Accuracy and Reliability of a Real-Ear-to-Coupler Difference Measurement Procedure Implemented within a Behind-the-Ear Hearing Aid

2011 ◽  
Vol 22 (09) ◽  
pp. 612-622 ◽  
Author(s):  
Susan Scollie ◽  
Marlene Bagatto ◽  
Sheila Moodie ◽  
Jeff Crukley

Background: Measurement of the real ear response of a fitted hearing aid allows matching of the frequency response to prescriptive targets, as well as comparison of the response to both threshold and loudness discomfort level (LDL). These processes are recommended procedures for hearing aid fittings. The real ear aided response (REAR) is often predicted based on the coupler response of the device, the real-ear-to-coupler difference (RECD), and the microphone location effect (MLE). Individualized measurement of the RECD tends to increase the accuracy of this prediction. A commercial hearing aid has been developed that measures the individual RECD and incorporates the data into the software-assisted fitting process. Purpose: This study evaluated the test-retest reliability and predictive validity of this particular method for measuring the RECD. Research Design: A repeated measures design was used to evaluate differences between subsequent measures of the RECD in the same ear, and prediction differences associated with using the RECD (and other information) to predict the REAR. Study Sample: Fifteen ears, on a convenience sample of ten adults (45–86 yr) and five children (6–15 yr) were tested. All participants were hearing aid users. Data Collection and Analysis: Predicted and measured REARs were collected using normal clinical procedures, on an Audioscan Verifit VF-1 for two test signals/levels. Reliability, mean differences between predicted and measured REARs, and 95% confidence intervals of the prediction accuracy are reported. Results: The RECD procedure had test-retest reliability within 2.5 dB for 14 out of 15 ears between 500 and 4000 Hz, and had predictive accuracy within 5 dB between 500 and 4000 Hz for 14 out of 15 ears. However, errors associated with earhook misalignment were discovered. Also, the RECD values measured using this hearing-aid-specific procedure differ somewhat from the normative data available from insert earphone RECDs. Conclusions: This procedure, when measured according to recommendations, provides a reasonably accurate prediction of the REAR. Functionally, this procedure does not replace the range of measures offered by modern real ear measurement systems. However, given the inaccuracy of software-assisted fittings without a measure of individual ear canal acoustics, use of this procedure may have the potential to improve the accuracy of fittings versus fittings completed without real ear measurement.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanzhi Bi ◽  
Xin Hou ◽  
Jiahui Zhong ◽  
Li Hu

AbstractPain perception is a subjective experience and highly variable across time. Brain responses evoked by nociceptive stimuli are highly associated with pain perception and also showed considerable variability. To date, the test–retest reliability of laser-evoked pain perception and its associated brain responses across sessions remain unclear. Here, an experiment with a within-subject repeated-measures design was performed in 22 healthy volunteers. Radiant-heat laser stimuli were delivered on subjects’ left-hand dorsum in two sessions separated by 1–5 days. We observed that laser-evoked pain perception was significantly declined across sessions, coupled with decreased brain responses in the bilateral primary somatosensory cortex (S1), right primary motor cortex, supplementary motor area, and middle cingulate cortex. Intraclass correlation coefficients between the two sessions showed “fair” to “moderate” test–retest reliability for pain perception and brain responses. Additionally, we observed lower resting-state brain activity in the right S1 and lower resting-state functional connectivity between right S1 and dorsolateral prefrontal cortex in the second session than the first session. Altogether, being possibly influenced by changes of baseline mental state, laser-evoked pain perception and brain responses showed considerable across-session variability. This phenomenon should be considered when designing experiments for laboratory studies and evaluating pain abnormalities in clinical practice.


2002 ◽  
Vol 82 (4) ◽  
pp. 364-371 ◽  
Author(s):  
Douglas P Gross ◽  
Michele C Battié

Abstract Background and Purpose. Functional capacity evaluations (FCEs) are measurement tools used in predicting readiness to return to work following injury. The interrater and test-retest reliability of determinations of maximal safe lifting during kinesiophysical FCEs were examined in a sample of people who were off work and receiving workers' compensation. Subjects. Twenty-eight subjects with low back pain who had plateaued with treatment were enrolled. Five occupational therapists, trained and experienced in kinesiophysical methods, conducted testing. Methods. A repeated-measures design was used, with raters testing subjects simultaneously, yet independently. Subjects were rated on 2 occasions, separated by 2 to 4 days. Analyses included intraclass correlation coefficients (ICCs) and 95% confidence intervals. Results. The ICC values for interrater reliability ranged from .95 to .98. Test-retest values ranged from .78 to .94. Discussion and Conclusion. Inconsistencies in subjects' performance across sessions were the greatest source of FCE measurement variability. Overall, however, test-retest reliability was good and interrater reliability was excellent.


