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Πέμπτη 1 Μαρτίου 2018
Speech Adaptation to Kinematic Recording Sensors: Perceptual and Acoustic Findings
Purpose
This study used perceptual and acoustic measures to examine the time course of speech adaptation after the attachment of electromagnetic sensor coils to the tongue, lips, and jaw.
Method
Twenty native English speakers read aloud stimulus sentences before the attachment of the sensors, immediately after attachment, and again 5, 10, 15, and 20 min later. They read aloud continuously between recordings to encourage adaptation. Sentence recordings were perceptually evaluated by 20 native English listeners, who rated 150 stimuli (which included 31 samples that were repeated to assess rater reliability) using a visual analog scale with the end points labeled as “precise” and “imprecise.” Acoustic analysis began by segmenting and measuring the duration of the fricatives /s/ and /ʃ/ as well as the whole sentence. The spectral center of gravity and spectral standard deviation of the 2 fricatives were measured using Praat. These phonetic targets were selected because the standard placement of sensor coils on the lingual surface was anticipated to interfere with normal fricative production, causing them to become distorted.
Results
Perceptual ratings revealed a decrease in speech precision after sensor attachment and evidence of adaptation over time; there was little perceptual change beyond the 10-min recording. The spectral center of gravity for /s/ decreased, and the spectral standard deviation for /ʃ/ increased after sensor attachment, but the acoustic measures showed no evidence of adaptation over time.
Conclusion
The findings suggest that 10 min may be sufficient time to allow speakers to adapt before experimental data collection with Northern Digital Instruments Wave electromagnetic sensors.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2oJsq3D
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Speech Adaptation to Kinematic Recording Sensors: Perceptual and Acoustic Findings
Purpose
This study used perceptual and acoustic measures to examine the time course of speech adaptation after the attachment of electromagnetic sensor coils to the tongue, lips, and jaw.
Method
Twenty native English speakers read aloud stimulus sentences before the attachment of the sensors, immediately after attachment, and again 5, 10, 15, and 20 min later. They read aloud continuously between recordings to encourage adaptation. Sentence recordings were perceptually evaluated by 20 native English listeners, who rated 150 stimuli (which included 31 samples that were repeated to assess rater reliability) using a visual analog scale with the end points labeled as “precise” and “imprecise.” Acoustic analysis began by segmenting and measuring the duration of the fricatives /s/ and /ʃ/ as well as the whole sentence. The spectral center of gravity and spectral standard deviation of the 2 fricatives were measured using Praat. These phonetic targets were selected because the standard placement of sensor coils on the lingual surface was anticipated to interfere with normal fricative production, causing them to become distorted.
Results
Perceptual ratings revealed a decrease in speech precision after sensor attachment and evidence of adaptation over time; there was little perceptual change beyond the 10-min recording. The spectral center of gravity for /s/ decreased, and the spectral standard deviation for /ʃ/ increased after sensor attachment, but the acoustic measures showed no evidence of adaptation over time.
Conclusion
The findings suggest that 10 min may be sufficient time to allow speakers to adapt before experimental data collection with Northern Digital Instruments Wave electromagnetic sensors.from #Audiology via ola Kala on Inoreader http://ift.tt/2oJsq3D
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Speech Adaptation to Kinematic Recording Sensors: Perceptual and Acoustic Findings
Purpose
This study used perceptual and acoustic measures to examine the time course of speech adaptation after the attachment of electromagnetic sensor coils to the tongue, lips, and jaw.
Method
Twenty native English speakers read aloud stimulus sentences before the attachment of the sensors, immediately after attachment, and again 5, 10, 15, and 20 min later. They read aloud continuously between recordings to encourage adaptation. Sentence recordings were perceptually evaluated by 20 native English listeners, who rated 150 stimuli (which included 31 samples that were repeated to assess rater reliability) using a visual analog scale with the end points labeled as “precise” and “imprecise.” Acoustic analysis began by segmenting and measuring the duration of the fricatives /s/ and /ʃ/ as well as the whole sentence. The spectral center of gravity and spectral standard deviation of the 2 fricatives were measured using Praat. These phonetic targets were selected because the standard placement of sensor coils on the lingual surface was anticipated to interfere with normal fricative production, causing them to become distorted.
Results
Perceptual ratings revealed a decrease in speech precision after sensor attachment and evidence of adaptation over time; there was little perceptual change beyond the 10-min recording. The spectral center of gravity for /s/ decreased, and the spectral standard deviation for /ʃ/ increased after sensor attachment, but the acoustic measures showed no evidence of adaptation over time.
Conclusion
The findings suggest that 10 min may be sufficient time to allow speakers to adapt before experimental data collection with Northern Digital Instruments Wave electromagnetic sensors.from #Audiology via ola Kala on Inoreader http://ift.tt/2oJsq3D
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Localization and Spatial Discrimination in Children and Adolescents with Moderate Sensorineural Hearing Loss Tested without Their Hearing Aids
Audiol Neurotol 2017;22:326–342
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Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25.
Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25.
J Am Acad Audiol. 2018 Mar;29(3):264-265
Authors: Iliadou VV, Eleftheriadis N
PMID: 29488877 [PubMed - in process]
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Response to Drs. Iliadou and Eleftheriadis Regarding "Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion".
Response to Drs. Iliadou and Eleftheriadis Regarding "Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion".
J Am Acad Audiol. 2018 Mar;29(3):262-263
Authors: Vermiglio AJ
PMID: 29488876 [PubMed - in process]
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Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis.
Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis.
J Am Acad Audiol. 2018 Mar;29(3):255-261
Authors: Aazh H, Moore BCJ
Abstract
BACKGROUND: There are conflicting reports with regard to the relationship between suicidal ideations and tinnitus and hyperacusis. Audiology departments play a major role in offering therapy and support for patients experiencing tinnitus and hyperacusis. If suicidal and self-harm ideations among patients seen in audiology clinics are high, then it would be important to screen for them to make onward referrals to mental health services.
PURPOSE: The aim of this study was to assess the prevalence of and factors related to suicidal and self-harm ideations in patients with tinnitus and hyperacusis seen at an audiology outpatient service.
RESEARCH DESIGN: This study was a part of a service evaluation survey using a correlational design.
STUDY SAMPLE: All patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic of the National Health Service in the United Kingdom in a 1-yr period were asked to complete the survey questionnaires (n = 402).
DATA COLLECTION AND ANALYSIS: The focus of this article is on analysis of the patients' responses about suicidal and self-harm ideations as measured via the Patient Health Questionnaire, item 9, and their associated factors.
RESULTS: A total of 150/402 of patients answered the question about suicidal and self-harm ideations. Of these, 13% indicated that they had suicidal or self-harm ideations in the past 2 weeks. Suicidal and self-harm ideations were moderately correlated with scores on the anxiety and depression subscales of the hospital anxiety and depression scale. Suicidal and self-harm ideations decreased with increasing age. There were small statistically significant correlations between suicidal and self-harm ideations and tinnitus handicap, hyperacusis handicap, insomnia, and scores on the visual analog scale (VAS) of effect of tinnitus on life. The correlations between suicidal and self-harm ideations and gender, pure-tone average of the worse and better ears, uncomfortable loudness levels of the worse ears, and VAS of tinnitus loudness and annoyance were not statistically significant. A regression model showed that abnormal depression scores increased the chance of suicidal and self-harm ideations by a factor of 6.2 (95% confidence interval = 1.13-34.1, p = 0.036).
CONCLUSIONS: Audiologists offering tinnitus and hyperacusis rehabilitation should screen for suicidal and self-harm ideations among patients, especially for those with comorbid depression, and make onward referral to appropriate services when needed.
PMID: 29488875 [PubMed - in process]
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Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss.
Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss.
J Am Acad Audiol. 2018 Mar;29(3):243-254
Authors: Seeto A, Searchfield GD
Abstract
BACKGROUND: Advances in digital signal processing have made it possible to provide a wide-band frequency response with smooth, precise spectral shaping. Several manufacturers have introduced hearing aids that are claimed to provide gain for frequencies up to 10-12 kHz. However, there is currently limited evidence and very few independent studies evaluating the performance of the extended bandwidth hearing aids that have recently become available.
PURPOSE: This study investigated an extended bandwidth hearing aid using measures of speech intelligibility and sound quality to find out whether there was a significant benefit of extended bandwidth amplification over standard amplification.
RESEARCH DESIGN: Repeated measures study designed to examine the efficacy of extended bandwidth amplification compared to standard bandwidth amplification.
STUDY SAMPLE: Sixteen adult participants with mild-to-moderate sensorineural hearing loss.
INTERVENTION: Participants were bilaterally fit with a pair of Widex Mind 440 behind-the-ear hearing aids programmed with a standard bandwidth fitting and an extended bandwidth fitting; the latter provided gain up to 10 kHz.
DATA COLLECTION AND ANALYSIS: For each fitting, and an unaided condition, participants completed two speech measures of aided benefit, the Quick Speech-in-Noise test (QuickSIN™) and the Phonak Phoneme Perception Test (PPT; high-frequency perception in quiet), and a measure of sound quality rating.
RESULTS: There were no significant differences found between unaided and aided conditions for QuickSIN™ scores. For the PPT, there were statistically significantly lower (improved) detection thresholds at high frequencies (6 and 9 kHz) with the extended bandwidth fitting. Although not statistically significant, participants were able to distinguish between 6 and 9 kHz 50% better with extended bandwidth. No significant difference was found in ability to recognize phonemes in quiet between the unaided and aided conditions when phonemes only contained frequency content <6 kHz. However significant benefit was found with the extended bandwidth fitting for recognition of 9-kHz phonemes. No significant difference in sound quality preference was found between the standard bandwidth and extended bandwidth fittings.
