International Journal of Audiology最新文献

Objective: Listening in a conversation has numerous demands not addressed by traditional speech-intelligibility tests. We here examine the utility of an alternative way to assess conversational listening, the just-follow conversation (JFC) test, namely its reproducibility and sensitivity to stimulus changes, as well as what it can tell us about conversational demands.

Design: Participants repeatedly adjusted the overall level of one monologue, one dialogue and two simultaneous monologues in the front hemifield until they could just follow the speech. Speech was presented in surrounding fixed-level café and same-spectrum noise backgrounds.

Study sample: Fifty-four adults, including 27 bilateral hearing-aid (HA) users, participated. HA users adjusted aided and unaided in separate blocks; non-users repeated each condition to evaluate reproducibility.

Results: JFCs were greater for dialogues than monologues, but not greater for two simultaneous monologues than dialogues. Individual JFCs correlated with self-reported speech understanding as well as pure-tone threshold averages. Aiding did not have a significant effect on results. Measures of reproducibility were comparable to more traditional speech-intelligibility tests.

Conclusion: The current results show that the JFC test is a relatively quick, repeatable measure that invokes both subjective and objective components of speech understanding, but it may be of limited use in evaluating amplification.

Objective: to measure the maximum stable gain (MSG, the feedback limit) and its variability in users with two percutaneous power bone conduction devices (BCDs), to determine an MSG-based fitting range, and to measure the available aided dynamic range.

Design: The MSG was determined with the BCD attached to a participant's head. The BCD output was measured on a skull simulator. A fitting range was derived using the speech intelligibility index.

Study sample: 42 adult BCD users.

Results: The average and range of the MSG was 13.3 ± 3.2 dB for device 1 and 16.1 ± 5.90 dB for device 2. The fitting range is 35-40 dB HL for a good understanding of soft speech and 45-50 dB HL for moderate-to-sufficient understanding of speech at a normal level in at least 50% of the cases with this hearing loss. The output for common speech levels is not limited by the maximum force output, except at low frequencies.

Conclusions: For users of a percutaneous power BCD, the maximum applicable gain is limited by feedback and is smaller than the full-on gain. Consequently, BCDs enable sufficient speech intelligibility only for mild-to-moderate sensorineural hearing loss. The aided dynamic range is adequate for hearing thresholds within this fitting range.

Objective: To introduce the Phoneme Discriminability Level (PDL) and compare its ability to predict scores on the Situated Phoneme (SiP) test with those of a phoneme-level version of the Speech Intelligibility Index (SIIP) and the original Speech Intelligibility Index (SII).

Design: SII, SIIP, and PDL values were calculated for 24,444 SiP-test trials and used to train and evaluate logistic regression models. Models were trained on half of the study sample and statistically evaluated on the other half.

Study sample: Seventy-four adult native speakers of Swedish (mean age = 62 years), with hearing ranging from normal to severe loss. All had symmetric hearing without conductive components.

Results: Models based on PDL and SIIP showed similar overall predictive power, and both outperformed the SII-based model. SIIP and SII were better at predicting average session scores, whereas PDL was better at predicting scores for individual test words. Adding random intercepts for test words improved the predictive accuracy of the SIIP and PDL models, but only at the level of individual words, not whole sessions.

Conclusions: All investigated models are useful for predicting SiP-test scores. SIIP and PDL appear suitable for optimising SiP-test settings and estimating critical differences.

Objective: To survey public attitudes about self-administered home-based hearing tests and fit-at-home hearing aids.

Design: Online survey enquiring about willingness to try the above. Explanatory variables included sex, age, and education.

Study sample: A representative sample of 2135 UK adults.

Results: Only 13% of respondents were unwilling to undertake a home-based hearing test. Perceived benefits of home-based testing were associated with convenience and ease, and its use as a precursor to a formal hearing test. Main concerns were associated with accuracy and reliability. Regarding hearing aid fitting pathways, 71%, 63% and 79% were willing to try a pre-programmed, self-programmed or audiologist-fit hearing aid, respectively. Respondents' preferred pathways were 37% fit-at-home (26% and 11% for pre-programmed and self-programmed, respectively) and 53% for audiologist-fit (10% responded "Don't Know"). Adults >65 years were less willing to complete and/or trust a home-based hearing test, and less willing to try fit-at-home hearing aids.

