An Argument for Self-Report as a Reference Standard in Audiology

Vermiglio, Andrew J.; Soli, Sigfrid D.; Fang, Xiangming

doi:10.3766/jaaa.16128

Cited by 34 publications

(31 citation statements)

References 78 publications

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“…Using self-reported hearing loss as a single hearing screen question or a questionnaire on hearing functioning have both been proposed as valid screening methods. 3 , 11 , 12 , 14 - 18 The Hearing Handicap Inventory for the Elderly–Shortened (HHIE-S), for example, is a screening questionnaire consisting of ten questions evaluating the perceived social situational and emotional effects of hearing loss in the elderly. 16 Although the HHIE-S was standardized for individuals older than 65 years, Nondahl et al 16 found that it demonstrated lower sensitivity and accuracy in older individuals (65-92 years) compared with younger individuals (48-64 years).…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Hearing Loss and Pure Tone Audiometry for Screening in Primary Health Care Clinics

Louw

Swanepoel

Eikelboom

2018

J Prim Care Community Health

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Objective: To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. Design: Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. Results: Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. Conclusion: While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.

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Section: Introductionmentioning

confidence: 99%

Self-Reported Hearing Loss and Pure Tone Audiometry for Screening in Primary Health Care Clinics

Louw

Swanepoel

Eikelboom

2018

J Prim Care Community Health

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“…The authors stated that tests designed to evaluate auditory function in quiet would not provide an accurate measure of the ability to hear speech in everyday noisy environments. This has been demonstrated in multiple studies where individuals with normal pure-tone thresholds have reported speech perception difficulties in the presence of noise (King, 1954;Saunders and Haggard, 1989;Vermiglio, Soli, et al, 2017).…”

Section: Introductionmentioning

confidence: 75%

“…A review of the literature has shown that SRN evaluations reveal information about listening ability in daily listening environments unavailable from puretone thresholds (King, 1954;Saunders and Haggard, 1989;Vermiglio, Soli, et al, 2017). Unfortunately, SRN evaluations are not commonly used in the clinic (ASHA, 2015;Mueller, 2016).…”

Section: Purposementioning

confidence: 99%

“…Regardless of the reasoning behind the development of a test protocol and materials, the ultimate test of a SRN protocol should be its ability to detect the presence and absence of a target disorder. The disorder could be an SRN disorder (Middelweerd et al, 1990;Vermiglio, Soli, et al, 2017), elevated pure-tone thresholds (Wilson, McArdle, et al, 2007), a lesion of the central auditory nervous system (Sinha, 1959;Richburg et al, 2017), or perhaps auditory neuropathy (Berlin, 2012). Clinicians and researchers should know the diagnostic accuracy of the available SRN protocols.…”

Section: Implications For Clinical Work and Researchmentioning

confidence: 99%

“…A diagnostic accuracy study requires the procurement of a reasonable reference standard test for the independent verification of the target disorder (Bossuyt et al, 2003). For example, Vermiglio, Soli, et al (2017) have argued that self-report is a reasonable reference standard for a SRN disorder. Previous investigators have used self-report as a reference standard to delineate between the presence and absence of various target disorders such as tinnitus (Schaette and McAlpine, 2011), pain (Stilma et al, 2015), hearing loss (Beasley, 1940;Steinberg et al, 1940), and an SRN disorder (Saunders and Haggard, 1989;Middelweerd et al, 1990;Zhao and Stephens, 2006).…”

Section: Implications For Clinical Work and Researchmentioning

confidence: 99%

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Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