CONCLUSIONS: This study demonstrated that a pair of currently available extended bandwidth hearing aids was technically capable of delivering high-frequency amplification that was both audible and useable to listeners with mild-to-moderate hearing loss. This amplification was of acceptable sound quality. Further research, particularly field trials, is required to ascertain the real-world benefit of high-frequency amplification.
PMID: 29488874 [PubMed - in process]
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Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test.
Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test.
J Am Acad Audiol. 2018 Mar;29(3):233-242
Authors: Saunders GH, Morse-Fortier C, McDermott DJ, Vachhani JJ, Grush LD, Griest S, Lewis MS
Abstract
BACKGROUND: The ability to manage hearing aids is crucial for successful outcomes and for maintaining hearing aid use. It is therefore important to have a tool that can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on that skill. Such a tool can also provide useful quantitative data for researchers.
PURPOSE: To collect normative data (Experiment 1) and assess inter- and intrarater reliability (Experiment 2) for a hearing aid management assessment tool known as the Hearing Aid Skills and Knowledge (HASK) test.
STUDY SAMPLE: Two hundred thirty-six new hearing aid users recruited from the VA Portland Health Care System and 126 experienced hearing aid users recruited from the local Portland community participated in Experiment 1. The veteran participants were taking part in a larger hearing aid study, and the community participants were recruited at community events that took place around Portland, OR. Three clinical audiologists and two AuD students completing their fourth year externship participated in Experiment 2.
DATA COLLECTION AND ANALYSIS: In Experiment 1, HASK data were collected from the new hearing aid users at 4-8 wk and 6-8 mo after the fitting of their first pair of hearing aids, and from experienced users on a single occasion. In addition, self-reported hearing aid use, benefit, and satisfaction were assessed for all participants. The audiologists/students in Experiment 2 watched and independently scored videos of six individuals completing the HASK. Intraclass correlation coefficients (ICCs) across audiologists were computed for HASK scores. Three audiologists/students rated at least one video on two occasions to provide interrater reliability data.
RESULTS: Mean performance on the HASK was about 70% for knowledge and 80% for skills for both the new and experienced hearing aid users. Performance did not change among the new users between the 4-8 wk and 6-8 mo administration. The specific skills lacking were associated with advanced management abilities (cleaning and troubleshooting). Experiment 2 revealed ICCs for inter- and intrarater reliability for HASK to range from 0.76 to 0.94, showing acceptable to excellent reliability.
CONCLUSIONS: The HASK is a quick and easy test with good-to-excellent inter- and intrarater reliability. It can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on those skills. Data show performance is ∼70% for knowledge and 80% for skills and this does not change with hearing aid experience. The significant positive correlations between HASK scores and hearing aid use and satisfaction highlight the notion that ability to manage hearing aids successfully is integral to good hearing aid outcome.
PMID: 29488873 [PubMed - in process]
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Test-Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training.
Test-Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training.
J Am Acad Audiol. 2018 Mar;29(3):223-232
Authors: Mahdavi ME, Pourbakht A, Parand A, Jalaie S
Abstract
BACKGROUND: Evaluation of dichotic listening to digits is a common part of many studies for diagnosis and managing auditory processing disorders in children. Previous researchers have verified test-retest relative reliability of dichotic digits results in normal children and adults. However, detecting intervention-related changes in the ear scores after dichotic listening training requires information regarding trial-to-trial typical variation of individual ear scores that is estimated using indices of absolute reliability. Previous studies have not addressed absolute reliability of dichotic listening results.
PURPOSE: To compare the results of the Persian randomized dichotic digits test (PRDDT) and its relative and absolute indices of reliability between typical achieving (TA) and learning-disabled (LD) children.
RESEARCH DESIGN: A repeated measures observational study.
STUDY SAMPLE: Fifteen LD children were recruited from a previously performed study with age range of 7-12 yr. The control group consisted of 15 TA schoolchildren with age range of 8-11 yr.
DATA COLLECTION AND ANALYSIS: The Persian randomized dichotic digits test was administered on the children under free recall condition in two test sessions 7-12 days apart. We compared the average of the ear scores and ear advantage between TA and LD children. Relative indices of reliability included Pearson's correlation and intraclass correlation (ICC2,1) coefficients and absolute reliability was evaluated by calculation of standard error of measurement (SEM) and minimal detectable change (MDC) using the raw ear scores.