Conclusion: Most adults reported a willingness to conduct home-based hearing tests and to try fit-at-home hearing aids. These pathways have the potential to shift care closer to home and provide innovative sustainable pathways for a proportion of the public. Their effectiveness combined with user preference has yet to be evaluated.

Objective: The overall aim of this study was to evaluate the construct validity, internal consistency and test-retest reliability of the Swedish version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ-SWE). The aim was to investigate how adults with hearing loss experience their everyday functioning from the perspective of hearing, using the HFEQ-SWE.

Design and study sample: A quantitative cross-sectional survey study with 628 adults, aged 30-96 years (mean 74.4, SD = 10.3) recruited from audiological clinics in three counties of Sweden. The factor structure of the HFEQ was examined by confirmatory factor analysis via comparisons with the 6 subscales of the HFEQ: health, hearing, communication, participation in society, individual resources and societal support. HFEQ ratings were compared for the following variables: sex, level of education, employment and hearing aid usage.

Results: With some modifications of the original HFEQ structure, a CFA showed sufficient model fit and confirmed the HFEQ construct. The internal consistency for the total score was satisfactory, and the correlations between repeated measurements showed stability over time for the total score. There were variations at item level and subscale levels. We identified broad variations in HFEQ ratings and found that the experience of everyday functioning is associated with factors such as age, gender, level of education, employment, and hearing aid usage. Significant correlations were found between self-reported hearing loss and 79% of the HFEQ items.

Conclusion: The overall study results strengthen the validity and reliability of the HFEQ and indicate satisfactory construct validity, internal consistency and test-retest reliability for the total score. Some items need further attention. Differences in the HFEQ rating were found at the item level for the variables of age, gender, education, employment, and hearing aid use, suggesting that these factors affect everyday functioning in addition to hearing loss.

Objective: In congenital cytomegalovirus (cCMV), risk factors for sensorineural hearing loss (SNHL)or deterioration remain unclear, and little is known about specific patterns of sensorineural hearing loss (SNHL). We describe SNHL in a cohort of cCMV infants; we reviewed clinical features and their correlation with distribution, timing, and progression of SNHL.

Design: Anonymised data regarding the first and the last available audiological assessment, along with clinical and treatment information from children with cCMV and SNHL followed up at Imperial College Healthcare NHS Trust (ICHT) and IRCSS-Meyer Children's University Hospital (MCH) were reviewed.

Study sample: Sixty-one children with cCMV and SNHL (both treated and untreated) were included.

Results: Congenital SNHL was found in 47/61 (77%) children, and 14/61 (23%) developed late-onset SNHL (LO-SNHL) at a median of 4.7 years (IQRs 2.2-6.8). Considering the age at development of LO-HL significant differences were found between the curves of untreated and treated for 6 weeks or 6 months (log rank p = 0.04, 0.0007 respectively); no differences were found among patients treated for 6 weeks or 6 months. On audiological assessment, all tested frequencies were usually affected. The majority of children had abnormal brain imaging at baseline, and those with normal imaging were less likely to have deterioration.

Conclusions: In this clinical cohort, LO-SNHL occurred more often in untreated children and the median age at deterioration was 4.7 years (IQRs 2.2-6.8), later than in other cohorts, highlighting the importance of ongoing audiological assessment until 5-6 years of age.

Objective: To summarise the air travel experiences of adults with hearing loss, identifying barriers, facilitators, and implications for accessibility.

Design: A scoping review guided by Arksey and O'Malley's framework. Relevant databases (Medline, CINAHL, SCOPUS, Web of Science, and Google Scholar) and gray literature were searched. Two independent reviewers screened the titles, abstracts, and full texts based on the inclusion criteria. Extracted data were analysed using reflexive thematic analysis.

Study sample: Ten studies met the inclusion criteria, originating from the USA, Australia, Brazil, and Taiwan, and published between 2008 and 2023.

