Keefe Douglas H, Simmons Jeffrey L
Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA.
J Acoust Soc Am. 2003 Dec;114(6 Pt 1):3217-38. doi: 10.1121/1.1625931.
The test performance of a wideband acoustic transfer function (ATF) test and 226-Hz tympanometry was assessed in predicting the presence of conductive hearing loss, based on an air-bone gap of 20 dB or more. Two ATF tests were designed using an improved calibration method over a frequency range (0.25-8 kHz): an ambient-pressure test and a tympanometric test using an excess static pressure in the ear canal. Wideband responses were objectively classified using moment analyses of energy transmittance, which was a more appropriate test variable than energy reflectance. Subjects included adults and children of age 10 years and up, with 42 normal-functioning ears and 18 ears with a conductive hearing loss. Predictors were based on the magnitudes of the moment deviations from the 10th to 90th percentiles of the normal group. Comparing tests at a fixed specificity of 0.90, the sensitivities were 0.28 for peak-compensated static acoustic admittance at 226 Hz, 0.72 for ambient-pressure ATF, and 0.94 for pressurized ATF. Pressurized ATF was accurate at predicting conductive hearing loss with an area under the receiver operating characteristic curve of 0.95. Ambient-pressure ATF may have sufficient accuracy to use in some hearing-screening applications, whereas pressurized ATF has additional accuracy that may be appropriate for hearing-diagnostic applications.
基于20 dB或更大的气骨导差，评估了宽带声传递函数（ATF）测试和226 Hz鼓室图在预测传导性听力损失存在方面的测试性能。使用改进的校准方法在0.25 - 8 kHz频率范围内设计了两种ATF测试：一种是环境压力测试，另一种是在耳道内使用额外静压的鼓室图测试。通过能量透射率的矩分析对宽带响应进行客观分类，能量透射率是比能量反射率更合适的测试变量。受试者包括10岁及以上的成人和儿童，其中42只耳朵功能正常，18只耳朵患有传导性听力损失。预测指标基于与正常组第10至90百分位数的矩偏差大小。在固定特异性为0.90的情况下比较测试，226 Hz时峰值补偿静态声导纳的灵敏度为0.28，环境压力ATF的灵敏度为0.72，加压ATF的灵敏度为0.94。加压ATF在预测传导性听力损失方面很准确，受试者工作特征曲线下面积为0.95。环境压力ATF可能具有足够的准确性用于某些听力筛查应用，而加压ATF具有更高的准确性，可能适用于听力诊断应用。