RESULTS: The Pearson correlation coefficient indicated that in both groups of children the ear scores of test and retest sessions were strongly and positively (greater than +0.8) correlated. The ear scores showed excellent ICC coefficient of consistency (0.78-0.82) and fair to excellent ICC coefficient of absolute agreement (0.62-0.74) in TA children and excellent ICC coefficients of consistency and absolute agreement in LD children (0.76-0.87). SEM and SEM% of the ear scores in TA children were 1.46 and 1.44% for the right ear and 4.68 and 5.47% for the left ear. SEM and SEM% of the ear scores in LD children were 4.55 and 5.88% for the right ear to 7.56 and 12.81% for the left ear. MDC and MDC% of the ear scores in TA children varied from 4.03 and 3.99% for the right ear to 12.93 and 15.13% for the left ear. MDC and MDC% of the ear scores in LD children varied from 12.57 and 16.25% for the right ear to 20.89 and 35.39% for the left ear.
CONCLUSIONS: The LD children indicated test-retest relative reliability as high as TA children in the ear scores measured by PRDDT. However, within-subject variations of the ear scores calculated by indices of absolute reliability were considerably higher in LD children versus TA children. The results of the current study could have implications for detecting real training-related changes in the ear scores.
PMID: 29488872 [PubMed - in process]
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An Argument for Self-Report as a Reference Standard in Audiology.
An Argument for Self-Report as a Reference Standard in Audiology.
J Am Acad Audiol. 2018 Mar;29(3):206-222
Authors: Vermiglio AJ, Soli SD, Fang X
Abstract
BACKGROUND: The primary components of a diagnostic accuracy study are an index test, the target condition (or disorder), and a reference standard. According to the Standards for Reporting Diagnostic Accuracy statement, the reference standard should be the best method available to independently determine if the results of an index test are correct. Pure-tone thresholds have been used as the "gold standard" for the validation of some tests used in audiology. Many studies, however, have shown a lack of agreement between the audiogram and the patient's perception of hearing ability. For example, patients with normal audiograms may report difficulty understanding speech in the presence of background noise.
PURPOSE: The primary purpose of this article is to present an argument for the use of self-report as a reference standard for diagnostic studies in the field of audiology. This will be in the form of a literature review on pure-tone threshold measures and self-report as reference standards. The secondary purpose is to determine the diagnostic accuracy of pure-tone threshold and Hearing-in-Noise Test (HINT) measures for the detection of a speech-recognition-in-noise disorder.
RESEARCH DESIGN: Two groups of participants with normal pure-tone thresholds were evaluated. The King-Kopetzky syndrome (KKS) group was made up of participants with the self-report of speech-recognition-in-noise difficulties. The control group was made up of participants with no reports of speech-recognition-in-noise problems. The reference standard was self-report. Diagnostic accuracy of HINT and pure-tone threshold measures was determined by measuring group differences, sensitivity and specificity, and the area under the curve (AUC) for receiver-operating characteristic (ROC) curves.
STUDY SAMPLE: Forty-seven participants were tested. All participants were native speakers of American English. Twenty-two participants were in the control group and 25 in the KKS group. The groups were matched for age.
DATA COLLECTION AND ANALYSIS: Pure-tone threshold data were collected using the Hughson-Westlake procedure. Speech-recognition-in-noise data was collected using a software system and the standard HINT protocol. Statistical analyses were conducted using descriptive, correlational, two-sample t tests, and logistic regression.
RESULTS: The literature review revealed that self-report has been used as a reference standard in investigations of patients with normal audiograms and the perception of difficulty understanding speech in the presence of background noise. Self-report may be a better indicator of hearing ability than pure-tone thresholds in some situations. The diagnostic accuracy investigation revealed statistically significant differences between control and KKS groups for HINT performance (p < 0.01), but not for pure-tone threshold measures. Better sensitivity was found for the HINT Composite score (88%) than pure-tone average (PTA; 28%). The specificities for the HINT Composite score and PTA were 77% and 95%, respectively. ROC curves revealed a greater AUC for the HINT Composite score (AUC = 0.87) than for PTA (AUC = 0.51).
CONCLUSION: Self-report is a reasonable reference standard for studies on the diagnostic accuracy of speech-recognition-in-noise tests. For individuals with normal pure-tone thresholds, the HINT demonstrated a higher degree of diagnostic accuracy than pure-tone thresholds for the detection of speech-recognition-in-noise disorder.
PMID: 29488871 [PubMed - in process]
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Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer.
Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer.
J Am Acad Audiol. 2018 Mar;29(3):197-205
Authors: Dorman MF, Natale S, Loiselle L
Abstract
BACKGROUND: Sentence understanding scores for patients with cochlear implants (CIs) when tested in quiet are relatively high. However, sentence understanding scores for patients with CIs plummet with the addition of noise.
PURPOSE: To assess, for patients with CIs (MED-EL), (1) the value to speech understanding of two new, noise-reducing microphone settings and (2) the effect of the microphone settings on sound source localization.
