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: 9052737
• 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 2019-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9052737
• 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; Health; 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; 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; 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种新的宽带综合测试组合，即宽带(WB)，听觉功能的声学测试在退伍军人群体中鉴别诊断中耳、耳蜗病和神经病理的作用。WB测试指的是使用从0.2 kHz到高达8 kHz的频率测量的声音响应进行的耳道测试，这是一个对语音感知至关重要的带宽。将对中耳电池进行测试 使用功率吸收进行评估，使用耳声发射(OAES)和使用中耳功率吸收进行声腓骨肌反射(ASR)进行耳蜗评估。结果将与常规用于评估退伍军人听觉功能的标准单频临床导抗测试电池进行比较。目的1通过比较WB测试组件与传统导抗测试组件对退伍军人常见疾病：鼓膜穿孔、浆液性中耳炎、胆脂瘤和耳硬化症的敏感性和特异性，评价WB测试组件在中耳病变和相关传导性听力损失鉴别诊断中的准确性。目的2试图修改WB ASR测试，以提供ASR阈值的自动检测，以便与传统的单频ASR阈值进行比较。目的3验证TEOAE和SSOAE测试在退伍军人中评估耳蜗声发射状态的应用，并评价其在听力正常和感音神经性耳聋分类中的测试性能。最后，目标4试图比较全WB测试电池和全单频导纳测试电池的诊断准确性，以检测任何类型的听力损失，包括感觉神经性、传导性和混合性听力损失。假设是，WB测试电池在识别听力状态正常的耳朵和具有一系列听觉病理风险的耳朵方面比传统的导纳测试电池更准确。 计划：这将是一个多站点研究项目，在两个退伍军人事务部站点收集数据：波特兰 退伍军人医疗中心、国家康复听觉功能中心(NCRAR)和山区之家退伍军人医疗中心。WB测试将与Boys town国家研究医院的Douglas Keefe博士合作开发。方法：这项研究的受试者将从波特兰VAMC和山之家的VA听力学诊所招募听力评估的受试者。这些受试者将响应传单，或成为在每个地点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估WB测试组与传统测试组在评估退伍军人管理局听力诊所就诊患者时的使用情况，因此从临床人群中招募受试者是至关重要的。在四年的研究中，我们将总共招募640名受试者，每个站点320人。 这一数量的科目将被要求获得足够数量的具有各种不同 听力障碍和病理，以允许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测试电池。临床导抗电池将包括226赫兹鼓室导纳测试和ASR阈值测试。WB电池将包括环境压力和鼓室导纳吸光度测试，自动ASR阈值测试，最后是瞬时OAE测试和同步-自发OAE测试，将在研究的第一年开发。将对数据进行分析，以比较WB和单频测试在退伍军人传导性、混合性和感觉神经性听力损失鉴别诊断中的作用。与目前的临床程序相比，WB测试组在诊断性能方面发现的任何改进都将提供一套集成的听觉测试，以更有效和高效地评估退伍军人的听觉功能。