Reformulating Hearing Assessment: Translating recent discoveries through a large-

描述（由申请人提供）：作为一个社会和国家，我们越来越意识到预防医学的价值。在听力健康领域，预防是通过认识对听力有害的因素和早期诊断听力状况的微小变化来实现的。目前在听力学中使用的诊断方案已经存在了半个多世纪，并且对听觉生理学的微小变化不敏感。我们建议评估检测听力状态改变的新方法。这些新方法是在一个测试电池中实现的，该测试电池应该有效地评估听力功能的几个方面，并与现实世界中个人经历的沟通困难有关。项目第一阶段的工作评估了我们实验室目前正在开发的新诊断系统的有效性，并检查了校准方法的有效性，以及刺激频率耳声发射的记录。这个系统将整合这里提出的所有测试的管理，并能够在一个前所未有的频率范围内管理它们。这一阶段的结果将纳入第二阶段，在按年龄分布的400名受试者中评估一系列测试。在研究的最后和最大的阶段，我们从前一阶段收集最有效的测试，并在1200名受试者的样本中评估它们在电池中的功效，以及单独的功效。这一阶段是在项目期间的最后三年在三个地点进行的。两个拟议的研究地点分别是大学和医疗环境中的功能听力学诊所。与项目的转化目标一致，我们开发了一种新的测量装置，其中包含了评估听觉系统的新方法。我们在大量不同的受试者中评估这些测试。最后，正如我们研究的总体结果所建议的那样，我们积极地、以证据为基础地推广这些新技术和方法。

DESCRIPTION (provided by applicant): As a society and nation we are increasingly aware of the value of preventive medicine. In the area of hearing health, prevention is achieved by awareness of elements hazardous to hearing and the early diagnosis of small changes in hearing status. The current diagnostic protocol used in audiology has been in place for over half a century and is insensitive to small changes in auditory physiology. We propose to evaluate novel methods of detecting alterations in hearing status. These novel methods are implemented within a test-battery that should effectively evaluate several aspects of hearing function and relate to communication difficulties experienced by individuals in the real world. Work during the first phase of the project evaluates the effectiveness of a new diagnostic system currently under development in our labs and examines the efficacy of methods of calibration, as well as recording of stimulus frequency otoacoustic emissions. This system will integrate the administration of all tests proposed here and be able to administer them over an unprecedented range of frequencies. The results of this phase are incorporated into a second phase where a battery of tests is evaluated in an age-distributed group of 400 subjects. In the final and largest phase of the study, we glean the most effective tests from the previous phase and evaluate their efficacy in a battery, as well as individually, on a sample of 1200 subjects. This phase is conducted over the last three years of the project period, at three sites. Two of the proposed study sites are functional audiology clinics in university and medical environments, respectively. Consistent with the translational goals of the project we develop a new measurement device which incorporates new methods of evaluating the auditory system. We evaluate these tests in a large cohort of diverse subjects. Finally, we engage in aggressive, evidence-based promotion of these new technologies and methods, as suggested by the overall findings of our study.