RESEARCH DESIGN: Single-subject, repeated measures design. For tests of speech understanding, repeated measures on (1) number of CIs (one, two), (2) microphone type (omni, natural, adaptive beamformer), and (3) type of noise (restaurant, cocktail party). For sound source localization, repeated measures on type of signal (low-pass [LP], high-pass [HP], broadband noise).
STUDY SAMPLE: Ten listeners, ranging in age from 48 to 83 yr (mean = 57 yr), participated in this prospective study.
INTERVENTION: Speech understanding was assessed in two noise environments using monaural and bilateral CIs fit with three microphone types. Sound source localization was assessed using three microphone types.
DATA COLLECTION AND ANALYSIS: In Experiment 1, sentence understanding scores (in terms of percent words correct) were obtained in quiet and in noise. For each patient, noise was first added to the signal to drive performance off of the ceiling in the bilateral CI-omni microphone condition. The other conditions were then administered at that signal-to-noise ratio in quasi-random order. In Experiment 2, sound source localization accuracy was assessed for three signal types using a 13-loudspeaker array over a 180° arc. The dependent measure was root-mean-score error.
RESULTS: Both the natural and adaptive microphone settings significantly improved speech understanding in the two noise environments. The magnitude of the improvement varied between 16 and 19 percentage points for tests conducted in the restaurant environment and between 19 and 36 percentage points for tests conducted in the cocktail party environment. In the restaurant and cocktail party environments, both the natural and adaptive settings, when implemented on a single CI, allowed scores that were as good as, or better, than scores in the bilateral omni test condition. Sound source localization accuracy was unaltered by either the natural or adaptive settings for LP, HP, or wideband noise stimuli.
CONCLUSION: The data support the use of the natural microphone setting as a default setting. The natural setting (1) provides better speech understanding in noise than the omni setting, (2) does not impair sound source localization, and (3) retains low-frequency sensitivity to signals from the rear. Moreover, bilateral CIs equipped with adaptive beamforming technology can engender speech understanding scores in noise that fall only a little short of scores for a single CI in quiet.
PMID: 29488870 [PubMed - in process]
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Tinnitus and Self-Harm Revisited.
Tinnitus and Self-Harm Revisited.
J Am Acad Audiol. 2018 Mar;29(3):196
Authors: Jacobson GP
PMID: 29488869 [PubMed - in process]
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Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25.
Response to the Letter from Dr. Vermiglio Regarding Iliadou and Eleftheriadis (2017): CAPD is Classified in ICD-10 as H93.25.
J Am Acad Audiol. 2018 Mar;29(3):264-265
Authors: Iliadou VV, Eleftheriadis N
PMID: 29488877 [PubMed - in process]
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Response to Drs. Iliadou and Eleftheriadis Regarding "Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion".
Response to Drs. Iliadou and Eleftheriadis Regarding "Auditory Processing Disorder (APD) as the Sole Manifestation of a Cerebellopontine and Internal Auditory Canal Lesion".
J Am Acad Audiol. 2018 Mar;29(3):262-263
Authors: Vermiglio AJ
PMID: 29488876 [PubMed - in process]
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Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis.
Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis.
J Am Acad Audiol. 2018 Mar;29(3):255-261
Authors: Aazh H, Moore BCJ
Abstract
BACKGROUND: There are conflicting reports with regard to the relationship between suicidal ideations and tinnitus and hyperacusis. Audiology departments play a major role in offering therapy and support for patients experiencing tinnitus and hyperacusis. If suicidal and self-harm ideations among patients seen in audiology clinics are high, then it would be important to screen for them to make onward referrals to mental health services.
PURPOSE: The aim of this study was to assess the prevalence of and factors related to suicidal and self-harm ideations in patients with tinnitus and hyperacusis seen at an audiology outpatient service.
RESEARCH DESIGN: This study was a part of a service evaluation survey using a correlational design.
STUDY SAMPLE: All patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic of the National Health Service in the United Kingdom in a 1-yr period were asked to complete the survey questionnaires (n = 402).
DATA COLLECTION AND ANALYSIS: The focus of this article is on analysis of the patients' responses about suicidal and self-harm ideations as measured via the Patient Health Questionnaire, item 9, and their associated factors.
RESULTS: A total of 150/402 of patients answered the question about suicidal and self-harm ideations. Of these, 13% indicated that they had suicidal or self-harm ideations in the past 2 weeks. Suicidal and self-harm ideations were moderately correlated with scores on the anxiety and depression subscales of the hospital anxiety and depression scale. Suicidal and self-harm ideations decreased with increasing age. There were small statistically significant correlations between suicidal and self-harm ideations and tinnitus handicap, hyperacusis handicap, insomnia, and scores on the visual analog scale (VAS) of effect of tinnitus on life. The correlations between suicidal and self-harm ideations and gender, pure-tone average of the worse and better ears, uncomfortable loudness levels of the worse ears, and VAS of tinnitus loudness and annoyance were not statistically significant. A regression model showed that abnormal depression scores increased the chance of suicidal and self-harm ideations by a factor of 6.2 (95% confidence interval = 1.13-34.1, p = 0.036).
