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使用视觉强化测听法、耳声发射和鼓室图对交叉核对原则进行的评估。

An evaluation of the cross-check principle using visual reinforcement audiometry, otoacoustic emissions, and tympanometry.

作者信息

Baldwin Stacey M, Gajewski Byron J, Widen Judith E

机构信息

Associated Audiologists, Overland Park, Kansas, USA.

出版信息

J Am Acad Audiol. 2010 Mar;21(3):187-96. doi: 10.3766/jaaa.21.3.7.

Abstract

BACKGROUND

Early intervention to reduce the effects of congenital hearing loss requires accurate description of hearing loss. In pediatric audiology, a cross-check principle is used to compare behavioral and physiological tests.

PURPOSE

The purpose of this study was to investigate the correspondence of visual reinforcement audiometry (VRA) minimal response levels (MRLs), otoacoustic emissions (OAEs), tympanometry, and VRA test reliability to determine the odds of obtaining the expected cross-check results. We hypothesized that (1) when MRLs were within normal limits (WNL), OAEs would be present; (2) in the event of normal MRLs and absent OAEs, tympanograms would be abnormal; and (3) in the event of elevated MRLs and present OAEs, the tester's confidence in the MRLs would be judged to be only fair, rather than good.

RESEARCH DESIGN

This was a retrospective study.

STUDY SAMPLE

A previous study provided data from 993 infants who had diagnostic audiologic evaluations at 8-12 mo of age.

DATA COLLECTION AND ANALYSIS

The data were analyzed to compare VRA MRLs with OAE signal-to-noise ratios at 1, 2, and 4 kHz. Odds ratios and 95% confidence intervals were calculated to test the three hypotheses related to the correspondence among MRLs, OAEs, tympanometry, and the reliability of MRLs.

RESULTS

The probability that OAEs would be present when MRLs were WNL varied from 12 to 26 to 1, depending on the test frequency. When OAEs were absent in the presence of normal MRLs, the odds of abnormal tympanometry varied from 5 to 10 to 1, depending on the test frequency. When MRLs were elevated (>20 dB HL), the odds suggested that examiners judged the MRLs at 1 and 2 kHz to lack reliability.

CONCLUSION

The results suggest that the cross-check principle is effective when employing VRA, OAE, and tympanometry to rule out or determine the degree, type, and configuration of hearing loss in infants.

摘要

背景

早期干预以减轻先天性听力损失的影响需要对听力损失进行准确描述。在儿科听力学中,采用交叉核对原则来比较行为测试和生理测试。

目的

本研究的目的是调查视觉强化测听法(VRA)的最小反应水平(MRL)、耳声发射(OAE)、鼓室图以及VRA测试可靠性之间的对应关系,以确定获得预期交叉核对结果的几率。我们假设:(1)当MRL在正常范围内(WNL)时,会出现OAE;(2)如果MRL正常但OAE缺失,鼓室图将异常;(3)如果MRL升高且OAE存在,测试者对MRL的信心将被判定为一般,而非良好。

研究设计

这是一项回顾性研究。

研究样本

先前的一项研究提供了993名在8至12月龄时接受诊断性听力学评估的婴儿的数据。

数据收集与分析

对数据进行分析,以比较VRA的MRL与1、2和4kHz处的OAE信噪比。计算优势比和95%置信区间,以检验与MRL、OAE、鼓室图以及MRL可靠性之间对应关系相关的三个假设。

结果

当MRL为WNL时出现OAE的概率因测试频率而异,范围从12比26到1。当MRL正常但OAE缺失时,鼓室图异常的几率因测试频率而异,范围从5比10到1。当MRL升高(>20dB HL)时,优势比表明检查者认为1和2kHz处的MRL缺乏可靠性。

结论

结果表明,在使用VRA、OAE和鼓室图来排除或确定婴儿听力损失的程度、类型和形态时,交叉核对原则是有效的。

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