Comprehensive Wide Bandwidth Test Battery of Auditory Function in Veterans

退伍军人听觉功能的综合宽带测试电池

• 批准号: 8675756
• 负责人: Martin Patrick Feeney
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8675756
• 关键词: Acoustics; Address; Adult; Age; Audiology; Audiometry; Auditory; Automation; Behavioral; Brain Stem; Caring; Cholesteatoma; Clinic; Clinical; Collaborations; Conductive hearing loss; Counseling; Data; Data Collection; Detection; Diagnosis; Diagnostic; Differential Diagnosis; Disease; Ear; Evaluation; External auditory canal; Frequencies; Generations; Goals; Hearing; Hearing problem; Home environment; Hospitals; Labyrinth; Lead; Left; Measurement; Measures; Medical; Medical center; Methods; Mixed Conductive-Sensorineural Hearing Loss; Nerve; Neurophysiology - biologic function; Otosclerosis; Pathology; Patients; Performance; Physicians; Physiological; Population; Procedures; Recruitment Activity; Reflex action; Registries; Rehabilitation therapy; Relative (related person); Research; Research Project Grants; Risk; Sensitivity and Specificity; Sensorineural Hearing Loss; Serous otitis media; Site; Speech Perception; Stimulus; System; Testing; Time; Tympanic Membrane Perforation; Tympanometry; Veterans; absorption; acoustic reflex; age effect; base; boys; diagnostic accuracy; evaluation/testing; hearing impairment; human subject; improved; middle ear; middle ear disorder; otoacoustic emission; performance tests; pressure; public health relevance; relating to nervous system; response; sound; tool; treatment planning; volunteer

DESCRIPTION (provided by applicant): The goal of this research is to evaluate a comprehensive test battery of new wide-bandwidth, i.e., wideband (WB), acoustical tests of auditory function in the differential diagnosis of middle ear, cochlear and neural pathologies in a population of Veterans. WB tests refer to ear canal tests using sound responses measured from 0.2 kHz to frequencies as high as 8 kHz, a bandwidth that is critical for speech perception. There will be tests in the battery for middle-ear assessment using power absorption, cochlear assessment using otoacoustic emissions (OAEs) and the acoustic stapedius reflex (ASR) using middle ear power absorption. Results will be compared with a standard single-frequency clinical immittance test battery routinely used in the assessment of auditory function in Veterans. Aim 1 seeks to evaluate the accuracy of the WB test battery in the differential diagnosis of middle-ear pathology and related conductive hearing loss by comparing the sensitivity and specificity of the WB battery to the traditional immittance battery for the following disorders common in Veterans: tympanic membrane perforation, serous otitis media, cholesteatoma, and otosclerosis. Aim 2 seeks to modify a WB ASR test to provide automatic detection of the ASR threshold for comparison with the traditional single-frequency ASR threshold. Aim 3 seeks to validate the use of TEOAE and SSOAE tests in Veterans to assess cochlear status, and evaluate their test performance in classifying ears with normal hearing and sensorineural hearing loss. Finally, Aim 4 seeks to compare the diagnostic accuracy of the full WB test battery with the full single-frequency admittance test battery to detect any type of hearing loss including sensorineural, conductive and mixed. The hypothesis is that the WB test battery is more accurate than the traditional immittance test battery in identifying ears with normal auditory status and ears with a range of risks for auditory pathology. Plan: This will be a multi-site research project with data collection at two VA sites: the Portland VA Medical Center, National Center for Rehabilitative Auditory Function (NCRAR) and the Mountain Home VA Medical Center. WB tests will be developed in collaboration with Dr. Douglas Keefe of the Boys Town National Research Hospital. Methods: Human subjects will be recruited for this study who have had a hearing evaluation from the VA Audiology Clinics at the Portland VAMC and Mountain Home, VAMC. These subjects will respond to flyers or be part of a human subject volunteer registry established at each site. Since the focus on the proposal is to evaluate the use of a WB test battery in comparison with the traditional battery in evaluating patients seen at VA Audiology clinics, the recruitment of subjects from clinic populations is critical. Across the 4 years of the study we will recruit a total 640 subjects, 320 from each site. This number of subjects will be required to obtain sufficient numbers of subjects with a variety of hearing disorders and pathologies to allow a comparison of results for traditional and wideband tests. All subjects will receive the same clinical and WB test battery. The clinical immittance tes battery will consist of 226 Hz tympanometry, and ASR threshold testing. The WB battery will consist of ambient pressure and tympanometric absorbance tests, an automated ASR threshold test, and finally a transient OAE test and a synchronous-spontaneous OAE test that will be developed in the first year of the study. Data will be analyzed to compare the utility of the WB and single-frequency tests in the differential diagnosis of conductive, mixed, and sensorineural hearing loss in Veterans. Any improvements found in the diagnostic performance of the WB test battery compared to current clinical procedures would provide an integrated set of auditory tests to more effectively and efficiently evaluate auditory function in Veterans.

