Hawley Monica L, Sherlock LaGuinn P, Formby Craig
Department of Otolaryngology, HNS, University of Iowa, Iowa City, Iowa.
Army Hearing Division, United States Army Public Health Center, Aberdeen Proving Ground, Aberdeen, Maryland; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland.
Semin Hear. 2017 Feb;38(1):3-25. doi: 10.1055/s-0037-1598063.
This research was to document intra- and intersubject variability in measures of pure tone thresholds, loudness discomfort levels, and the Contour test of loudness for tonal and speech stimuli across 8 to 10 repeated test sessions over a period of almost 1 year in a group of 11 normal-hearing, older middle-aged adults (39 to 73 years, mean of 56 years). The measured pure tone thresholds and loudness discomfort levels were determined to be stable across sessions, with variability on the order of 5 dB. The categorical judgments for the Contour test for both warbled tones and spondaic speech stimuli decreased over time in level required for categories greater than comfortable. This result contrasts with reports of a slight increase over time when young, normal-hearing adults were tested in comparable measures. The intrasubject variability in the Contour test results was greatest for the 4,000-Hz tonal stimulus for which the largest time effects were observed. The intersubject variability was typically greater than the intrasubject variability and typically increased as the loudness category increased, with some exceptions. The results from this study can be used to aid in power and sample size analyses using these measures in future studies designed to compare effects of treatments based on changes in loudness judgments over time.
本研究旨在记录11名听力正常的中老年成年人(年龄39至73岁,平均56岁)在近1年时间内,经过8至10次重复测试,纯音听阈、响度不适级以及音调与言语刺激响度轮廓测试指标的个体内和个体间变异性。结果显示,测量得到的纯音听阈和响度不适级在各次测试中保持稳定,变异性约为5分贝。对于大于舒适级别的类别,随着时间推移,颤音和重读言语刺激响度轮廓测试的分类判断所需水平降低。这一结果与针对年轻听力正常成年人进行类似测量时随时间略有增加的报告形成对比。在轮廓测试结果中,个体内变异性在4000赫兹音调刺激下最大,且观察到最大的时间效应。个体间变异性通常大于个体内变异性,且通常随响度类别增加而增大,但也有一些例外情况。本研究结果可用于辅助未来研究的功效和样本量分析,这些研究旨在根据响度判断随时间的变化来比较治疗效果。