2014 ◽  
Vol 25 (04) ◽  
pp. 335-342 ◽  
Author(s):  
Elisabeth Hutter ◽  
Miriam Grapp ◽  
Heike Argstatter ◽  
Hans Volker Bolay

Background: In general, tinnitus pitch has been observed to be variable across time for most patients experiencing tinnitus. Some tinnitus therapies relate to the dominant tinnitus pitch in order to adjust therapeutic interventions. As studies focusing on tinnitus pitch rarely conduct consecutive pitch matching in therapeutic settings, little is known about the course and variability of tinnitus pitch during therapeutic interventions. Purpose: The purpose of this study was to investigate the variability and development of tinnitus pitch in the course of therapeutic interventions. Tinnitus pitch was suspected to be highly variable. Research design: The researchers conducted a descriptive, retrospective analysis of data. Study Sample: A total of 175 adult patients experiencing chronic tinnitus served as participants. All patients had received a neuro-music therapy according to the “Heidelberg Model of Music Therapy for Chronic Tinnitus.” Data Collection and Analysis: During therapeutic interventions lasting for 5 consecutive days, the individual tinnitus frequency was assessed daily by means of a tinnitus pitch–matching procedure. The extent of variability in tinnitus pitch was calculated by mean ratios of frequencies between subsequent tinnitus measurements. Analysis of variance of repeated measures and post hoc paired samples t-tests were used for comparison of means in tinnitus frequencies, and the test-retest reliability of measurements was obtained by the Pearson product-moment correlation coefficient. Results: Tinnitus pitch displayed a variability of approximately 3/5 to 4/5 octaves per day. Overall, the mean frequency declined in the course of the therapy. Detailed analysis revealed three groups of patients with diverging tinnitus progression. The test-retest reliability between assessments turned out to be robust (r = 0.74 or higher). Conclusions: Considerable variation in tinnitus pitch was found. Consequently, a frequent rechecking of tinnitus frequency is suggested during frequency-specific acoustic stimulation in order to train appropriate frequency bands.


2012 ◽  
Vol 23 (05) ◽  
pp. 366-378 ◽  
Author(s):  
Daniel B. Putterman ◽  
Michael Valente

Background: A telecoil (t-coil) is essential for hearing aid users when listening on the telephone because using the hearing aid microphone when communicating on the telephone can cause feedback due to telephone handset proximity to the hearing aid microphone. Clinicians may overlook the role of the t-coil due to a primary concern of matching the microphone frequency response to a valid prescriptive target. Little has been published to support the idea that the t-coil frequency response should match the microphone frequency response to provide “seamless” and perhaps optimal performance on the telephone. If the clinical goal were to match both frequency responses, it would be useful to know the relative differences, if any, that currently exist between these two transducers. Purpose: The primary purpose of this study was to determine if statistically significant differences were present between the mean output (in dB SPL) of the programmed microphone program and the hearing aid manufacturer's default t-coil program as a function of discrete test frequencies. In addition, pilot data are presented on the feasibility of measuring the microphone and t-coil frequency response with real-ear measures using a digital speech-weighted noise. Research Design: A repeated-measures design was utilized for a 2-cc coupler measurement condition. Independent variables were the transducer (microphone, t-coil) and 11 discrete test frequencies (15 discrete frequencies in the real-ear pilot condition). Study Sample: The study sample was comprised of behind-the-ear (BTE) hearing aids from one manufacturer. Fifty-two hearing aids were measured in a coupler condition, 39 of which were measured in the real-ear pilot condition. Hearing aids were previously programmed and verified using real-ear measures to the NAL-NL1 (National Acoustic Laboratories—Non-linear 1) prescriptive target by a licensed audiologist. Data Collection and Analysis: Hearing aid output was measured with a Fonix 7000 hearing aid analyzer (Frye Electronics, Inc.) in a HA-2 2-cc coupler condition using a pure-tone sweep at an input level of 60 dB SPL with the hearing aid in the microphone program and 31.6 mA/M in the t-coil program. A digital speech weighted noise input signal presented at additional input levels was used in the real-ear pilot condition. A mixed-model repeated-measures analysis of variance (ANOVA) and the Tukey Honestly Significant Difference (HSD) post hoc test were utilized to determine if significant differences were present in performance across treatment levels. Results: There was no significant difference between mean overall t-coil and microphone output averaged across 11 discrete frequencies (F(1,102) = 0, p < 0.98). A mixed-model repeated-measures ANOVA revealed a significant transducer by frequency interaction (F(10,102) = 13.0, p < 0.0001). Significant differences were present at 200 and 400 Hz where the mean t-coil output was less than the mean microphone output, and at 4000, 5000, and 6300 Hz where the mean t-coil output was greater than the mean microphone output. Conclusions: The mean t-coil output was significantly lower than the mean microphone output at 400 Hz, a frequency that lies within the typical telephone bandwidth of 300–3300 Hz. This difference may partially help to explain why some patients often complain the t-coil fails to provide sufficient loudness for telephone communication.


