Narne Vijaya Kumar, Mohan Dhanya, Avileri Sruthi Das, Jain Saransh, Ravi Sunil Kumar, Yerraguntla Krishna, Almudhi Abdulaziz, Moore Brian C J
Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61481, Saudi Arabia.
Speech Language Pathology Unit, College of Applied Medical Sciences, King Khalid University, Abha 61481, Saudi Arabia.
Diagnostics (Basel). 2024 Jun 30;14(13):1397. doi: 10.3390/diagnostics14131397.
Audiological diagnosis and rehabilitation often involve the assessment of whether the maximum speech identification score (PB) is poorer than expected from the pure-tone average (PTA) threshold. This requires the estimation of the lower boundary of the PB values expected for a given PTA (one-tailed 95% confidence limit, CL). This study compares the accuracy and consistency of three methods for estimating the 95% CL.
The 95% CL values were estimated using a simulation method, the Harrell-Davis (HD) estimator, and non-linear quantile regression (nQR); the latter two are both distribution-free methods. The first two methods require the formation of sub-groups with different PTAs. Accuracy and consistency in the estimation of the 95% CL were assessed by applying each method to many random samples of 50% of the available data and using the fitted parameters to predict the data for the remaining 50%.
A total of 642 participants aged 17 to 84 years with sensorineural hearing loss were recruited from audiology clinics. Pure-tone audiograms were obtained and PB scores were measured using monosyllables at 40 dB above the speech recognition threshold or at the most comfortable level.
For the simulation method, 6.7 to 8.2% of the PB values fell below the 95% CL for both ears, exceeding the target value of 5%. For the HD and nQR methods, the PB values fell below the estimated 95% CL for approximately 5% of the ears, indicating good accuracy. Consistency, estimated from the standard deviation of the deviations from the target value of 5%, was similar for all the methods.
The nQR method is recommended because it has good accuracy and consistency, and it does not require the formation of arbitrary PTA sub-groups.
听力学诊断与康复通常涉及评估最大言语识别得分（PB）是否比基于纯音平均听阈（PTA）预期的得分更差。这需要估计给定PTA预期的PB值的下限（单尾95%置信限，CL）。本研究比较了三种估计95%置信限的方法的准确性和一致性。
使用模拟方法、哈雷尔 - 戴维斯（HD）估计器和非线性分位数回归（nQR）来估计95%置信限值；后两种方法均为无分布方法。前两种方法需要形成具有不同PTA的亚组。通过将每种方法应用于可用数据的50%的多个随机样本，并使用拟合参数预测其余50%的数据，来评估95%置信限估计的准确性和一致性。
从听力学诊所招募了642名年龄在17至84岁之间的感音神经性听力损失患者。获取了纯音听力图，并使用高于言语识别阈值40 dB或最舒适水平的单音节词测量了PB得分。
对于模拟方法，双耳的PB值有6.7%至8.2%低于95%置信限，超过了目标值5%。对于HD和nQR方法，约5%的耳朵的PB值低于估计的95%置信限，表明准确性良好。从与5%目标值偏差的标准差估计的一致性，在所有方法中相似。
推荐使用nQR方法，因为它具有良好的准确性和一致性，并且不需要形成任意的PTA亚组。