CONCLUSIONS: Audiologists offering tinnitus and hyperacusis rehabilitation should screen for suicidal and self-harm ideations among patients, especially for those with comorbid depression, and make onward referral to appropriate services when needed.
PMID: 29488875 [PubMed - in process]
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Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss.
Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss.
J Am Acad Audiol. 2018 Mar;29(3):243-254
Authors: Seeto A, Searchfield GD
Abstract
BACKGROUND: Advances in digital signal processing have made it possible to provide a wide-band frequency response with smooth, precise spectral shaping. Several manufacturers have introduced hearing aids that are claimed to provide gain for frequencies up to 10-12 kHz. However, there is currently limited evidence and very few independent studies evaluating the performance of the extended bandwidth hearing aids that have recently become available.
PURPOSE: This study investigated an extended bandwidth hearing aid using measures of speech intelligibility and sound quality to find out whether there was a significant benefit of extended bandwidth amplification over standard amplification.
RESEARCH DESIGN: Repeated measures study designed to examine the efficacy of extended bandwidth amplification compared to standard bandwidth amplification.
STUDY SAMPLE: Sixteen adult participants with mild-to-moderate sensorineural hearing loss.
INTERVENTION: Participants were bilaterally fit with a pair of Widex Mind 440 behind-the-ear hearing aids programmed with a standard bandwidth fitting and an extended bandwidth fitting; the latter provided gain up to 10 kHz.
DATA COLLECTION AND ANALYSIS: For each fitting, and an unaided condition, participants completed two speech measures of aided benefit, the Quick Speech-in-Noise test (QuickSIN™) and the Phonak Phoneme Perception Test (PPT; high-frequency perception in quiet), and a measure of sound quality rating.
RESULTS: There were no significant differences found between unaided and aided conditions for QuickSIN™ scores. For the PPT, there were statistically significantly lower (improved) detection thresholds at high frequencies (6 and 9 kHz) with the extended bandwidth fitting. Although not statistically significant, participants were able to distinguish between 6 and 9 kHz 50% better with extended bandwidth. No significant difference was found in ability to recognize phonemes in quiet between the unaided and aided conditions when phonemes only contained frequency content <6 kHz. However significant benefit was found with the extended bandwidth fitting for recognition of 9-kHz phonemes. No significant difference in sound quality preference was found between the standard bandwidth and extended bandwidth fittings.
CONCLUSIONS: This study demonstrated that a pair of currently available extended bandwidth hearing aids was technically capable of delivering high-frequency amplification that was both audible and useable to listeners with mild-to-moderate hearing loss. This amplification was of acceptable sound quality. Further research, particularly field trials, is required to ascertain the real-world benefit of high-frequency amplification.
PMID: 29488874 [PubMed - in process]
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Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test.
Description, Normative Data, and Utility of the Hearing Aid Skills and Knowledge Test.
J Am Acad Audiol. 2018 Mar;29(3):233-242
Authors: Saunders GH, Morse-Fortier C, McDermott DJ, Vachhani JJ, Grush LD, Griest S, Lewis MS
Abstract
BACKGROUND: The ability to manage hearing aids is crucial for successful outcomes and for maintaining hearing aid use. It is therefore important to have a tool that can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on that skill. Such a tool can also provide useful quantitative data for researchers.
PURPOSE: To collect normative data (Experiment 1) and assess inter- and intrarater reliability (Experiment 2) for a hearing aid management assessment tool known as the Hearing Aid Skills and Knowledge (HASK) test.
STUDY SAMPLE: Two hundred thirty-six new hearing aid users recruited from the VA Portland Health Care System and 126 experienced hearing aid users recruited from the local Portland community participated in Experiment 1. The veteran participants were taking part in a larger hearing aid study, and the community participants were recruited at community events that took place around Portland, OR. Three clinical audiologists and two AuD students completing their fourth year externship participated in Experiment 2.
DATA COLLECTION AND ANALYSIS: In Experiment 1, HASK data were collected from the new hearing aid users at 4-8 wk and 6-8 mo after the fitting of their first pair of hearing aids, and from experienced users on a single occasion. In addition, self-reported hearing aid use, benefit, and satisfaction were assessed for all participants. The audiologists/students in Experiment 2 watched and independently scored videos of six individuals completing the HASK. Intraclass correlation coefficients (ICCs) across audiologists were computed for HASK scores. Three audiologists/students rated at least one video on two occasions to provide interrater reliability data.
