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Phillips I, Bieber RE, Dirks C, Grant KW, Brungart DS. Age Impacts Speech-in-Noise Recognition Differently for Nonnative and Native Listeners. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1602-1623. [PMID: 38569080 DOI: 10.1044/2024_jslhr-23-00470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
PURPOSE The purpose of this study was to explore potential differences in suprathreshold auditory function among native and nonnative speakers of English as a function of age. METHOD Retrospective analyses were performed on three large data sets containing suprathreshold auditory tests completed by 5,572 participants who were self-identified native and nonnative speakers of English between the ages of 18-65 years, including a binaural tone detection test, a digit identification test, and a sentence recognition test. RESULTS The analyses show a significant interaction between increasing age and participant group on tests involving speech-based stimuli (digit strings, sentences) but not on the binaural tone detection test. For both speech tests, differences in speech recognition emerged between groups during early adulthood, and increasing age had a more negative impact on word recognition for nonnative compared to native participants. Age-related declines in performance were 2.9 times faster for digit strings and 3.3 times faster for sentences for nonnative participants compared to native participants. CONCLUSIONS This set of analyses extends the existing literature by examining interactions between aging and self-identified native English speaker status in several auditory domains in a cohort of adults spanning young adulthood through middle age. The finding that older nonnative English speakers in this age cohort may have greater-than-expected deficits on speech-in-noise perception may have clinical implications on how these individuals should be diagnosed and treated for hearing difficulties.
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Affiliation(s)
- Ian Phillips
- Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Rebecca E Bieber
- Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD
| | - Coral Dirks
- Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Ken W Grant
- Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Douglas S Brungart
- Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
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Chee J, Eikelboom RH, Smits C, Swanepoel DW, Wee SL, Ng TP, Heywood RL. Digits in noise testing in a multilingual sample of Asian adults. Int J Audiol 2024; 63:269-274. [PMID: 36847757 DOI: 10.1080/14992027.2023.2179549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE Appropriate speech-in noise assessment is challenging in multilingual populations. This study aimed to assess whether first preferred language affected performance on an English Digits-in-noise (DIN) test in the local Asian multilingual population, controlling for hearing threshold, age, sex, English fluency and educational status. A secondary aim was to determine the association between DIN test scores and hearing thresholds. DESIGN English digit-triplets in noise testing and pure-tone audiometry were conducted. Multiple regression analysis was performed with DIN scores and hearing thresholds as dependent variables. Correlation analysis was performed between DIN-SRT and hearing thresholds. STUDY SAMPLE 165 subjects from the Singapore Longitudinal Ageing Study, a population-based longitudinal study of community-dwellers over 55 years of age. RESULTS Mean DIN speech reception threshold (DIN-SRT) was -5.7 dB SNR (SD 3.6; range 6.7 to -11.2). Better ear pure tone average and English fluency were significantly associated with DIN-SRT. CONCLUSIONS DIN performance was independent of first preferred language in a multilingual ageing Singaporean population after adjusting for age, gender and education. Those with poorer English fluency had a significantly lower DIN-SRT score. The DIN test has the potential to provide a quick, uniform method of testing speech in noise in this multilingual population.
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Affiliation(s)
- Jeremy Chee
- Department of Otolaryngology - Head and Neck Surgery, National University Hospital, Singapore
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Curtin Medical School, Curtin University, Bentley, Australia
| | - Cas Smits
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - De Wet Swanepoel
- Ear Science Institute Australia, Subiaco, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Tze Pin Ng
- Geriatric Education and Research Institute, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Rebecca L Heywood
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia
- Department of Otolaryngology, Ng Teng Fong General Hospital, Singapore
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Jansen LA, van Wier MF, Vernimmen FPJ, Goderie T, van de Berg R, Lemke U, Lissenberg-Witte BI, Kramer SE. Ten-year association between change in speech-in-noise recognition and falls due to balance problems: a longitudinal cohort study. BMC Public Health 2024; 24:732. [PMID: 38454406 PMCID: PMC10919036 DOI: 10.1186/s12889-024-18187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study examined the relationship between speech-in-noise recognition and incident/recurrent falls due to balance problems ten years later (RQ-1); 10-year change in speech-in-noise recognition and falls (RQ-2a), as well as the role of dizziness in this relationship (RQ-2b). The association between hearing aid use and falls was also examined (RQ-3). METHODS Data was collected from the Netherlands Longitudinal Study on Hearing between 2006 and December 2022. Participants completed an online survey and digits-in-noise test every five years. For this study, data was divided into two 10-year follow-up time intervals: T0 (baseline) to T2 (10-year follow-up), and T1 (5-years) to T3 (15-years). For all RQs, participants aged ≥ 40 years at baseline, without congenital hearing loss, and non-CI users were eligible (n = 592). Additionally, for RQ-3 participants with a speech reception threshold in noise (SRTn) ≥ -5.5 dB signal-to-noise ratio were included (n = 422). Analyses used survey variables on hearing, dizziness, falls due to balance problems, chronic health conditions, and psychosocial health. Logistic regressions using General Estimating Equations were conducted to assess all RQs. RESULTS Among individuals with obesity, those with poor baseline SRTn had a higher odds of incident falls ten years later (odds ratio (OR):14.7, 95% confidence interval (CI) [2.12, 103]). A 10-year worsening of SRTn was significantly associated with a higher odds of recurrent (OR: 2.20, 95% CI [1.03, 4.71]) but not incident falls. No interaction was found between dizziness and change in SRTn. Hearing aid use (no use/ < 2 years use vs. ≥ 2 years) was not significantly associated with incident nor recurrent falls. Although there was a significant interaction with sex for this association, the effect of hearing aid use on incident/recurrent falls was not statistically significant among males nor females. CONCLUSIONS A longitudinal association between the deterioration in SRTn and recurrent falls due to balance problems after 10 years was confirmed in this study. This result stresses the importance of identifying declines in hearing earlier and justifies including hearing ability assessments within fall risk prevention programs. Mixed results of hearing aid use on fall risk warrant further investigation into the temporality of this association and possible differences between men and women.
