver Reliability and Agreement

Purpose

The purpose of this study is to raise awareness of interobserver concordance and the differences between interobserver reliability and agreement when evaluating the responsiveness of a clinician-administered survey and, specifically, to demonstrate the clinical implications of data types (nominal/categorical, ordinal, interval, or ratio) and statistical index selection (for example, Cohen's kappa, Krippendorff's alpha, or interclass correlation).

Methods

In this prospective cohort study, 3 clinical audiologists, who were masked to each other's scores, administered the Practical Hearing Aid Skills Test–Revised to 18 adult owners of hearing aids. Interobserver concordance was examined using a range of reliability and agreement statistical indices.

Results

The importance of selecting statistical measures of concordance was demonstrated with a worked example, wherein the level of interobserver concordance achieved varied from “no agreement” to “almost perfect agreement” depending on data types and statistical index selected.

Conclusions

This study demonstrates that the methodology used to evaluate survey score concordance can influence the statistical results obtained and thus affect clinical interpretations.

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Stream segregation of concurrent speech and the verbal transformation effect: Influence of fundamental frequency and lateralization cues

Publication date: Available online 2 August 2017
Source:Hearing Research
Author(s): Marcin Stachurski, Robert J. Summers, Brian Roberts
Repeating a recorded word produces verbal transformations (VTs); perceptual regrouping of acoustic-phonetic segments may contribute to this effect. The influence of fundamental frequency (F0) and lateralization grouping cues was explored by presenting two concurrent sequences of the same word resynthesized on different F0s (100 and 178 Hz). In experiment 1, listeners monitored both sequences simultaneously, reporting for each any change in stimulus identity. Three lateralization conditions were used – diotic, ±680-μs interaural time difference, and dichotic. Results were similar for the first two conditions, but fewer forms and later initial transformations were reported in the dichotic condition. This suggests that large lateralization differences per se have little effect – rather, there are more possibilities for regrouping when each ear receives both sequences. In the dichotic condition, VTs reported for one sequence were also more independent of those reported for the other. Experiment 2 used diotic stimuli and explored the effect of the number of sequences presented and monitored. The most forms and earliest transformations were reported when two sequences were presented but only one was monitored, indicating that high task demands decreased reporting of VTs for concurrent sequences. Overall, these findings support the idea that perceptual regrouping contributes to the VT effect.



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Stream segregation of concurrent speech and the verbal transformation effect: Influence of fundamental frequency and lateralization cues

Publication date: Available online 2 August 2017
Source:Hearing Research
Author(s): Marcin Stachurski, Robert J. Summers, Brian Roberts
Repeating a recorded word produces verbal transformations (VTs); perceptual regrouping of acoustic-phonetic segments may contribute to this effect. The influence of fundamental frequency (F0) and lateralization grouping cues was explored by presenting two concurrent sequences of the same word resynthesized on different F0s (100 and 178 Hz). In experiment 1, listeners monitored both sequences simultaneously, reporting for each any change in stimulus identity. Three lateralization conditions were used – diotic, ±680-μs interaural time difference, and dichotic. Results were similar for the first two conditions, but fewer forms and later initial transformations were reported in the dichotic condition. This suggests that large lateralization differences per se have little effect – rather, there are more possibilities for regrouping when each ear receives both sequences. In the dichotic condition, VTs reported for one sequence were also more independent of those reported for the other. Experiment 2 used diotic stimuli and explored the effect of the number of sequences presented and monitored. The most forms and earliest transformations were reported when two sequences were presented but only one was monitored, indicating that high task demands decreased reporting of VTs for concurrent sequences. Overall, these findings support the idea that perceptual regrouping contributes to the VT effect.



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Stream segregation of concurrent speech and the verbal transformation effect: Influence of fundamental frequency and lateralization cues

Publication date: Available online 2 August 2017
Source:Hearing Research
Author(s): Marcin Stachurski, Robert J. Summers, Brian Roberts
Repeating a recorded word produces verbal transformations (VTs); perceptual regrouping of acoustic-phonetic segments may contribute to this effect. The influence of fundamental frequency (F0) and lateralization grouping cues was explored by presenting two concurrent sequences of the same word resynthesized on different F0s (100 and 178 Hz). In experiment 1, listeners monitored both sequences simultaneously, reporting for each any change in stimulus identity. Three lateralization conditions were used – diotic, ±680-μs interaural time difference, and dichotic. Results were similar for the first two conditions, but fewer forms and later initial transformations were reported in the dichotic condition. This suggests that large lateralization differences per se have little effect – rather, there are more possibilities for regrouping when each ear receives both sequences. In the dichotic condition, VTs reported for one sequence were also more independent of those reported for the other. Experiment 2 used diotic stimuli and explored the effect of the number of sequences presented and monitored. The most forms and earliest transformations were reported when two sequences were presented but only one was monitored, indicating that high task demands decreased reporting of VTs for concurrent sequences. Overall, these findings support the idea that perceptual regrouping contributes to the VT effect.