描述（由申请人提供）： 本研究的目的是评估一个新的宽带综合测试电池，即，在退伍军人群体中鉴别诊断中耳、耳蜗和神经病理的听觉功能的宽带（WB）声学测试。WB测试是指使用从0.2 kHz到高达8 kHz的频率测量的声音响应的耳道测试，这是对语音感知至关重要的带宽。会有中耳测试 使用功率吸收的耳蜗评估、使用耳声发射（OAE）的耳蜗评估和使用中耳功率吸收的声镫骨肌反射（ASR）。结果将与常规用于退伍军人听觉功能评估的标准单频临床导抗测试组合进行比较。目的1旨在通过比较WB测试组合与传统导抗测试组合对退伍军人常见疾病（鼓膜穿孔、浆液性中耳炎、中耳炎瘤和耳硬化症）的敏感性和特异性，评价WB测试组合在中耳病理学和相关传导性听力损失鉴别诊断中的准确性。目标2寻求修改WB ASR测试以提供ASR阈值的自动检测以用于与传统单频ASR阈值进行比较。目的3旨在验证TEOAE和SSOAE测试在退伍军人中的使用，以评估耳蜗状态，并评估其在分类听力正常和感音神经性听力损失耳朵方面的测试性能。最后，目标4旨在比较全WB测试组合与全单频导纳测试组合的诊断准确性，以检测任何类型的听力损失，包括感音神经性、传导性和混合性听力损失。假设WB测试组合在识别具有正常听觉状态的耳朵和具有一系列听觉病理风险的耳朵方面比传统导抗测试组合更准确。 计划：这将是一个多地点研究项目，在两个VA地点收集数据：波特兰 VA医疗中心，国家反射听觉功能中心（NCRAR）和山居VA医疗中心。WB测试将与男孩镇国家研究医院的道格拉斯基夫博士合作开发。研究方法：本研究将招募已在波特兰VAMC和山居，VAMC的VA听力学诊所接受听力评价的人类受试者。这些受试者将对传单做出回应，或成为每个研究中心建立的人类受试者志愿者登记的一部分。由于该提案的重点是评价WB测试组合与传统组合在评价VA听力学诊所患者中的使用，因此从诊所人群中招募受试者至关重要。在4年的研究期间，我们将招募总计640例受试者，每个研究中心320例。 这一数量的受试者将需要获得足够数量的具有各种 听力障碍和病理，以便比较传统和宽带测试的结果。所有受试者将接受相同的临床和WB测试组合。临床导抗测试组合将包括226 Hz鼓室测试和ASR阈值测试。WB组合将包括环境压力和鼓室吸光度测试、自动化ASR阈值测试，以及最后的瞬态OAE测试和同步自发OAE测试，这些测试将在研究的第一年开发。将分析数据以比较WB和单频测试在退伍军人传导性、混合性和感音神经性听力损失鉴别诊断中的效用。与当前临床程序相比，WB测试组合的诊断性能的任何改进都将提供一套完整的听觉测试，以更有效地评估退伍军人的听觉功能。