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Affiliation(s)
- Lotte A Jansen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Marieke F van Wier
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Freek P J Vernimmen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Thadé Goderie
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands
| | - Ulrike Lemke
- Research & Development, Sonova AG, Staefa, Switzerland
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Yang TH, Chen YF, Cheng YF, Huang JN, Wu CS, Chu YC. Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S. BioData Min 2023; 16:35. [PMID: 38098102 PMCID: PMC10722728 DOI: 10.1186/s13040-023-00351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVES The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults. METHODS We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model-which had the greatest AUC of 0.83 (95% CI 0.81-0.85)-was then only used on the holdout testing data. RESULTS On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79-0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques-specifically, the LGBM classifier-with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects. CONCLUSIONS Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.
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Affiliation(s)
- Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan
- General Education Center, University of Taipei, Taipei, 10671, Taiwan
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Fu Chen
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
| | - Yen-Fu Cheng
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Jue-Ni Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Chuan-Song Wu
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan.
- College of Science and Engineering, Fu Jen University, Taipei, 243, Taiwan.
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Big Data Center, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan.
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Ferguson MA, Eikelboom RH, Sucher CM, Maidment DW, Bennett RJ. Remote Technologies to Enhance Service Delivery for Adults: Clinical Research Perspectives. Semin Hear 2023; 44:328-350. [PMID: 37484990 PMCID: PMC10361795 DOI: 10.1055/s-0043-1769742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
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Affiliation(s)
- Melanie A. Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M. Sucher
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca J. Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
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Zadeh LM, Brennan V, Swanepoel DW, Lin L, Moore DR. Remote self-report and speech-in-noise measures predict clinical audiometric thresholds. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2022.05.09.22274843. [PMID: 35821983 PMCID: PMC9275664 DOI: 10.1101/2022.05.09.22274843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Developments in smartphone technology and the COVID-19 pandemic have highlighted the feasibility and need for remote, but reliable hearing tests. Previous studies used remote testing but did not directly compare results in the same listeners with standard lab or clinic testing. This study investigated reliability of remote, self-administered digits-in-noise (remote-DIN) compared with lab-based, supervised (lab-DIN) testing. Predictive validity was further examined in relation to a commonly used self-report, Speech, Spatial, and Qualities of Hearing (SSQ-12), and lab-based, pure tone audiometry. DIN speech reception thresholds (SRTs) of adults (18-64 y/o) with normal-hearing (NH, N=16) and hearing loss (HL, N=18), were measured using English-language digits (0-9), binaurally presented as triplets in one of four speech-shaped noise maskers (broadband, low-pass filtered at 2, 4, 8 kHz) and two digit phases (diotic, antiphasic). High, significant intraclass correlation coefficients indicated strong internal consistency of remote-DIN SRTs, which also correlated significantly with lab-DIN SRTs. There was no significant mean difference between remote- and lab-DIN on any tests. NH listeners had significantly higher SSQ scores, and remote- and lab-DIN SRTs than listeners with HL. All versions of remote-DIN SRTs correlated significantly with pure-tone-average (PTA), with the 2-kHz filtered test the best predictor, explaining 50% of variance in PTA. SSQ total score also significantly and independently predicted PTA (17% of variance) and all test versions of the remote-DIN, except the antiphasic BB test. This study shows that remote SSQ-12 and remote-DIN are sensitive tools for capturing important aspects of auditory function.
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Affiliation(s)
- Lina Motlagh Zadeh
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - Veronica Brennan
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield 0028, SA
| | - Li Lin
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - David R. Moore
- Communication Sciences Research Center, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
- Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester M13 9PL, UK
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Sanchez VA, Arnold ML, Moore DR, Clavier O, Abrams HB. Speech-in-noise testing: Innovative applications for pediatric patients, underrepresented populations, fitness for duty, clinical trials, and remote services. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2336. [PMID: 36319253 PMCID: PMC9722269 DOI: 10.1121/10.0014418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/24/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
Speech perception testing, defined as providing standardized speech stimuli and requiring a listener to provide a behavioral and scored response, has been an integral part of the audiologic test battery since the beginning of the audiology profession. Over the past several decades, limitations in the diagnostic and prognostic validity of standard speech perception testing as routinely administered in the clinic have been noted, and the promotion of speech-in-noise testing has been highlighted. This review will summarize emerging and innovative approaches to speech-in-noise testing with a focus on five applications: (1) pediatric considerations promoting the measurement of sensory and cognitive components separately; (2) appropriately serving underrepresented populations with special attention to racial, ethnic, and linguistic minorities, as well as considering biological sex and/or gender differences as variables of interest; (3) binaural fitness for duty assessments of functional hearing for occupational settings that demand the ability to detect, recognize, and localize sounds; (4) utilization of speech-in-noise tests in pharmacotherapeutic clinical trials with considerations to the drug mechanistic action, the patient populations, and the study design; and (5) online and mobile applications of hearing assessment that increase accessibility and the direct-to-consumer market.
