Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, USA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
J Acoust Soc Am. 2022 Jul;152(1):214. doi: 10.1121/10.0012217.
Statistical approaches that could be used as standardized methodology for evaluating reliability and validity of data obtained using remote audiometry are proposed. Using data from the Nurses' Health Study II (n = 31), the approaches to evaluate the reliability and validity of hearing threshold measurements obtained by a self-administered iPhone-based hearing assessment application (Decibel Therapeutics, Inc., Boston, MA) compared with measurements obtained by clinical (soundbooth) audiometry are described. These approaches use mixed-effects models to account for multilevel correlations, intraclass correlation coefficients (ICCs) of single and averaged measurements, and regression techniques with the generalized estimating equations (GEEs) to account for between-ear correlations. Threshold measurements obtained using the iPhone application were moderately reliable. The reliability was improved substantially by averaging repeated measurements; good reliability was achieved by averaging three repeated measurements. In the linear regression analyses that assessed validity, the range of intercepts (2.3-8.4) and range of slopes (0.4-0.7) indicated that the measurements from the application were likely biased from those obtained by clinical audiometry. When evaluating alternative hearing assessment tools, it is recommended to assess reliability through mixed-effects models and use ICCs to determine the number of repeated assessments needed to achieve satisfactory reliability. When evaluating validity, GEE methods are recommended to estimate regression coefficients.
提出了可用于评估使用远程听力计获得的数据的可靠性和有效性的标准化方法。使用来自护士健康研究 II (n = 31)的数据,描述了通过自我管理的基于 iPhone 的听力评估应用程序(Decibel Therapeutics,Inc.,Boston,MA)获得的听力阈值测量值与通过临床(隔音室)听力计获得的测量值的可靠性和有效性评估的方法。这些方法使用混合效应模型来解释多层次相关性、单次和平均测量的组内相关系数(ICCs)以及广义估计方程(GEEs)的回归技术来解释耳间相关性。使用 iPhone 应用程序获得的阈值测量值具有中等可靠性。通过重复测量值的平均值,可以大大提高可靠性;通过平均三个重复测量值,可以获得良好的可靠性。在评估有效性的线性回归分析中,截距范围(2.3-8.4)和斜率范围(0.4-0.7)表明,应用程序的测量值可能与临床听力计获得的测量值存在偏差。在评估替代听力评估工具时,建议通过混合效应模型评估可靠性,并使用 ICC 确定获得令人满意的可靠性所需的重复评估次数。在评估有效性时,建议使用 GEE 方法估计回归系数。
J Acoust Soc Am. 2022-7
J Laryngol Otol. 2016-3
Ann Otol Rhinol Laryngol. 2020-6
J Appl Stat. 2023-11-17
Stat Med. 2022-11-20
J Am Geriatr Soc. 2021-2
J Otolaryngol Head Neck Surg. 2019-11-7
Am J Epidemiol. 2020-3-2
JMIR Mhealth Uhealth. 2018-1-10
J Am Acad Audiol. 2017-3