Validation of a clinical assessment of spectral-ripple resolution for cochlear implant users.
Validation of a clinical assessment of spectral-ripple resolution for cochlear implant users.
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DOI：
10.1097/aud.0000000000000009
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发表时间：
2014-05
期刊：
影响因子：
3.7
通讯作者：
Rubinstein JT
中科院分区：
文献类型：
--
作者：
Drennan WR;Anderson ES;Won JH;Rubinstein JT
频谱分辨率的非语音心理物理测试，如频谱纹波辨别任务，已被证明与人工耳蜗（CI）用户的语音识别性能相关。然而，这些测试最适合在研究实验室环境中使用，并且对于临床使用是不切实际的。已经开发了一种更快且更容易在临床环境中实施的光谱分辨率测试。本研究的目的是：1）确定这种新的临床涟漪测试是否会产生与更长的适应性版本的涟漪辨别测试相当的个体结果; 2）评估临床涟漪测量的重测信度;以及3）检查一组CI听众在安静状态下临床涟漪表现与单音节词识别之间的关系。28名CI接受者参加了这项研究。每个受试者都进行了自适应和临床版本的光谱涟漪歧视，以及安静的CNC单词识别测试。自适应版本的频谱涟漪采用2-up，1-down的程序来确定频谱涟漪鉴别阈值。临床涟漪测试使用恒定刺激的方法，对12个固定涟漪密度中的每一个进行随机顺序的6次试验。然后将来自临床涟漪测试的结果（比例校正）与来自自适应测试的涟漪辨别阈值（以每倍频程的纹波为单位）进行比较。临床涟漪测试显示出较强的同时有效性，证明了临床涟漪和自适应涟漪结果之间的良好相关性（r=0.79），以及与单词识别的相关性（r = 0.7）。良好的重测信度也表现出较高的重测相关性（r = 0.9）。临床涟漪测试是一种可靠的光谱分辨率的非语言测量方法，针对临床环境中人工耳蜗用户的使用进行了优化。该测试可能是有用的，作为一种诊断工具，或作为一个可能的替代结果的措施，用于评估治疗效果的听力。
Non-speech psychophysical tests of spectral resolution, such as the spectral-ripple discrimination task, have been shown to correlate with speech recognition performance in cochlear implant (CI) users. However, these tests are best suited for use in the research laboratory setting and are impractical for clinical use. A test of spectral resolution that is quicker and could more easily be implemented in the clinical setting has been developed. The objectives of this study were 1) To determine if this new clinical ripple test would yield individual results equivalent to the longer, adaptive version of the ripple discrimination test; 2) To evaluate test-retest reliability for the clinical ripple measure; and 3) To examine the relationship between clinical ripple performance and monosyllabic word recognition in quiet for a group of CI listeners. Twenty-eight CI recipients participated in the study. Each subject was tested on both the adaptive and the clinical versions of spectral ripple discrimination, as well as CNC word recognition in quiet. The adaptive version of spectral ripple employed a 2-up, 1-down procedure for determining spectral ripple discrimination threshold. The clinical ripple test used a method of constant stimuli, with trials for each of 12 fixed ripple densities occurring six times in random order. Results from the clinical ripple test (proportion correct) were then compared to ripple discrimination thresholds (in ripples per octave) from the adaptive test. The clinical ripple test showed strong concurrent validity, evidenced by a good correlation between clinical ripple and adaptive ripple results (r=0.79), as well as a correlation with word recognition (r = 0.7). Excellent test-retest reliability was also demonstrated with a high test-retest correlation (r = 0.9). The clinical ripple test is a reliable non-linguistic measure of spectral resolution, optimized for use with cochlear implant users in a clinical setting. The test might be useful as a diagnostic tool or as a possible surrogate outcome measure for evaluating treatment effects in hearing.