Schlauch R S, Arnce K D, Olson L M, Sanchez S, Doyle T N
Department of Communication Disorders, University of Minnesota, Minneapolis, USA.
Ear Hear. 1996 Jun;17(3):229-36. doi: 10.1097/00003446-199606000-00006.
To determine the extent to which procedural variations affect pure-tone average-spondee threshold (PTA-SRT) agreement in pseudohypacusis, to propose a theoretical framework to account for threshold differences due to procedural variations, and to devise an effective screening test for identification of pseudohypacusis.
The subjects were normally hearing listeners who feigned a hearing loss. One experimental group received an ascending pure-tone (PT) technique combined with an ascending SRT procedure. A second experimental group received an ascending PT technique paired with a descending SRT procedure. A third experimental group received an ascending SRT procedure paired with a descending PT procedure.
The group mean difference between the three-frequency PTA and the SRT was 10.6, 2.3, and 41.6 dB for the first, second, and third experimental groups, respectively. Comparison SRTs and PTAs from cooperative patients with hearing loss showed that a two-frequency PTA yielded a more effective test for pseudohypacusis than did a three-frequency PTA.
The procedural differences noted in this study are consistent with a loudness bias. It is recommended that clinicians employ an ascending procedure to measure SRTs and a descending procedure to measure PT thresholds to maximize the effectiveness of a screening test for pseudohypacusis based on PTA-SRT differences.
确定在伪聋中程序变化对纯音平均-言语接受阈（PTA-SRT）一致性的影响程度，提出一个理论框架来解释因程序变化导致的阈值差异，并设计一种有效的筛查测试以识别伪聋。
受试者为假装听力损失的听力正常的听众。一个实验组接受升序纯音（PT）技术结合升序言语接受阈（SRT）程序。第二个实验组接受升序PT技术与降序SRT程序配对。第三个实验组接受升序SRT程序与降序PT程序配对。
第一、第二和第三个实验组的三频率PTA与SRT之间的组平均差异分别为10.6、2.3和41.6dB。对有听力损失的合作患者的比较言语接受阈和纯音平均听阈显示，双频率PTA对伪聋的测试比三频率PTA更有效。
本研究中指出的程序差异与响度偏差一致。建议临床医生采用升序程序测量言语接受阈，采用降序程序测量纯音阈值，以基于PTA-SRT差异最大化伪聋筛查测试的有效性。
