气骨导间距的分布特征：主观听力测试中的偏差证据
Distribution Characteristics of Air-Bone Gaps: Evidence of Bias in Manual Audiometry.
作者信息
Margolis Robert H, Wilson Richard H, Popelka Gerald R, Eikelboom Robert H, Swanepoel De Wet, Saly George L
机构信息
1Audiology Incorporated, Arden Hills, Minnesota, USA; 2James H. Quillen VA Medical Center, Mountain Home, Tennessee, USA; 3Department of Otolaryngology, Stanford University, Stanford, California, USA; 4Ear Science Institute Australia, Subiaco, Australia; 5Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; and 6Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands, Australia.
出版信息
Ear Hear. 2016 Mar-Apr;37(2):177-88. doi: 10.1097/AUD.0000000000000246.
OBJECTIVES
Five databases were mined to examine distributions of air-bone gaps obtained by automated and manual audiometry. Differences in distribution characteristics were examined for evidence of influences unrelated to the audibility of test signals.
DESIGN
The databases provided air- and bone-conduction thresholds that permitted examination of air-bone gap distributions that were free of ceiling and floor effects. Cases with conductive hearing loss were eliminated based on air-bone gaps, tympanometry, and otoscopy, when available. The analysis is based on 2,378,921 threshold determinations from 721,831 subjects from five databases.
RESULTS
Automated audiometry produced air-bone gaps that were normally distributed suggesting that air- and bone-conduction thresholds are normally distributed. Manual audiometry produced air-bone gaps that were not normally distributed and show evidence of biasing effects of assumptions of expected results. In one database, the form of the distributions showed evidence of inclusion of conductive hearing losses.
CONCLUSIONS
Thresholds obtained by manual audiometry show tester bias effects from assumptions of the patient's hearing loss characteristics. Tester bias artificially reduces the variance of bone-conduction thresholds and the resulting air-bone gaps. Because the automated method is free of bias from assumptions of expected results, these distributions are hypothesized to reflect the true variability of air- and bone-conduction thresholds and the resulting air-bone gaps.
目的
对五个数据库进行挖掘，以研究通过自动和手动听力测定法获得的气骨导间距的分布情况。检查分布特征的差异，以寻找与测试信号可听度无关的影响证据。
设计
数据库提供了气导和骨导阈值，从而能够对不受上限和下限效应影响的气骨导间距分布进行研究。如有可能，根据气骨导间距、鼓室图和耳镜检查结果，排除传导性听力损失病例。该分析基于来自五个数据库的721,831名受试者的2,378,921次阈值测定结果。
结果
自动听力测定法产生的气骨导间距呈正态分布，这表明气导和骨导阈值呈正态分布。手动听力测定法产生的气骨导间距不呈正态分布，且显示出预期结果假设的偏差效应证据。在一个数据库中，分布形式显示出纳入了传导性听力损失的证据。
结论
手动听力测定法获得的阈值显示出测试者因对患者听力损失特征的假设而产生的偏差效应。测试者偏差人为地降低了骨导阈值以及由此产生的气骨导间距的方差。由于自动方法不受预期结果假设的偏差影响，因此推测这些分布反映了气导和骨导阈值以及由此产生的气骨导间距的真实变异性。
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