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Speech Understanding in Noise by Patients With Cochlear Implants Using a Monaural Adaptive Beamformer

Purpose

The aim of this experiment was to compare, for patients with cochlear implants (CIs), the improvement for speech understanding in noise provided by a monaural adaptive beamformer and for two interventions that produced bilateral input (i.e., bilateral CIs and hearing preservation [HP] surgery).

Method

Speech understanding scores for sentences were obtained for 10 listeners fit with a single CI. The listeners were tested with and without beamformer activated in a “cocktail party” environment with spatially separated target and maskers. Data for 10 listeners with bilateral CIs and 8 listeners with HP CIs were taken from Loiselle, Dorman, Yost, Cook, and Gifford (2016), who used the same test protocol.

Results

The use of the beamformer resulted in a 31 percentage point improvement in performance; in bilateral CIs, an 18 percentage point improvement; and in HP CIs, a 20 percentage point improvement.

Conclusion

A monaural adaptive beamformer can produce an improvement in speech understanding in a complex noise environment that is equal to, or greater than, the improvement produced by bilateral CIs and HP surgery.

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Speech Understanding in Noise by Patients With Cochlear Implants Using a Monaural Adaptive Beamformer

Purpose

The aim of this experiment was to compare, for patients with cochlear implants (CIs), the improvement for speech understanding in noise provided by a monaural adaptive beamformer and for two interventions that produced bilateral input (i.e., bilateral CIs and hearing preservation [HP] surgery).

Method

Speech understanding scores for sentences were obtained for 10 listeners fit with a single CI. The listeners were tested with and without beamformer activated in a “cocktail party” environment with spatially separated target and maskers. Data for 10 listeners with bilateral CIs and 8 listeners with HP CIs were taken from Loiselle, Dorman, Yost, Cook, and Gifford (2016), who used the same test protocol.

Results

The use of the beamformer resulted in a 31 percentage point improvement in performance; in bilateral CIs, an 18 percentage point improvement; and in HP CIs, a 20 percentage point improvement.

Conclusion

A monaural adaptive beamformer can produce an improvement in speech understanding in a complex noise environment that is equal to, or greater than, the improvement produced by bilateral CIs and HP surgery.

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Speech Understanding in Noise by Patients With Cochlear Implants Using a Monaural Adaptive Beamformer

Purpose

The aim of this experiment was to compare, for patients with cochlear implants (CIs), the improvement for speech understanding in noise provided by a monaural adaptive beamformer and for two interventions that produced bilateral input (i.e., bilateral CIs and hearing preservation [HP] surgery).

Method

Speech understanding scores for sentences were obtained for 10 listeners fit with a single CI. The listeners were tested with and without beamformer activated in a “cocktail party” environment with spatially separated target and maskers. Data for 10 listeners with bilateral CIs and 8 listeners with HP CIs were taken from Loiselle, Dorman, Yost, Cook, and Gifford (2016), who used the same test protocol.

Results

The use of the beamformer resulted in a 31 percentage point improvement in performance; in bilateral CIs, an 18 percentage point improvement; and in HP CIs, a 20 percentage point improvement.

Conclusion

A monaural adaptive beamformer can produce an improvement in speech understanding in a complex noise environment that is equal to, or greater than, the improvement produced by bilateral CIs and HP surgery.

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Stream segregation of concurrent speech and the verbal transformation effect: Influence of fundamental frequency and lateralization cues

Publication date: Available online 2 August 2017
Source:Hearing Research
Author(s): Marcin Stachurski, Robert J. Summers, Brian Roberts
Repeating a recorded word produces verbal transformations (VTs); perceptual regrouping of acoustic-phonetic segments may contribute to this effect. The influence of fundamental frequency (F0) and lateralization grouping cues was explored by presenting two concurrent sequences of the same word resynthesized on different F0s (100 and 178 Hz). In experiment 1, listeners monitored both sequences simultaneously, reporting for each any change in stimulus identity. Three lateralization conditions were used – diotic, ±680-μs interaural time difference, and dichotic. Results were similar for the first two conditions, but fewer forms and later initial transformations were reported in the dichotic condition. This suggests that large lateralization differences per se have little effect – rather, there are more possibilities for regrouping when each ear receives both sequences. In the dichotic condition, VTs reported for one sequence were also more independent of those reported for the other. Experiment 2 used diotic stimuli and explored the effect of the number of sequences presented and monitored. The most forms and earliest transformations were reported when two sequences were presented but only one was monitored, indicating that high task demands decreased reporting of VTs for concurrent sequences. Overall, these findings support the idea that perceptual regrouping contributes to the VT effect.



