Goehring Jenny L, Hughes Michelle L
Boys Town National Research Hospital, Omaha, NE.
J Speech Lang Hear Res. 2017 Mar 1;60(3):732-740. doi: 10.1044/2016_JSLHR-H-16-0184.
This study evaluated the use of telepractice for measuring cochlear implant (CI) behavioral threshold (T) levels in children using conditioned play audiometry (CPA). The goals were to determine whether (a) T levels measured via telepractice were not significantly different from those obtained in person, (b) response probability differed between remote and in-person conditions, and (c) the remote visit required more time than the in-person condition.
An ABBA design (A, in-person; B, remote) was split across 2 visits. Nineteen children aged 2.6-7.1 years participated. T levels were measured using CPA for 3 electrodes per session. A "hit" rate was calculated to determine whether the likelihood of obtaining responses differed between conditions. Test time was compared across conditions. A questionnaire was administered to assess parent/caregiver attitudes about telepractice.
Results indicated no significant difference in T levels between conditions. Hit rates were not significantly different between in-person and remote conditions (98% vs. 97%, respectively). Test time was similar between conditions. Questionnaire results revealed that 100% of caregivers would use telepractice for CI appointments either some or all of the time.
Telepractice is a viable option for routine pediatric programming appointments for children using CPA to set behavioral thresholds.
本研究评估了通过远程医疗实践，使用条件性游戏测听法（CPA）测量儿童人工耳蜗（CI）行为阈值（T）水平的情况。目标是确定：（a）通过远程医疗实践测量的T水平与亲自测量的T水平是否无显著差异；（b）远程和亲自测量两种情况下的反应概率是否不同；（c）远程就诊是否比亲自就诊需要更多时间。
采用ABBA设计（A为亲自测量；B为远程测量），分两次就诊进行。19名年龄在2.6至7.1岁的儿童参与了研究。每次就诊时，使用CPA对3个电极测量T水平。计算“命中”率，以确定不同情况下获得反应的可能性是否不同。比较不同情况下的测试时间。发放问卷以评估家长/照顾者对远程医疗实践的态度。
结果表明，不同情况下的T水平无显著差异。亲自测量和远程测量两种情况下的“命中”率无显著差异（分别为98%和97%）。不同情况下的测试时间相似。问卷结果显示，100%的照顾者会在部分或全部CI预约中使用远程医疗实践。
对于使用CPA设定行为阈值的儿童，远程医疗实践是常规儿科程序预约的可行选择。
