Henry James A, McMillan Garnett P, Thielman Emily J, Galvez Gino, Zaugg Tara L, Porsov Edward, Silaski Grayson
VA Medical Center, Portland, OR 97207, USA.
J Rehabil Res Dev. 2013;50(4):573-84. doi: 10.1682/jrrd.2012.05.0090.
The Department of Veterans Affairs (VA) considers tinnitus a disability. Veterans can claim tinnitus as a "service-connected" disability if the tinnitus is thought to be connected to military service. The VA adjudicates each claim and determines whether reasonable evidence exists to support it. Currently, determining the presence of tinnitus is based on subjective reporting-objective measures do not exist. The aim of this study was to develop and document a test for detecting the presence/absence of tinnitus with high confidence. Using our computer-automated, self-guided tinnitus evaluation system, we conducted three phases of testing to compare psychoacoustic measures of tinnitus between participants with versus without tinnitus. Phase 1 measures included loudness match, pitch match, minimum masking level, residual inhibition, Békésy, and forced-choice double staircase. Phases 2 and 3 measures were chosen based on results of the previous phase. The number of tests and time of testing decreased during each successive phase. Differences were seen between groups; most notably, higher low-frequency loudness matches and higher median pitch matches were observed for participants with tinnitus. Results of this study suggest that further efforts can produce a defined psychoacoustic test battery for identifying the presence/absence of tinnitus.
美国退伍军人事务部（VA）将耳鸣视为一种残疾。如果认为耳鸣与军事服役有关，退伍军人可以将耳鸣作为“与服役相关的”残疾提出索赔。VA对每项索赔进行裁决，并确定是否存在合理证据支持该索赔。目前，耳鸣的诊断基于主观报告，不存在客观测量方法。本研究的目的是开发并记录一种能够高置信度检测耳鸣是否存在的测试方法。我们使用计算机自动化、自我引导的耳鸣评估系统，进行了三个阶段的测试，以比较有耳鸣和无耳鸣参与者之间耳鸣的心理声学指标。第一阶段的测量包括响度匹配、音高匹配、最小掩蔽级、残余抑制、贝凯西测试和强制选择双阶梯测试。第二阶段和第三阶段的测量根据前一阶段的结果进行选择。在每个连续阶段，测试次数和测试时间都有所减少。两组之间存在差异；最显著的是，耳鸣参与者的低频响度匹配更高，中位音高匹配也更高。本研究结果表明，进一步的努力可以产生一套明确的心理声学测试组合，用于识别耳鸣的存在与否。
