Fluctuations in Subjective Tinnitus Ratings Over Time: Implications for Clinical Research.
Fluctuations in Subjective Tinnitus Ratings Over Time: Implications for Clinical Research.
复制标题
主观耳鸣评级随时间的波动：对临床研究的影响。
DOI：
10.1097/mao.0000000000002759
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Polley DB
中科院分区：
文献类型：
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作者：
Chen JX;Whitton JP;Parthasarathy A;Hancock KE;Polley DB
慢性主观性耳鸣患者通常接受一系列听力测试，以确定他们的耳鸣感觉。即使是一个全面的电池，如果只使用一次，也不能捕捉到耳鸣强度或质量随时间的波动。此外，受试者在报告他们耳鸣感知的详细特征时会经历一个学习曲线，这样一次评估就会反映出对测试要求的不熟悉。我们通过编写一个自动化软件平台来应对这些挑战，该平台在两周的时间里用于家庭耳鸣的特征描述。前瞻性病例系列。第三转诊中心，病人之家。在最初的临床访问后，25名慢性主观性耳鸣患者带着平板电脑和校准耳机回家，完成问卷、听力测试和耳鸣心理声学测试。在两周的时间里，我们反复描述了响度、不适程度和耳鸣的匹配情况。主要结果包括受试者在测试过程中在响度不适程度、耳鸣强度和耳鸣声学匹配方面的内部变异性。通过排除初始测量和只关注耳鸣匹配尝试，所有结果测量的受试者内部变异性可以减少约25%-50%，受试者报告对其评级的准确性具有高度信心。耳鸣自我报告本身是可变的，但通过扩展测试可以收敛到可靠的值。反复的、自我导向的耳鸣评估可能对识别伪装者有影响。此外，这些发现表明，延长耳鸣特征的基线阶段将增加未来专注于耳鸣干预的研究的统计能力。
Patients with chronic, subjective tinnitus are often administered a battery of audiometric tests to characterize their tinnitus percept. Even a comprehensive battery, if applied just once, cannot capture fluctuations in tinnitus strength or quality over time. Moreover, subjects experience a learning curve when reporting the detailed characteristics of their tinnitus percept, such that a single assessment will reflect a lack of familiarity with test requirements. We addressed these challenges by programming an automated software platform for at-home tinnitus characterization over a two-week period. Prospective case series. Tertiary referral center, patients’ homes. Following an initial clinic visit, 25 subjects with chronic subjective tinnitus returned home with a tablet computer and calibrated headphones to complete questionnaires, hearing tests and tinnitus psychoacoustic testing. We repeatedly characterized loudness discomfort levels and tinnitus matching over a 2-week period. Primary outcomes included intra-subject variability in loudness discomfort levels, tinnitus intensity, and tinnitus acoustic matching over the course of testing. Within-subject variability for all outcome measures could be reduced by approximately 25–50% by excluding initial measurements and by focusing only on tinnitus matching attempts where subjects report high confidence in the accuracy of their ratings. Tinnitus self-report is inherently variable but can converge on reliable values with extended testing. Repeated, self-directed tinnitus assessments may have implications for identifying malingerers. Further, these findings suggest that extending the baseline phase of tinnitus characterizations will increase the statistical power for future studies focused on tinnitus interventions.