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Affiliation(s)
- Victoria A Sanchez
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC 73, Tampa, Florida 33612, USA
| | - Michelle L Arnold
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida 33612, USA
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, Ohio 45229, USA
| | | | - Harvey B Abrams
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida 33612, USA
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Hisagi M, Baker M, Alvarado E, Shafiro V. Online Assessment of Speech Perception and Auditory Spectrotemporal Processing in Spanish-English Bilinguals. Am J Audiol 2022; 31:936-949. [PMID: 35537127 DOI: 10.1044/2022_aja-21-00225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE There is limited access to audiology services for the growing population of Spanish-English bilinguals in the United States. Online auditory testing can potentially provide a cost-effective alternative to in-person visits. However, even for bilinguals with high English proficiency, age of English acquisition may affect speech perception accuracy. This study used a comprehensive test battery to assess speech perception and spectrotemporal processing abilities in Spanish-English bilinguals and to evaluate susceptibility of different tests to effects of native language. METHOD The online battery comprised three tests of speech in quiet (vowel and consonant identification and words in sentences), four tests of speech perception in noise (two for intelligibility and two for comprehension), and three tests of spectrotemporal processing (two tests of stochastically modulated pattern discrimination and one test of spectral resolution). Participants were 28 adult Spanish-English bilinguals whose English acquisition began either early (≤ 6 years old) or late (≥ 7 years old) and 18 English monolingual speakers. RESULTS Significant differences were found in six of the 10 tests. The differences were most pronounced for vowel perception in quiet, speech-in-noise test, and two tests of speech comprehension in noise. Late bilinguals consistently scored lower than native English speakers or early bilinguals. In contrast, no differences between groups were observed for digits-in-noise or three tests of spectrotemporal processing abilities. CONCLUSION The findings suggest initial feasibility of online assessment in this population and can inform selection of tests for auditory assessment of Spanish-English bilinguals.
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Affiliation(s)
- Miwako Hisagi
- Department of Communication Disorders, California State University, Los Angeles
| | - Melissa Baker
- Long Island Doctor of Audiology Consortium, Hofstra University, Hempstead, NY
| | - Elizabeth Alvarado
- Department of Communication Disorders, California State University, Los Angeles
| | - Valeriy Shafiro
- Department of Communication Disorders and Sciences, Rush University Medical Center, Chicago, IL
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Bent T, Baese-Berk M, Ryherd E, Perry S. Intelligibility of medically related sentences in quiet, speech-shaped noise, and hospital noise. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 151:3496. [PMID: 35649935 DOI: 10.1121/10.0011394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Noise in healthcare settings, such as hospitals, often exceeds levels recommended by health organizations. Although researchers and medical professionals have raised concerns about the effect of these noise levels on spoken communication, objective measures of behavioral intelligibility in hospital noise are lacking. Further, no studies of intelligibility in hospital noise used medically relevant terminology, which may differentially impact intelligibility compared to standard terminology in speech perception research and is essential for ensuring ecological validity. Here, intelligibility was measured using online testing for 69 young adult listeners in three listening conditions (i.e., quiet, speech-shaped noise, and hospital noise: 23 listeners per condition) for four sentence types. Three sentence types included medical terminology with varied lexical frequency and familiarity characteristics. A final sentence set included non-medically related sentences. Results showed that intelligibility was negatively impacted by both noise types with no significant difference between the hospital and speech-shaped noise. Medically related sentences were not less intelligible overall, but word recognition accuracy was significantly positively correlated with both lexical frequency and familiarity. These results support the need for continued research on how noise levels in healthcare settings in concert with less familiar medical terminology impact communications and ultimately health outcomes.
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Affiliation(s)
- Tessa Bent
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana 47408, USA
| | - Melissa Baese-Berk
- Department of Linguistics, University of Oregon, Eugene, Oregon 97403-1290, USA
| | - Erica Ryherd
- Durham School of Architectural Engineering and Construction, University of Nebraska-Lincoln, Omaha, Nebraska 68182-0816, USA
| | - Sydney Perry
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana 47408, USA
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Diagnostic Validity of Self-Reported Hearing Loss in Elderly Taiwanese Individuals: Diagnostic Performance of a Hearing Self-Assessment Questionnaire on Audiometry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413215. [PMID: 34948824 PMCID: PMC8707226 DOI: 10.3390/ijerph182413215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022]
Abstract
Key Points: Question: Can the traditional Chinese version of the hearing handicap inventory for elderly screening (HHIE-S) checklist screen for age-related hearing loss (ARHL) in elderly individuals? Findings: In this cross-sectional study of 1696 Taiwanese patients who underwent annual government-funded geriatric health checkups, the Chinese version of the HHIE-S had a sensitivity of 76.9% and a specificity of 79.8% with a cutoff score greater than 6 for identifying patients with disabled hearing loss (defined as a PTA > 40 dB). Meaning: The traditional Chinese version of the HHIE-S is an effective test to detect ARHL and can improve the feasibility of large-scale hearing screening among elderly individuals. Purpose: The traditional Chinese version of the hearing handicap inventory for elderly screening (TC-HHIE-S) was translated from English and is intended for use with people whose native language is traditional Chinese, but its effectiveness and diagnostic performance are still unclear. The purpose of this study was to evaluate the validity and reliability of the traditional Chinese version of the HHIE-S for screening for age-related hearing loss (ARHL). Methods: A total of 1696 elderly people underwent the government’s annual geriatric medical examination at community hospitals. In this cross-sectional study, we recorded average conducted pure-tone averages (PTA) (0.5 kHz, 1 kHz, 2 kHz, 4 kHz), age, sex, and HHIE-S data. Receiver operating characteristic (ROC) curve analysis was used to identify the best critical point for detecting hearing impairment, and the validity of the structure was verified by the agreement between the TC-HHIE-S and PTA results. Results: The HHIE-S scores were correlated with the better-ear pure-tone threshold averages (PTAs) at 0.5–4 kHz (correlation coefficient r = 0.45). The internal consistency of the total HHIE-S score was excellent (Cronbach’s alpha = 0.901), and the test-retest reliability was also excellent (Spearman’s correlation coefficient = 0.60, intraclass correlation coefficient = 0.75). In detecting disabled hearing loss (i.e., PTA at 0.5–4 kHz > 40 dB), the HHIE-S cutoff score of > 6 had a sensitivity of 76.9% and a specificity of 79.8%. Conclusions: The traditional Chinese version of the HHIE-S is a valid, reliable, and efficient tool for large-scale screening for ARHL.
