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新的宽带综合测试组，即宽带（WB）听觉功能声学测试，用于退伍军人群体中耳、耳蜗和神经病变的鉴别诊断。 WB 测试是指使用从 0.2 kHz 到高达 8 kHz 频率测量的声音响应进行耳道测试，该带宽对于语音感知至关重要。中耳电池将进行测试 使用功率吸收进行评估、使用耳声发射 (OAE) 进行耳蜗评估以及使用中耳功率吸收进行声镫骨反射 (ASR) 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。目标 1 旨在通过比较 WB 测试电池与传统导抗电池对退伍军人中常见的以下疾病的敏感性和特异性，评估 WB 测试电池在中耳病理和相关传导性听力损失鉴别诊断中的准确性：膜穿孔、浆液性中耳炎、胆脂瘤和耳硬化症。目标 2 寻求修改 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。目标 3 旨在验证退伍军人使用 TEOAE 和 SSOAE 测试来评估耳蜗状态，并评估他们在对正常听力和感音神经性听力损失的耳朵进行分类方面的测试性能。最后，Aim 4 试图将完整的 WB 测试组合与完整的单频导纳测试组合的诊断准确性进行比较，以检测任何类型的听力损失，包括感音神经性听力损失、传导性听力损失和混合性听力损失。假设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，WB 测试电池比传统的导抗测试电池更准确。 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、国家听觉功能康复中心 (NCRAR) 和 Mountain Home VA 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：本研究将招募已在波特兰 VAMC 和 Mountain Home, VAMC 的 VA 听力学诊所进行过听力评估的人类受试者。这些受试者将对传单做出回应，或者成为在每个站点建立的人类受试者志愿者登记册的一部分。由于该提案的重点是评估 WB 测试电池与传统电池在评估 VA 听力学诊所就诊患者时的使用情况，因此从诊所人群中招募受试者至关重要。在为期 4 年的研究中，我们将总共招募 640 名受试者，每个地点 320 名。 需要这个数量的受试者才能获得足够数量的具有各种 听力障碍和病理学可以比较传统测试和宽带测试的结果。所有受试者将接受相同的临床和 WB 测试电池。临床导抗测试电池将包括 226 Hz 鼓室导抗测试和 ASR 阈值测试。 WB 电池将包括环境压力和鼓室导抗吸光度测试、自动 ASR 阈值测试，最后是瞬态 OAE 测试和同步自发 OAE 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的鉴别诊断中的效用。与当前临床程序相比，WB 测试组的诊断性能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。