RESULTS: Mean performance on the HASK was about 70% for knowledge and 80% for skills for both the new and experienced hearing aid users. Performance did not change among the new users between the 4-8 wk and 6-8 mo administration. The specific skills lacking were associated with advanced management abilities (cleaning and troubleshooting). Experiment 2 revealed ICCs for inter- and intrarater reliability for HASK to range from 0.76 to 0.94, showing acceptable to excellent reliability.
CONCLUSIONS: The HASK is a quick and easy test with good-to-excellent inter- and intrarater reliability. It can effectively identify which hearing aid management skills are lacking so that the audiologist can provide additional education and training on those skills. Data show performance is ∼70% for knowledge and 80% for skills and this does not change with hearing aid experience. The significant positive correlations between HASK scores and hearing aid use and satisfaction highlight the notion that ability to manage hearing aids successfully is integral to good hearing aid outcome.
PMID: 29488873 [PubMed - in process]
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Test-Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training.
Test-Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training.
J Am Acad Audiol. 2018 Mar;29(3):223-232
Authors: Mahdavi ME, Pourbakht A, Parand A, Jalaie S
Abstract
BACKGROUND: Evaluation of dichotic listening to digits is a common part of many studies for diagnosis and managing auditory processing disorders in children. Previous researchers have verified test-retest relative reliability of dichotic digits results in normal children and adults. However, detecting intervention-related changes in the ear scores after dichotic listening training requires information regarding trial-to-trial typical variation of individual ear scores that is estimated using indices of absolute reliability. Previous studies have not addressed absolute reliability of dichotic listening results.
PURPOSE: To compare the results of the Persian randomized dichotic digits test (PRDDT) and its relative and absolute indices of reliability between typical achieving (TA) and learning-disabled (LD) children.
RESEARCH DESIGN: A repeated measures observational study.
STUDY SAMPLE: Fifteen LD children were recruited from a previously performed study with age range of 7-12 yr. The control group consisted of 15 TA schoolchildren with age range of 8-11 yr.
DATA COLLECTION AND ANALYSIS: The Persian randomized dichotic digits test was administered on the children under free recall condition in two test sessions 7-12 days apart. We compared the average of the ear scores and ear advantage between TA and LD children. Relative indices of reliability included Pearson's correlation and intraclass correlation (ICC2,1) coefficients and absolute reliability was evaluated by calculation of standard error of measurement (SEM) and minimal detectable change (MDC) using the raw ear scores.
RESULTS: The Pearson correlation coefficient indicated that in both groups of children the ear scores of test and retest sessions were strongly and positively (greater than +0.8) correlated. The ear scores showed excellent ICC coefficient of consistency (0.78-0.82) and fair to excellent ICC coefficient of absolute agreement (0.62-0.74) in TA children and excellent ICC coefficients of consistency and absolute agreement in LD children (0.76-0.87). SEM and SEM% of the ear scores in TA children were 1.46 and 1.44% for the right ear and 4.68 and 5.47% for the left ear. SEM and SEM% of the ear scores in LD children were 4.55 and 5.88% for the right ear to 7.56 and 12.81% for the left ear. MDC and MDC% of the ear scores in TA children varied from 4.03 and 3.99% for the right ear to 12.93 and 15.13% for the left ear. MDC and MDC% of the ear scores in LD children varied from 12.57 and 16.25% for the right ear to 20.89 and 35.39% for the left ear.
CONCLUSIONS: The LD children indicated test-retest relative reliability as high as TA children in the ear scores measured by PRDDT. However, within-subject variations of the ear scores calculated by indices of absolute reliability were considerably higher in LD children versus TA children. The results of the current study could have implications for detecting real training-related changes in the ear scores.
PMID: 29488872 [PubMed - in process]
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An Argument for Self-Report as a Reference Standard in Audiology.
An Argument for Self-Report as a Reference Standard in Audiology.
J Am Acad Audiol. 2018 Mar;29(3):206-222
Authors: Vermiglio AJ, Soli SD, Fang X
Abstract
BACKGROUND: The primary components of a diagnostic accuracy study are an index test, the target condition (or disorder), and a reference standard. According to the Standards for Reporting Diagnostic Accuracy statement, the reference standard should be the best method available to independently determine if the results of an index test are correct. Pure-tone thresholds have been used as the "gold standard" for the validation of some tests used in audiology. Many studies, however, have shown a lack of agreement between the audiogram and the patient's perception of hearing ability. For example, patients with normal audiograms may report difficulty understanding speech in the presence of background noise.
PURPOSE: The primary purpose of this article is to present an argument for the use of self-report as a reference standard for diagnostic studies in the field of audiology. This will be in the form of a literature review on pure-tone threshold measures and self-report as reference standards. The secondary purpose is to determine the diagnostic accuracy of pure-tone threshold and Hearing-in-Noise Test (HINT) measures for the detection of a speech-recognition-in-noise disorder.