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Stream segregation of concurrent speech and the verbal transformation effect: Influence of fundamental frequency and lateralization cues

Publication date: Available online 2 August 2017
Source:Hearing Research
Author(s): Marcin Stachurski, Robert J. Summers, Brian Roberts
Repeating a recorded word produces verbal transformations (VTs); perceptual regrouping of acoustic-phonetic segments may contribute to this effect. The influence of fundamental frequency (F0) and lateralization grouping cues was explored by presenting two concurrent sequences of the same word resynthesized on different F0s (100 and 178 Hz). In experiment 1, listeners monitored both sequences simultaneously, reporting for each any change in stimulus identity. Three lateralization conditions were used – diotic, ±680-μs interaural time difference, and dichotic. Results were similar for the first two conditions, but fewer forms and later initial transformations were reported in the dichotic condition. This suggests that large lateralization differences per se have little effect – rather, there are more possibilities for regrouping when each ear receives both sequences. In the dichotic condition, VTs reported for one sequence were also more independent of those reported for the other. Experiment 2 used diotic stimuli and explored the effect of the number of sequences presented and monitored. The most forms and earliest transformations were reported when two sequences were presented but only one was monitored, indicating that high task demands decreased reporting of VTs for concurrent sequences. Overall, these findings support the idea that perceptual regrouping contributes to the VT effect.



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Botulinum Toxin Injections Into the Lateral Cricoarytenoid Muscles for Vocal Process Granuloma

Publication date: Available online 1 August 2017
Source:Journal of Voice
Author(s): Q. Pham, R. Campbell, J. Mattioni, R. Sataloff
ObjectiveContact granulomas are benign, exophytic inflammatory lesions of the larynx that typically arise on or near the vocal process of the arytenoid cartilage. The most common management options include voice therapy and antireflux pharmacotherapy, intralesional steroid injections, botulinum toxin injections, and surgical excision. In-office Botox injection into the lateral cricoarytenoid (LCA) muscle can be effective even for recurrent granulomas.Study DesignThis is a retrospective chart review and literature review.MethodWe reviewed more than 400 charts and included two patients, who underwent in-office injection with botulinum toxin A into LCA muscles bilaterally, after previously failing both conservative and surgical management.ResultsBoth cases showed significant improvement of the laryngeal granulomas after 6 months and a single botulinum toxin injection. Both cases were initially grade III granuloma that improved to grade I.ConclusionsIn-office injection of botulinum toxin A targeting the LCA muscle appears to be a safe and effective treatment modality in refractory laryngeal granuloma.



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Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Related Articles

Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Eur Arch Otorhinolaryngol. 2017 Jul 31;:

Authors: Shambhu T, Kumar SD, Prabhu P

Abstract
The present study attempted to determine the effect of practicing yoga on functioning of sacculo-collic pathway using cervical vestibular evoked myogenic potential (cVEMP). cVEMP was recorded from 40 participants (20 who practice yoga regularly and 20 who do not practice yoga regularly). The differences in amplitude of P1, N1, P1-N1 complex, asymmetry ratio and latencies of P1 and N1 of cVEMP were compared between both the groups. The results of the study showed that there was a significant increase (p < 0.05) in the amplitude of P1, N1 and P1-N1 complex and a significant reduction in latency (p < 0.05) for experimental group. The asymmetry ratio in individuals who practice yoga was significantly lower (Mean = 6.73) compared to the control group (Mean = 19.13). Multivariate regression analyses suggested that the number of years of yoga practice significantly predicted the amplitude of P1-N1 complex (β = 0.70, p < 0.01) and amplitude ratio (β = 0.72, p < 0.01). Thus, practicing yoga improves postural control and strengthens the muscles and vestibular system leading to enhanced cVEMP responses. The plastic changes in the vestibular system and increased muscular strength because of constant practicing of yoga could have led to changes in cVEMP responses. However, further studies on a larger group of individuals are essential for better clinical applicability of the results.