et al. 2019

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Speech recognition in noise (SRN) evaluations reveal information about listening ability that is unavailable from pure-tone thresholds. Unfortunately, SRN evaluations are not commonly used in the clinic. A lack of standardization may be an explanation for the lack of widespread acceptance of SRN testing. Arguments have been made for the utilization of steady-state speech-shaped noise vs. multi-talker babble. Previous investigations into the effect of masker type have used a monaural presentation of the stimuli. However, results of monaural SRN tests cannot be generalized to binaural listening conditions.The purpose of this study was to investigate the effect of masker type on SRN thresholds under binaural listening conditions.The Hearing in Noise Test (HINT) protocol was selected in order to measure SRN thresholds in steady-state speech-shaped noise (HINT noise) and four-talker babble with and without the spatial separation of the target speech and masker stimuli.Fifty native speakers of English with normal pure-tone thresholds (≤ 25 dB HL, 250–4000 Hz) participated in the study. The mean age was 20.5 years (SD 1.01).All participants were tested using the standard protocol for the HINT in a simulated soundfield environment under TDH-50P headphones. Thresholds were measured for the Noise Front, Noise Left, and Noise Right listening conditions with HINT noise and four-talker babble. The HINT composite score was determined for each noise condition. The spatial advantage was calculated from the HINT thresholds. Pure-tone threshold data were collected using the modified Hughson-Westlake procedure. Statistical analyses include descriptive statistics, effect size, correlations, and repeated measures ANOVA followed by matched-pairs t-tests.Repeated measures ANOVA was conducted to investigate the effects of masker type and noise location on HINT thresholds. Both main effects and their interaction were statistically significant (p < 0.01). No significant differences were found between masker conditions for the Noise Front thresholds. However, for the Noise Side conditions the four-talker babble thresholds were significantly better than the HINT noise thresholds. Overall, greater spatial advantage was found for the four-talker babble as opposed to the HINT noise conditions (p < 0.01). Pearson correlation analysis revealed no significant relationships between four-talker babble and HINT noise speech recognition performances for the Noise Front, Noise Right conditions, and the spatial advantage measures. Significant relationships (p < 0.05) were found between masking noise performances for the Noise Left condition and the Noise Composite scores.One cannot assume that a patient who performs within normal limits on a speech in four-talker babble test will also perform within normal limits on a speech in steady-state speech-shaped noise test, and vice-versa. Additionally, performances for the Noise Front condition cannot be used to predict performances for the Noise Side conditions. The utilization of both HINT noise and four-talker babble maskers, with and without the spatial separation of the stimuli, may be useful when determining the range of speech recognition in noise abilities found in everyday listening conditions.

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Association of Polygenic Risk Scores for Hearing Difficulty in Older Adults With Hearing Loss in Mid-Childhood and Midlife

Wang

Lange

Sung

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceAlthough more than 200 genes have been associated with monogenic congenital hearing loss, the polygenic contribution to hearing decline across the life course remains largely unknown.ObjectiveTo examine the association of polygenic risk scores (PRSs) for self-reported hearing difficulty among adults (40-69 years) with measured hearing and speech reception abilities in mid-childhood and early midlife.Design, Setting, and ParticipantsThis was a population-based cross-sectional study nested within the Longitudinal Study of Australian Children that included 1608 children and 1642 adults. Pure tone audiometry, speech reception threshold against noise, and genetic data were evaluated. Linear and logistic regressions of PRSs were conducted for hearing outcomes. Study analysis was performed from March 1 to 31, 2022.Main Outcomes and MeasuresGenotypes were generated from saliva or blood using global single-nucleotide polymorphisms array and PRSs derived from published genome-wide association studies of self-reported hearing difficulty (PRS1) and hearing aid use (PRS2). Hearing outcomes were continuous using the high Fletcher index (mean hearing threshold, 1, 2, and 4 kHz) and speech reception threshold (SRT); and dichotomized for bilateral hearing loss of more than 15 dB HL and abnormal SRT.ResultsIncluded in the study were 1608 children (mean [SD] age, 11.5 [0.5] years; 812 [50.5%] male children; 1365 [84.9%] European and 243[15.1%] non-European) and 1642 adults (mean [SD] age, 43.7 [5.1] years; 1442 [87.8%] female adults; 1430 [87.1%] European and 212 [12.9%] non-European individuals). In adults, both PRS1 and PRS2 were associated with hearing thresholds. For each SD increment in PRS1 and PRS2, hearing thresholds were 0.4 (95% CI, 0-0.8) decibel hearing level (dB HL) and 0.9 (95% CI, 0.5-1.2) dB HL higher on the high Fletcher index, respectively. Each SD increment in PRS increased the odds of adult hearing loss of more than 15 dB HL by 10% to 30% (OR for PRS1, 1.1; 95% CI, 1.0-1.3; OR for PRS2, 1.3; 95% CI, 1.1-1.5). Similar but attenuated patterns were noted in children (OR for PRS1, 1.1; 95% CI, 0.8-1.2; OR for PRS2, 1.2; 95% CI, 1.0-1.5). Both PRSs showed minimal evidence of associations with speech reception thresholds or abnormal SRT in children or adults.Conclusions and RelevanceThis population-based cross-sectional study of PRSs for self-reported hearing difficulty among adults found an association with hearing ability in mid-childhood. This adds to the evidence that age-related hearing loss begins as early as the first decade of life and that polygenic inheritance may play a role together with other environmental risk factors.

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An Argument for Self-Report as a Reference Standard in Audiology

Cited by 34 publications

References 78 publications

Self-Reported Hearing Loss and Pure Tone Audiometry for Screening in Primary Health Care Clinics

Self-Reported Hearing Loss and Pure Tone Audiometry for Screening in Primary Health Care Clinics

Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

Association of Polygenic Risk Scores for Hearing Difficulty in Older Adults With Hearing Loss in Mid-Childhood and Midlife

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