RESEARCH DESIGN: Two groups of participants with normal pure-tone thresholds were evaluated. The King-Kopetzky syndrome (KKS) group was made up of participants with the self-report of speech-recognition-in-noise difficulties. The control group was made up of participants with no reports of speech-recognition-in-noise problems. The reference standard was self-report. Diagnostic accuracy of HINT and pure-tone threshold measures was determined by measuring group differences, sensitivity and specificity, and the area under the curve (AUC) for receiver-operating characteristic (ROC) curves.
STUDY SAMPLE: Forty-seven participants were tested. All participants were native speakers of American English. Twenty-two participants were in the control group and 25 in the KKS group. The groups were matched for age.
DATA COLLECTION AND ANALYSIS: Pure-tone threshold data were collected using the Hughson-Westlake procedure. Speech-recognition-in-noise data was collected using a software system and the standard HINT protocol. Statistical analyses were conducted using descriptive, correlational, two-sample t tests, and logistic regression.
RESULTS: The literature review revealed that self-report has been used as a reference standard in investigations of patients with normal audiograms and the perception of difficulty understanding speech in the presence of background noise. Self-report may be a better indicator of hearing ability than pure-tone thresholds in some situations. The diagnostic accuracy investigation revealed statistically significant differences between control and KKS groups for HINT performance (p < 0.01), but not for pure-tone threshold measures. Better sensitivity was found for the HINT Composite score (88%) than pure-tone average (PTA; 28%). The specificities for the HINT Composite score and PTA were 77% and 95%, respectively. ROC curves revealed a greater AUC for the HINT Composite score (AUC = 0.87) than for PTA (AUC = 0.51).
CONCLUSION: Self-report is a reasonable reference standard for studies on the diagnostic accuracy of speech-recognition-in-noise tests. For individuals with normal pure-tone thresholds, the HINT demonstrated a higher degree of diagnostic accuracy than pure-tone thresholds for the detection of speech-recognition-in-noise disorder.
PMID: 29488871 [PubMed - in process]
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Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer.
Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer.
J Am Acad Audiol. 2018 Mar;29(3):197-205
Authors: Dorman MF, Natale S, Loiselle L
Abstract
BACKGROUND: Sentence understanding scores for patients with cochlear implants (CIs) when tested in quiet are relatively high. However, sentence understanding scores for patients with CIs plummet with the addition of noise.
PURPOSE: To assess, for patients with CIs (MED-EL), (1) the value to speech understanding of two new, noise-reducing microphone settings and (2) the effect of the microphone settings on sound source localization.
RESEARCH DESIGN: Single-subject, repeated measures design. For tests of speech understanding, repeated measures on (1) number of CIs (one, two), (2) microphone type (omni, natural, adaptive beamformer), and (3) type of noise (restaurant, cocktail party). For sound source localization, repeated measures on type of signal (low-pass [LP], high-pass [HP], broadband noise).
STUDY SAMPLE: Ten listeners, ranging in age from 48 to 83 yr (mean = 57 yr), participated in this prospective study.
INTERVENTION: Speech understanding was assessed in two noise environments using monaural and bilateral CIs fit with three microphone types. Sound source localization was assessed using three microphone types.
DATA COLLECTION AND ANALYSIS: In Experiment 1, sentence understanding scores (in terms of percent words correct) were obtained in quiet and in noise. For each patient, noise was first added to the signal to drive performance off of the ceiling in the bilateral CI-omni microphone condition. The other conditions were then administered at that signal-to-noise ratio in quasi-random order. In Experiment 2, sound source localization accuracy was assessed for three signal types using a 13-loudspeaker array over a 180° arc. The dependent measure was root-mean-score error.
RESULTS: Both the natural and adaptive microphone settings significantly improved speech understanding in the two noise environments. The magnitude of the improvement varied between 16 and 19 percentage points for tests conducted in the restaurant environment and between 19 and 36 percentage points for tests conducted in the cocktail party environment. In the restaurant and cocktail party environments, both the natural and adaptive settings, when implemented on a single CI, allowed scores that were as good as, or better, than scores in the bilateral omni test condition. Sound source localization accuracy was unaltered by either the natural or adaptive settings for LP, HP, or wideband noise stimuli.
CONCLUSION: The data support the use of the natural microphone setting as a default setting. The natural setting (1) provides better speech understanding in noise than the omni setting, (2) does not impair sound source localization, and (3) retains low-frequency sensitivity to signals from the rear. Moreover, bilateral CIs equipped with adaptive beamforming technology can engender speech understanding scores in noise that fall only a little short of scores for a single CI in quiet.
PMID: 29488870 [PubMed - in process]
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Tinnitus and Self-Harm Revisited.
Tinnitus and Self-Harm Revisited.
J Am Acad Audiol. 2018 Mar;29(3):196
Authors: Jacobson GP
PMID: 29488869 [PubMed - in process]
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