PMID: 28762044 [PubMed - as supplied by publisher]

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Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Related Articles

Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Eur Arch Otorhinolaryngol. 2017 Jul 31;:

Authors: Shambhu T, Kumar SD, Prabhu P

Abstract
The present study attempted to determine the effect of practicing yoga on functioning of sacculo-collic pathway using cervical vestibular evoked myogenic potential (cVEMP). cVEMP was recorded from 40 participants (20 who practice yoga regularly and 20 who do not practice yoga regularly). The differences in amplitude of P1, N1, P1-N1 complex, asymmetry ratio and latencies of P1 and N1 of cVEMP were compared between both the groups. The results of the study showed that there was a significant increase (p < 0.05) in the amplitude of P1, N1 and P1-N1 complex and a significant reduction in latency (p < 0.05) for experimental group. The asymmetry ratio in individuals who practice yoga was significantly lower (Mean = 6.73) compared to the control group (Mean = 19.13). Multivariate regression analyses suggested that the number of years of yoga practice significantly predicted the amplitude of P1-N1 complex (β = 0.70, p < 0.01) and amplitude ratio (β = 0.72, p < 0.01). Thus, practicing yoga improves postural control and strengthens the muscles and vestibular system leading to enhanced cVEMP responses. The plastic changes in the vestibular system and increased muscular strength because of constant practicing of yoga could have led to changes in cVEMP responses. However, further studies on a larger group of individuals are essential for better clinical applicability of the results.

PMID: 28762044 [PubMed - as supplied by publisher]

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Evidence of surgical treatments for intractable Meniere's disease.

Related Articles

Evidence of surgical treatments for intractable Meniere's disease.

Auris Nasus Larynx. 2017 Jul 28;:

Authors: Kitahara T

Abstract
Meniere's disease is an inner ear disease, characterized by recurrent rotatory vertigo, sensorineural hearing loss and tinnitus. There are some with frequent vertigo attacks, progressive hearing loss and persistent annoying tinnitus even through the continuous standard medical treatments. These cases are thought to account for 10%-20% of all cases of Meniere's disease. In this review article, we would like to demonstrate the evidences for surgical treatments according to the previous papers, and consider the next therapeutic strategies including surgical options according to the international guidelines.

PMID: 28760332 [PubMed - as supplied by publisher]

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Maximizing Research, Audiology Fundamentals in ANSD Management

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Communication Repair Strategies for Hearing-Impaired Children

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Autoimmune Hearing Loss

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Why Patients Need Hearing Loops

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Language Matters: Considerations in Measuring Speech Intelligibility

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Breaking Down Barriers: Summer Academy Takes on Educational Attainment Gap Between Deaf and Hearing Students

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What do Commuters Know About Noise-Induced Hearing Loss?

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Symptom: Asymmetric Hearing Loss

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Emergency Preparation for People With Hearing Loss

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6 Steps to Embed RIC Hearing Aids

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Counseling Training in AuD Programs: A Syllabi Review

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Manufacturers News

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Maximizing Research, Audiology Fundamentals in ANSD Management

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Communication Repair Strategies for Hearing-Impaired Children

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Autoimmune Hearing Loss

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Why Patients Need Hearing Loops

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Language Matters: Considerations in Measuring Speech Intelligibility

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Breaking Down Barriers: Summer Academy Takes on Educational Attainment Gap Between Deaf and Hearing Students

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What do Commuters Know About Noise-Induced Hearing Loss?

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Symptom: Asymmetric Hearing Loss

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Emergency Preparation for People With Hearing Loss

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6 Steps to Embed RIC Hearing Aids

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Counseling Training in AuD Programs: A Syllabi Review

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Manufacturers News

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Maximizing Research, Audiology Fundamentals in ANSD Management

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Communication Repair Strategies for Hearing-Impaired Children

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Autoimmune Hearing Loss

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Why Patients Need Hearing Loops

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Language Matters: Considerations in Measuring Speech Intelligibility

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Breaking Down Barriers: Summer Academy Takes on Educational Attainment Gap Between Deaf and Hearing Students

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What do Commuters Know About Noise-Induced Hearing Loss?

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Symptom: Asymmetric Hearing Loss

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Emergency Preparation for People With Hearing Loss

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6 Steps to Embed RIC Hearing Aids

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Counseling Training in AuD Programs: A Syllabi Review

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Manufacturers News

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