Results: Three main themes emerged: communication barriers, accessibility challenges, and emotional impacts. These themes were mapped across the four stages of the air travel journey: pre-travel, airport, in-flight, and post-flight. Key facilitators included real-time digital updates, improved signage, travel companions, and assistive technologies.

Conclusions: Adults with hearing loss face barriers during air travel that affect their travel experience and emotional well-being. While some facilitators were identified, there remains a need for increased awareness and implementation of inclusive practices within the aviation industry. Future research should explore the effectiveness of policy interventions and evaluate airport and airline compliance with accessibility guidelines.

Objective: To develop a reliable objective method to measure temporal resolution thresholds using Auditory Brainstem Response (ABR) with statistical response detection methods.

Design: The ABR paradigms "Two Clicks (2C)" and "Temporal Notched Noise with Click (TNNC)" were evaluated for measuring objective temporal resolution thresholds. Statistical methods were used for ABR detection. Test-retest reliability of both ABR paradigms was also assessed. For comparison, a Gaps in Noise test and psychometric TNNC paradigm measured behavioural thresholds from the same subjects.

Study sample: 23 normal-hearing participants in the main study, and an additional 10 in the test-retest experiment, aged 20-35 years.

Results: Objective temporal resolution thresholds averaged 4.04 ms for the 2C paradigm and 3.21 ms for the TNNC paradigm. Group-level data showed reduced ABR amplitude and detection as gap durations approached threshold, whilst individual ABR amplitudes fluctuated across gap durations. Behavioural thresholds averaged 1.49 and 2.22 ms. In the test-retest experiment, TNNC showed moderate repeatability, while 2C had slight, non-significant repeatability (measured by Cohen's Kappa).

Conclusions: While these objective approaches show promise for measuring temporal resolution at a group level, their application in individuals remains challenging due to high variability across subjects. The TNNC paradigm demonstrated better performance in terms of ABR repeatability.

Objective: To psychoacoustically characterise a corpus of Danish sentences that have been developed for speech-in-noise experiments and to assess the influence of speech intelligibility scoring methods and linguistic syntax on the resulting psychometric functions.

Design: Psychometric functions are estimated for each sentence in stationary speech-shaped noise using the method of constant stimuli and five signal-to-noise ratios from -10 to 0 dB.

Study sample: Sentences from one of the four talkers in the corpus were presented pseudo-randomly to 60 normal hearing participants so that each sentence was heard by 20 different participants.

Results: The inflection point of the psychometric function was affected by both the scoring rule applied and by the number of scoring units per sentence, but not by the linguistic syntax. The slope of the psychometric function was significantly affected by only the number of scoring units. The mean psychometric function based on one of the scoring methods revealed a speech reception threshold (${\text{SRT}}_{50}$) of -4.8 dB and a slope of 11.7%/dB.

Conclusions: The psychometric functions of the sentences are modifiable depending on the scoring method applied. Moreover, the linguistic variation of the syntax present in the corpus does not lead to systematic changes in the psychometric functions.

Objective: To assess whether bedside parental education improves the loss to follow-up (LTF) rate after undergoing universal newborn hearing screening (UNHS) in Thailand.

Design: A randomised controlled trial.

Study sample: Parents of newborns who did not pass the first-stage hearing screening were included and randomly allocated to the control and intervention groups. For parents in the control group, nurses or nurse assistants provided verbal information on the UNHS at bedside. For parents in the intervention group, a physician provided detailed verbal and written information at bedside. LTF was defined as any referred newborns who did not attend the rescreening, diagnostic, or intervention stage by 1, 3 or 6 months of age.

Results: Among 5,148 newborns, 271 who did not pass the screening were included. The LTF rate in the intervention group (10.37%, 14/135 participants) was significantly lower than that in the control group (21.32%, 29/136 participants) in the intention-to-treat analysis (p = 0.021, 95% confidence interval: 1.6-20.3%). Nine and five infants with hearing loss in the intervention and control groups, respectively, were identified.

Conclusion: Bedside parental education provided by the physician, along with written information, could improve the LTF rate.This study was registered in the Thai Clinical Trials Registry (TCTR20210902008).