{"title":"耳蜗丢失对耳蜗后评估听觉脑干反应(ABR)特异性及假阳性率影响的研究","authors":"D R Watson","doi":"10.3109/00206099909073017","DOIUrl":null,"url":null,"abstract":"<p><p>The auditory brainstem response (ABR) test is widely used as a screen for retrocochlear dysfunction in individuals suffering idiopathic auditory and vestibular disturbance. Although its sensitivity for lesions of the lower brainstem is well established, hearing loss is known to have significant effects upon the test's specificity and false positive rate. This study analysed the effects of aspects of cochlear hearing loss including level, slope and general audiogram shape on these properties of the ABR test in a large clinical group. The study comprised 306 patients (153 male, 153 female) referred for ABR screening to exclude retrocochlear dysfunction. Of 566 ears meeting the inclusion criteria, 85 (15 per cent) failed the test. On follow-up eight ears (3 per cent) were confirmed to have some form of retrocochlear abnormality, seven of which were pathological. All had abnormal ABR results. No cases of retrocochlear abnormality were found in the ABR pass group. In those patients diagnosed as free of retrocochlear problems, the importance of the I-V interval as a primary index of function was confirmed. It displayed a high specificity (>90 per cent) which was largely independent of the level or slope of high-frequency hearing loss. In contrast wave V specificity decreased with increasing loss and increasing slope. Its value as a functional index was limited with losses greater than 70 dB HL in whom specificity fell below 70 per cent. The study concluded that, despite reducing interval availability above 60 dB HL, wave V latency cannot be used as an alternative index because it displays weakening specificity over this range of loss. With the problems inherent in applying latency corrections, the author advocates the use of improved procedures for wave I identification in these cases.</p>","PeriodicalId":75571,"journal":{"name":"Audiology : official organ of the International Society of Audiology","volume":"38 3","pages":"155-64"},"PeriodicalIF":0.0000,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/00206099909073017","citationCount":"8","resultStr":"{\"title\":\"A study of the effects of cochlear loss on the auditory brainstem response (ABR) specificity and false positive rate in retrocochlear assessment.\",\"authors\":\"D R Watson\",\"doi\":\"10.3109/00206099909073017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The auditory brainstem response (ABR) test is widely used as a screen for retrocochlear dysfunction in individuals suffering idiopathic auditory and vestibular disturbance. Although its sensitivity for lesions of the lower brainstem is well established, hearing loss is known to have significant effects upon the test's specificity and false positive rate. This study analysed the effects of aspects of cochlear hearing loss including level, slope and general audiogram shape on these properties of the ABR test in a large clinical group. The study comprised 306 patients (153 male, 153 female) referred for ABR screening to exclude retrocochlear dysfunction. Of 566 ears meeting the inclusion criteria, 85 (15 per cent) failed the test. On follow-up eight ears (3 per cent) were confirmed to have some form of retrocochlear abnormality, seven of which were pathological. All had abnormal ABR results. No cases of retrocochlear abnormality were found in the ABR pass group. In those patients diagnosed as free of retrocochlear problems, the importance of the I-V interval as a primary index of function was confirmed. It displayed a high specificity (>90 per cent) which was largely independent of the level or slope of high-frequency hearing loss. In contrast wave V specificity decreased with increasing loss and increasing slope. Its value as a functional index was limited with losses greater than 70 dB HL in whom specificity fell below 70 per cent. The study concluded that, despite reducing interval availability above 60 dB HL, wave V latency cannot be used as an alternative index because it displays weakening specificity over this range of loss. 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引用次数: 8
摘要
听觉脑干反应(ABR)试验被广泛用于筛查患有特发性听觉和前庭障碍的个体的耳蜗后功能障碍。虽然它对下脑干病变的敏感性是公认的,但听力损失对测试的特异性和假阳性率有显著影响。本研究分析了大量临床人群中耳蜗听力损失的各个方面,包括水平、坡度和一般听力图形状对ABR测试这些特性的影响。该研究纳入306例患者(153名男性,153名女性),进行ABR筛查以排除耳蜗后功能障碍。在符合纳入标准的566只耳朵中,有85只(15%)没有通过测试。在随访中,8只耳朵(3%)被证实有某种形式的耳蜗后异常,其中7只是病理性的。所有患者的ABR结果均异常。ABR通组未见耳蜗后异常。在诊断为无耳蜗后问题的患者中,证实了I-V间期作为功能主要指标的重要性。它显示出高特异性(> 90%),这在很大程度上与高频听力损失的水平或坡度无关。相反,波V特异性随着损失和斜率的增加而降低。当损失大于70 dB HL时,其作为功能指标的价值有限,特异性低于70%。该研究得出结论,尽管间隔可用性在60 dB HL以上降低,但波V潜伏期不能作为替代指标,因为它在损失范围内的特异性较弱。由于应用延迟校正的固有问题,作者主张在这些情况下使用改进的波I识别程序。
A study of the effects of cochlear loss on the auditory brainstem response (ABR) specificity and false positive rate in retrocochlear assessment.
The auditory brainstem response (ABR) test is widely used as a screen for retrocochlear dysfunction in individuals suffering idiopathic auditory and vestibular disturbance. Although its sensitivity for lesions of the lower brainstem is well established, hearing loss is known to have significant effects upon the test's specificity and false positive rate. This study analysed the effects of aspects of cochlear hearing loss including level, slope and general audiogram shape on these properties of the ABR test in a large clinical group. The study comprised 306 patients (153 male, 153 female) referred for ABR screening to exclude retrocochlear dysfunction. Of 566 ears meeting the inclusion criteria, 85 (15 per cent) failed the test. On follow-up eight ears (3 per cent) were confirmed to have some form of retrocochlear abnormality, seven of which were pathological. All had abnormal ABR results. No cases of retrocochlear abnormality were found in the ABR pass group. In those patients diagnosed as free of retrocochlear problems, the importance of the I-V interval as a primary index of function was confirmed. It displayed a high specificity (>90 per cent) which was largely independent of the level or slope of high-frequency hearing loss. In contrast wave V specificity decreased with increasing loss and increasing slope. Its value as a functional index was limited with losses greater than 70 dB HL in whom specificity fell below 70 per cent. The study concluded that, despite reducing interval availability above 60 dB HL, wave V latency cannot be used as an alternative index because it displays weakening specificity over this range of loss. With the problems inherent in applying latency corrections, the author advocates the use of improved procedures for wave I identification in these cases.