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Frank A, Goldlist S, Mark Fraser AE, Bromwich M. Validation of SHOEBOX QuickTest Hearing Loss Screening Tool in Individuals With Cognitive Impairment. Front Digit Health 2021; 3:724997. [PMID: 34713195 PMCID: PMC8521917 DOI: 10.3389/fdgth.2021.724997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The aim of this study was to validate a novel iPad-based rapid hearing loss screening tool (SHOEBOX QuickTest) in individuals with cognitive impairment. Design: Cross-sectional validation study. Setting: Bruyère Research Institute, Ottawa, Canada. Subjects and Methods: Twenty-five individuals with mild cognitive impairment (MCI) and mild dementia from the Bruyère Memory Program were included in this study. The study consisted of two components: (1) SHOEBOX QuickTest hearing screener and (2) a conventional hearing test (pure tone audiometry). Measurements: Hearing was assessed at 1,000, 2,000, and 4,000 Hz separately for each ear. The agreement between hearing ability groupings (good vs. reduced) from conventional hearing test and SHOEBOX QuickTest was determined. Specifically, accuracy, sensitivity, specificity, as well as alignment between conventional thresholds and hearing threshold ranges. Results: An overall accuracy of 84% was observed for SHOEBOX QuickTest, and a sensitivity and specificity of 100 and 66.7%, respectively. 72% ([95% CI], 60.0–84.1%) of conventional audiometry thresholds were within the pre-established 10 dB SHOEBOX QuickTest. Conclusion: SHOEBOX QuickTest is a valid hearing loss screening tool for individuals with cognitive impairment. Implementing this iPad-based screening tool in memory clinics could not only aid in the timely diagnosis of hearing loss, but also assist physicians in providing a better assessment of cognitive impairment by ruling out hearing loss as a confounding variable.
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Affiliation(s)
| | | | | | - Matthew Bromwich
- SHOEBOX Ltd, Ottawa, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, CHEO, Ottawa, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada
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12
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Digital Technology for Remote Hearing Assessment—Current Status and Future Directions for Consumers. SUSTAINABILITY 2021. [DOI: 10.3390/su131810124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Globally, more than 1.5 billion people have hearing loss. Unfortunately, most people with hearing loss reside in low- and middle-income countries (LMICs) where traditional face-to-face services rendered by trained health professionals are few and unequally dispersed. The COVID-19 pandemic has further hampered the effectiveness of traditional service delivery models to provide hearing care. Digital health technologies are strong enablers of hearing care and can support health delivery models that are more sustainable. The convergence of advancing technology and mobile connectivity is enabling new ways of providing decentralized hearing services. Recently, an abundance of digital applications that offer hearing tests directly to the public has become available. A growing body of evidence has shown the ability of several approaches to provide accurate, accessible, and remote hearing assessment to consumers. Further effort is needed to promote greater accuracy across a variety of test platforms, improve sensitivity to ear disease, and scale up hearing rehabilitation, especially in LMICs.
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13
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Folmer RL, Saunders GH, Vachhani JJ, Margolis RH, Saly G, Yueh B, McArdle RA, Feth LL, Roup CM, Feeney MP. Hearing Health Care Utilization Following Automated Hearing Screening. J Am Acad Audiol 2021; 32:235-245. [PMID: 34062603 DOI: 10.1055/s-0041-1723041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The study examined follow-up rates for pursuing hearing health care (HHC) 6 to 8 months after participants self-administered one of three hearing screening methods: an automated method for testing of auditory sensitivity (AMTAS), a four-frequency pure-tone screener (FFS), or a digits-in-noise test (DIN), with and without the presentation of a 2-minute educational video about hearing. PURPOSE The study aims to determine if the type of self-administered hearing screening method (with or without an educational video) affects HHC follow-up rates. RESEARCH DESIGN The study is a randomized controlled trial of three automated hearing screening methods, plus control group, with and without an educational video. The control group completed questionnaires and provided follow-up data but did not undergo a hearing screening test. STUDY SAMPLE The study sample includes 1,665 participants (mean age 50.8 years; 935 males) at two VA Medical Centers and at university and community centers in Portland, OR; Bay Pines, FL; Minneapolis, MN; Mauston, WI; and Columbus, OH. DATA COLLECTION AND ANALYSIS HHC follow-up data at 6 to 8 months were obtained by contacting participants by phone or mail. Screening methods and participant characteristics were compared in relation to the probability of participants pursuing HHC during the follow-up period. RESULTS The 2-minute educational video did not have a significant effect on HHC follow-up rates. When all participants who provided follow-up data are considered (n = 1012), the FFS was the only test that resulted in a significantly greater percentage of HHC follow-up (24.6%) compared with the control group (16.8%); p = 0.03. However, for participants who failed a hearing screening (n = 467), follow-up results for all screening methods were significantly greater than for controls. The FFS resulted in a greater probability for HHC follow-up overall than the other two screening methods. Moreover, veterans had higher follow-up rates for all screening methods than non-veterans. CONCLUSION The FFS resulted in a greater HHC follow-up rate compared with the other screening methods. This self-administered test may be more motivational for HHC follow-up because participants who fail the screening are aware of sounds they could not hear which does not occur with adaptive assessments like AMTAS or the DIN test. It is likely that access to and reduced personal cost of audiological services for veterans contributed to higher HHC follow-up rates in this group compared with non-veteran participants.
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Affiliation(s)
- Robert L Folmer
- VA National Center for Rehabilitative Auditory Research, VA Portland Medical Center, Portland, Oregon.,Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
| | - Gabrielle H Saunders
- VA National Center for Rehabilitative Auditory Research, VA Portland Medical Center, Portland, Oregon.,Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Jay J Vachhani
- VA National Center for Rehabilitative Auditory Research, VA Portland Medical Center, Portland, Oregon
| | | | - George Saly
- Audiology Incorporated, Arden Hills, Minnesota
| | - Bevan Yueh
- Department of Otolaryngology/Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Rachel A McArdle
- Office of Patient Care Services, Veterans Health Administration, Washington, DC
| | - Lawrence L Feth
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio
| | - Christina M Roup
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio
| | - M Patrick Feeney
- VA National Center for Rehabilitative Auditory Research, VA Portland Medical Center, Portland, Oregon.,Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon
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14
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Van den Borre E, Denys S, van Wieringen A, Wouters J. The digit triplet test: a scoping review. Int J Audiol 2021; 60:946-963. [PMID: 33840339 DOI: 10.1080/14992027.2021.1902579] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This review article presents an overview of all Digit Triplet Tests (DTT) and digits-in-noise tests (DIN) and their variations in language, speech material, masking noise, test procedures, and targeted population. The effects on aspects of validity, reliability, and feasibility are investigated. DESIGN Scoping review. STUDY SAMPLE All studies referring to the DTT and DIN were collected from Pubmed and Embase. Search terms "digit triplet test" and "digits in noise" were used. Citations of selected articles were scanned backwards in time (the bibliography of the already selected research article) and forward in time (articles that cited the already selected research article). The search terms yielded 95 results in total. Eventually, 39 papers were selected. RESULTS Analyses showed psychometric reference-curves with steep slopes and speech reception thresholds with high measurement precision which are strongly associated with pure tone audiometry. High sensitivity and specificity to detect elevated pure tone thresholds were noted for test variants. Certain procedural modifications of the DTT and DIN can further improve the test. Additionally, large-scale application of the DTT and DIN is feasible. CONCLUSION The DTT and DIN are a very valuable tool for screening and diagnostics for a wide variety of populations.
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Affiliation(s)
- Elien Van den Borre
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
| | - Sam Denys
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
| | | | - Jan Wouters
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
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15
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Ooster J, Krueger M, Bach JH, Wagener KC, Kollmeier B, Meyer BT. Speech Audiometry at Home: Automated Listening Tests via Smart Speakers With Normal-Hearing and Hearing-Impaired Listeners. Trends Hear 2020; 24:2331216520970011. [PMID: 33272109 PMCID: PMC7720343 DOI: 10.1177/2331216520970011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Speech audiometry in noise based on sentence tests is an important diagnostic tool to assess listeners’ speech recognition threshold (SRT), i.e., the signal-to-noise ratio corresponding to 50% intelligibility. The clinical standard measurement procedure requires a professional experimenter to record and evaluate the response (expert-conducted speech audiometry). The use of automatic speech recognition enables self-conducted measurements with an easy-to-use speech-based interface. This article compares self-conducted SRT measurements using smart speakers with expert-conducted laboratory measurements. With smart speakers, there is no control over the absolute presentation level, potential errors from the automated response logging, and room acoustics. We investigate the differences between highly controlled measurements in the laboratory and smart speaker-based tests for young normal-hearing (NH) listeners as well as for elderly NH, mildly and moderately hearing-impaired listeners in low, medium, and highly reverberant room acoustics. For the smart speaker setup, we observe an overall bias in the SRT result that depends on the hearing loss. The bias ranges from +0.7 dB for elderly moderately hearing-impaired listeners to +2.2 dB for young NH listeners. The intrasubject standard deviation is close to the clinical standard deviation (0.57/0.69 dB for the young/elderly NH compared with 0.5 dB observed for clinical tests and 0.93/1.09 dB for the mild/moderate hearing-impaired listeners compared with 0.9 dB). For detecting a clinically elevated SRT, the speech-based test achieves an area under the curve value of 0.95 and therefore seems promising for complementing clinical measurements.
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Affiliation(s)
- Jasper Ooster
- Communication Acoustics, Carl von Ossietzky Universität, Oldenburg, Germany.,Cluster of Excellence Hearing4all, Germany
| | - Melanie Krueger
- Cluster of Excellence Hearing4all, Germany.,HörTech gGmbH, Oldenburg, Germany
| | - Jörg-Hendrik Bach
- Cluster of Excellence Hearing4all, Germany.,HörTech gGmbH, Oldenburg, Germany.,Hörzentrum GmbH, Oldenburg, Germany
| | - Kirsten C Wagener
- Cluster of Excellence Hearing4all, Germany.,HörTech gGmbH, Oldenburg, Germany.,Hörzentrum GmbH, Oldenburg, Germany
| | - Birger Kollmeier
- Cluster of Excellence Hearing4all, Germany.,HörTech gGmbH, Oldenburg, Germany.,Hörzentrum GmbH, Oldenburg, Germany.,Medizinische Physik, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Bernd T Meyer
- Communication Acoustics, Carl von Ossietzky Universität, Oldenburg, Germany.,Cluster of Excellence Hearing4all, Germany.,HörTech gGmbH, Oldenburg, Germany
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16
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Denys S, De Laat J, Dreschler W, Hofmann M, van Wieringen A, Wouters J. Language-Independent Hearing Screening Based on Masked Recognition of Ecological Sounds. Trends Hear 2020; 23:2331216519866566. [PMID: 32516059 PMCID: PMC6728675 DOI: 10.1177/2331216519866566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A language-independent automated self-test on tablet based on masked recognition
of ecological sounds, the Sound Ear Check (SEC), was developed. In this test, 24
trials of eight different sounds are randomly presented in a noise that was
spectrally shaped according to the average frequency spectra of the stimulus
sounds, using a 1-up 2-down adaptive procedure. The test was evaluated in adults
with normal hearing and hearing loss, and its feasibility was investigated in
young children, who are the target population of this test. Following
equalization of perceptual difficulty across sounds by applying level
adjustments to the individual tokens, a reference curve with a steep slope of
18%/dB was obtained, resulting in a test with a high test–retest reliability of
1 dB. The SEC sound reception threshold was significantly associated with the
averaged pure tone threshold (r = .70), as well as with the
speech reception threshold for the Digit Triplet Test
(r = .79), indicating that the SEC is susceptible to both
audibility and signal-to-noise ratio loss. Sensitivity and specificity values on
the order of magnitude of ∼70% and ∼80% to detect individuals with mild and
moderate hearing loss, respectively, and ∼80% to detect individuals with slight
speech-in-noise recognition difficulties were obtained. Homogeneity among sounds
was verified in children. Psychometric functions fitted to the data indicated a
steep slope of 16%/dB, and test–retest reliability of sound reception threshold
estimates was 1.3 dB. A reference value of −9 dB signal-to-noise ratio was
obtained. Test duration was around 6 minutes, including training and
acclimatization.
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Affiliation(s)
- Sam Denys
- KU Leuven, Department of Neurosciences, ExpORL, Leuven, Belgium
| | - Jan De Laat
- Leiden University Medical Centre, Department of Audiology, Leiden, the Netherlands
| | - Wouter Dreschler
- Academic Medical Centre, Department of ENT, Clinical and Experimental Audiology, Amsterdam, the Netherlands
| | - Michael Hofmann
- KU Leuven, Department of Neurosciences, ExpORL, Leuven, Belgium
| | | | - Jan Wouters
- KU Leuven, Department of Neurosciences, ExpORL, Leuven, Belgium
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17
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Abstract
OBJECTIVES Hearing loss is most commonly observed at high frequencies. High-frequency hearing loss (HFHL) precedes and predicts hearing loss at lower frequencies. It was previously shown that an automated, self-administered digits-in-noise (DIN) test can be sensitized for detection of HFHL by low-pass filtering the speech-shaped masking noise at 1.5 kHz. This study was designed to investigate whether sensitivity of the DIN to HFHL can be enhanced further using low-pass noise filters with higher cutoff frequencies. DESIGN The US-English digits 0 to 9, homogenized for audibility, were binaurally presented in different noise maskers including one broadband and three low-pass (cutoff at 2, 4, and 8 kHz) filtered speech-shaped noises. DIN-speech reception thresholds (SRTs) were obtained from 60 normal hearing (NH), and 40 mildly hearing impaired listeners with bilateral symmetric sensorineural hearing loss. Standard and extended high-frequency audiometric pure-tone averages (PTAs) were compared with the DIN-SRTs. RESULTS Narrower masking noise bandwidth generally produced better (more sensitive) mean DIN-SRTs. There were strong and significant correlations between SRT and PTA in the hearing impaired group. Lower frequency PTALF 0.5,1, 2, 4 kHz had the highest correlation and the steepest slope with SRTs obtained from the 2-kHz filter. Higher frequency PTAHF 4,8,10,12.5 kHz correlated best with SRTs obtained from 4- and 8-kHz filtered noise. The 4-kHz low-pass filter also had the highest sensitivity (92%) and equally highest (with the 8-kHz filter) specificity (90%) for detecting an average PTAHF of 20 dB or more. CONCLUSIONS Of the filters used, DIN sensitivity to higher frequency hearing loss was greatest using the 4-kHz low-pass filter. These results suggest that low-pass filtered noise may be usefully substituted for broadband noise to improve earlier detection of HFHL using DIN.
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18
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Motlagh Zadeh L, Silbert NH, Sternasty K, Moore DR. Development and validation of a digits-in-noise hearing test in Persian. Int J Audiol 2020; 60:202-209. [PMID: 32903129 DOI: 10.1080/14992027.2020.1814969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The prevalence of unrecognised and late-diagnosed hearing loss is higher in low- and middle-income than in high-income countries, due in part to lack of access to hearing services. Because hearing screening is important for early identification of hearing loss, development of an accessible, self-screening test that can detect hearing loss reliably and quickly would provide significant benefits, especially for underserved populations. This study aimed to develop and validate a new version of the digits-in-noise (DIN) test for Persian speaking countries. DESIGN Recordings of Persian digits 0-9 were binaurally presented in broadband speech-shaped noise. Using fitted speech intelligibility functions, digits were homogenised to achieve equal perceptual difficulty across stimuli. The evaluation was established by reference to existing English DIN tests. STUDY SAMPLE Thirty Persian speaking young adults with normal hearing thresholds (≤20 dB HL, 0.25-8 kHz). RESULTS Speech intelligibility functions produced a mean speech reception threshold (SRT) of -7.7 dB, corresponding closely to previously developed DIN tests. There was no significant difference between test and retest SRTs, indicating high reliability of the test. Our findings suggest that language-specific factors need to be considered for cross-language comparison of DIN-SRTs. CONCLUSION This study introduces a convenient tool for future hearing screening in Persian speaking countries with limited access to audiology services.
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Affiliation(s)
- Lina Motlagh Zadeh
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Noah H Silbert
- Department of Communication Sciences & Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Katherine Sternasty
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.,Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
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19
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Armstrong NM, Oosterloo BC, Croll PH, Ikram MA, Goedegebure A. Discrimination of degrees of auditory performance from the digits-in-noise test based on hearing status. Int J Audiol 2020; 59:897-904. [PMID: 32673129 DOI: 10.1080/14992027.2020.1787531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To discriminate among degrees of auditory performance of the Digits-in-Noise (DIN) test. DESIGN We performed Pearson's correlations and age- and sex-adjusted linear regression models to examine the correlation between pure-tone average (PTA) from pure-tone audiometric tests and speech recognition thresholds (SRT) from the DIN test. Then, optimal SRT cut-points by PTA-defined hearing status (0-25 dB HL [normal], 26-40 dB HL [mild hearing loss], 41-50 dB HL [moderate hearing loss]) were compared across three methods: Youden, Nearest, and Liu. SRT-defined categories of auditory performance were compared to PTA-defined hearing categories to examine the convergence of similar categories. Study Sample: 3422 Rotterdam Study participants aged 51-98 years between 2011 and 2014. RESULTS The correlation between SRT and PTA was 0.65 (95% Confidence Interval: 0.63, 0.67) in the overall sample. The variability of SRT explained by PTA after age and sex adjustment was 54%. Optimal cut-points for the overall sample across the three methods were: ≤ -5.55 dB SNR (normal); > -5.55 to ≤ -3.80 dB SNR (insufficient performance); > -3.80 dB SNR (poor performance). When comparing the SRT- or PTA-defined categories, 59.8% had concordant hearing categories and 40.2% had discordant hearing categories. CONCLUSIONS Discrimination of degrees of auditory performance may add greater utility of the DIN test.
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Affiliation(s)
- Nicole M Armstrong
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Berthe C Oosterloo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Pauline H Croll
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Mohammad Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
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20
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Giguère C, Lagacé J, Ellaham NN, Pichora-Fuller MK, Goy H, Bégin C, Alary É, Bowman R. Development of the Canadian Digit Triplet Test in English and French. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:EL252. [PMID: 32237800 DOI: 10.1121/10.0000825] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 02/11/2020] [Indexed: 06/11/2023]
Abstract
The Canadian Digit Triplet Test was developed in English and French, the official languages of Canada. Four versions were developed on a common software platform using recordings produced by two fluent bilinguals, one male and one female, following procedures recommended by international guidelines. Phase I of test development focused on homogenizing digit recognition across tokens and positions within the triplets for young adults with normal hearing (n = 48). In phase II, normative data were collected for young adults with normal hearing (n = 64). Statistical properties were found to be uniform across test versions and comparable to digit triplet tests in other languages.
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Affiliation(s)
- Christian Giguère
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - Josée Lagacé
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - Nicolas N Ellaham
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - M Kathleen Pichora-Fuller
- Department of Psychology, University of Toronto (Mississauga), 3359 Mississauga Road, Mississauga, Ontario L5L 1C6, , , , , , , ,
| | - Huiwen Goy
- Department of Psychology, University of Toronto (Mississauga), 3359 Mississauga Road, Mississauga, Ontario L5L 1C6, , , , , , , ,
| | - Camille Bégin
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - Émilie Alary
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
| | - Rachael Bowman
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
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21
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Denys S, Hofmann M, van Wieringen A, Wouters J. Improving the efficiency of the digit triplet test using digit scoring with variable adaptive step sizes. Int J Audiol 2019; 58:670-677. [DOI: 10.1080/14992027.2019.1622042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sam Denys
- KU Leuven, Department of Neurosciences, ExpORL, Leuven, Belgium
| | - Michael Hofmann
- KU Leuven, Department of Neurosciences, ExpORL, Leuven, Belgium
| | | | - Jan Wouters
- KU Leuven, Department of Neurosciences, ExpORL, Leuven, Belgium
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22
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De Sousa KC, Swanepoel DW, Moore DR, Smits C. A Smartphone National Hearing Test: Performance and Characteristics of Users. Am J Audiol 2018; 27:448-454. [PMID: 30452748 DOI: 10.1044/2018_aja-imia3-18-0016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/30/2018] [Indexed: 01/21/2023] Open
Abstract
PURPOSE The smartphone digits-in-noise hearing test, called hearZA, was made available as a self-test in South Africa in March 2016. This study determined characteristics and test performance of the listeners who took the test. METHOD A retrospective analysis of 24,072 persons who completed a test between March 2016 and August 2017 was conducted. User characteristics, including age, English-speaking competence, and self-reported hearing difficulty, were analyzed. Regression analyses were conducted to determine predictors of the speech reception threshold. RESULTS Overall referral rate of the hearZA test was 22.4%, and 37% of these reported a known hearing difficulty. Age distributions showed that 33.2% of listeners were ages 30 years and younger, 40.5% were between ages 31 and 50 years, and 26.4% were older than 50 years. Age, self-reported English-speaking competence, and self-reported hearing difficulty were significant predictors of the speech reception threshold. CONCLUSIONS High test uptake, particularly among younger users, and high overall referral rate indicates that the hearZA app addresses a public health need. The test also reaches target audiences, including those with self-reported hearing difficulty and those with normal hearing who should monitor their hearing ability.
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Affiliation(s)
- Karina C. De Sousa
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands
- Ear Science Institute Australia, Subiaco
| | - David R. Moore
- Communication Sciences Research Center, Cincinnati Childrens' Hospital Medical Center, Cincinnati, OH
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
| | - Cas Smits
- Department of Otolaryngology/Head & Neck Surgery, Section Ear & Hearing, and Amsterdam Public Health Research Institute, VU University Medical Center, the Netherlands
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23
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School-Age Hearing Screening Based on Speech-in-Noise Perception Using the Digit Triplet Test. Ear Hear 2018; 39:1104-1115. [DOI: 10.1097/aud.0000000000000563] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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24
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Carlson KF, Sell S, Vachhani J, Folmer RL, Saunders G, Feeney MP. Enhancing Screening Systems to Facilitate Hearing-Healthcare Access: A Qualitative Study. J Am Acad Audiol 2018; 30:250-263. [PMID: 30461385 DOI: 10.3766/jaaa.15087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Although hearing loss is a common health issue, hearing healthcare (HHC) is poorly accessed. Screening to identify hearing loss is an important part of HHC access, specifically for those who screen positive for hearing loss and would benefit from seeing a HHC provider. New technologies can be automated to provide information and recommendations that are tailored to the needs of individual users, potentially enhancing rates of HHC access after positive screens. A greater understanding of the facilitators of postscreening HHC access that could be leveraged in such systems is needed. PURPOSE The purpose of this project was to identify facilitators of postscreening HHC access that can be used in automated screening systems. RESEARCH DESIGN This qualitative study used focus groups (FGs) to understand perceived barriers, perceived benefits, and potential cues to action, as informed by the Health Belief Model, for accessing HHC after use of automated hearing screening systems. STUDY SAMPLE Fifty individuals participated in one of seven FGs. FGs were conducted separately with three types of stakeholders: four FGs included adults who reported some degree of perceived hearing loss and had recently completed a hearing screening; two FGs included adults who had recently sought HHC for the first time because of hearing loss; and one FG involved significant others/family members of individuals with hearing loss. DATA COLLECTION AND ANALYSIS FGs were 60-90 minutes in length and were led by a trained facilitator following a discussion guide. A research audiologist was present at each FG and served as a notetaker. FGs were recorded and transcribed by research team members, and transcripts were then coded in an iterative process by multiple team members. Qualitative content analysis was used to reduce data and to identify salient themes and subthemes, following an inductive approach. We focused on identifying themes that were related to facilitators of HHC access after positive screens for hearing loss and, separately, potential enhancements to automated hearing screening systems that would leverage these facilitators to improve HHC access. RESULTS We identified five key themes related to HHC access after a positive screen for hearing loss, along with ideas for enhancing automated hearing screening systems based on these themes. The themes included knowledge, trust, access, quality of life, and interpersonal influence. CONCLUSIONS The results of our work help inform the development of innovative hearing screening systems that can be automated to leverage individual facilitators of HHC access.
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Affiliation(s)
- Kathleen F Carlson
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR.,Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.,Oregon Health and Science University, Portland, OR
| | - Sara Sell
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR
| | - Jay Vachhani
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR
| | - Robert L Folmer
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR.,Oregon Health and Science University, Portland, OR
| | - Gabrielle Saunders
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR.,Oregon Health and Science University, Portland, OR
| | - M Patrick Feeney
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR.,Oregon Health and Science University, Portland, OR
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25
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Mosley CL, Langley LM, Davis A, McMahon CM, Tremblay KL. Reliability of the Home Hearing Test: Implications for Public Health. J Am Acad Audiol 2018; 30:208-216. [PMID: 30461396 DOI: 10.3766/jaaa.17092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The projected increase in the aging population raises concerns about how to manage the health-care needs in a cost-effective way. Within hearing health care, there are presently too few audiologists to meet the expected demand, and training more professionals may not be a feasible way of addressing this problem. For this reason, there is a need to develop different ways of assessing hearing sensitivity that can be conducted accurately and inexpensively when a certified audiologist and/or sound-attenuated booth is unavailable. More specifically, there is a need to determine if the Etymotic Home Hearing Test (HHT) can yield accurate and reliable data from older adults with varying degrees of hearing loss. PURPOSE To compare audiometric thresholds obtained using the HHT, an automated pure-tone air-conduction test, to those obtained using manual audiometry (MA), among older adults with varying degrees of hearing loss. STUDY SAMPLE Participants were 112 English-speaking adults (58% Female), aged 60 yr and older. Participants were excluded from this study if otoscopy revealed cerumen impaction and/or suspected ear pathology. INTERVENTION All participants completed the HHT on tablet computers in a carpeted classroom and MA in a double-walled sound-attenuated booth using insert earphones for both measures. Both measures were completed in the same test session, and the order of testing (MA versus HHT) was counterbalanced. DATA COLLECTION AND ANALYSIS Absolute differences in threshold measurements (in dB HL) were calculated across all ears (n = 224 ears) and for all frequencies (octave frequencies from 0.5 to 8 kHz). Correlation and multiple linear regression analyses were conducted to determine if thresholds obtained using the HHT significantly correlated with thresholds using MA. Mean thresholds for each method (HHT and MA) were compared using correlation analyses for each test frequency. Multiple linear regression analysis was used to examine the relationship between the four-frequency pure-tone average (PTA) (average threshold at 0.5, 1, 2, and 4 kHz) in the better-hearing ear measured using the HHT and a set of seven independent factors: four-frequency PTA in the better-hearing ear measured via MA, treatment group (HHT versus MA), age, gender, and degree of hearing loss (mild, moderate, and >moderate). RESULTS Correlation analyses revealed significant frequency-specific correlations, ranging from 0.91 to 0.97 (p < 0.001), for air-conduction thresholds obtained using the HHT and MA. Mean HHT thresholds were significantly correlated with mean MA thresholds in both ears across the frequency range. This relationship held true across different degrees of hearing loss. The regression model accounted for a significant amount of variance in the HHT better-ear PTA, with MA better-ear PTA being the only significant predictor in our final model, with no effect of degree of loss, age, or gender. CONCLUSIONS The HHT is an accurate and cost-effective method of establishing pure-tone air-conduction thresholds, when compared with MA. Therefore, the HHT can be used as a tool to acquire accurate air-conduction hearing thresholds from older adults, in-group settings, without the use of a sound-attenuated booth or a certified audiologist.
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Affiliation(s)
- Cornetta L Mosley
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA
| | - Lauren M Langley
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA
| | | | | | - Kelly L Tremblay
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA
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