2005 ◽  
Vol 85 (6) ◽  
pp. 502-514 ◽  
Author(s):  
Carolyn A Emery ◽  
J David Cassidy ◽  
Terry P Klassen ◽  
Rhonda J Rosychuk ◽  
Brian H Rowe

AbstractBackground and Purpose. There is a need in sports medicine for a static and dynamic standing balance measure to quantify balance ability in adolescents. The purposes of this study were to determine the test-retest reliability of timed static (eyes open) and dynamic (eyes open and eyes closed) unipedal balance measurements and to examine factors associated with balance. Subjects. Adolescents (n=123) were randomly selected from 10 Calgary high schools. Methods. This study used a repeated-measures design. One rater measured unipedal standing balance, including timed eyes-closed static (ECS), eyes-open dynamic (EOD), and eyes-closed dynamic (ECD) balance at baseline and 1 week later. Dynamic balance was measured on a foam surface. Reliability was examined using both intraclass correlation coefficients (ICCs) and Bland and Altman statistical techniques. Multiple linear regressions were used to examine other potentially influencing factors. Results. Based on ICCs, test-retest reliability was adequate for ECS, EOD, and ECD balance (ICC=.69, .59, and .46, respectively). The results of Bland and Altman methods, however, suggest that caution is required in interpreting reliability based on ICCs alone. Although both ECS balance and ECD balance appear to demonstrate adequate test-retest reliability by ICC, Bland and Altman methods of agreement demonstrate sufficient reliability for ECD balance only. Thirty percent of the subjects reached the 180-second maximum on EOD balance, suggesting that this test is not appropriate for use in this population. Balance ability (ECS and ECD) was better in adolescents with no past history of lower-extremity injury. Discussion and Conclusion. Timed ECD balance is an appropriate and reliable clinical measurement for use in adolescents and is influenced by previous injury.


1981 ◽  
Vol 24 (3) ◽  
pp. 366-374 ◽  
Author(s):  
Jerry L. Punch ◽  
Cheryl A. Parker

The relationships among pairwise judgments of the quality of connected discourse, pairwise judgments of the relative intelligibility of discourse, and measured intelligibility on a nonsense-syllable test were evaluated under identical conditions of primary talker and competitive babble. Stimuli were processed by eight hearing aids and presented in a repeated-measures design to 12 listeners with sensorineural hearing loss. Results revealed moderately high test-retest reliability for all three experimental conditions. Overall, a noteworthy positive relationship was evident between relative intelligibility judgments and measured phonemic identification, although this relationship varied considerably among individual listeners. The correspondence between quality judgments and relative intelligibility judgments was substantially lower, while the relationship between judgments of quality and phonemic identification scores was negligible, Findings demonstrate the potential importance of instructional set in producing valid judgments of the relative intelligibility of aided speech. The determination of measurement error inherent in pairwise preference data is discussed from the viewpoint of a probabilistic model encompassing a binomial distribution. It is concluded that experimental optimization of the agreement between relative intelligibility judgments and measured intelligibility performance of individual listeners will be required before the pairwise comparison technique can be considered a viable alternative to traditional hearing aid evaluation procedures.


2014 ◽  
Vol 57 (4) ◽  
pp. 1323-1329 ◽  
Author(s):  
Sally K. Gallena ◽  
Nancy Pearl Solomon ◽  
Arthur T. Johnson ◽  
Jafar Vossoughi ◽  
Wei Tian

Purpose In this study, the authors aimed to determine reliability of the airflow perturbation device (APD) to measure respiratory resistance within and across sessions during resting tidal (RTB) and postexercise breathing in healthy athletes, and during RTB across trials within a session in athletes with paradoxical vocal fold motion (PVFM) disorder. Method Prospective, repeated-measures design. The APD measured respiratory resistance during 3 baseline assessments in 24 teenage female athletes, 12 with and 12 without PVFM. Control athletes provided data at rest and following a customized exercise challenge during each of 3 sessions. Intraclass correlation coefficient (ICC) analysis assessed strength of relationships, and repeated-measures analysis of variance assessed differences across trials and sessions. Results ICC analyses confirmed strong correlations across RTB trials for inspiratory, expiratory, and mean respiratory resistance in both groups. Inspiratory resistance decreased ~5% between sessions for control participants; expiratory and mean respiratory resistances were stable. Data from control athletes across sessions and following rigorous exercise were strongly correlated when taken at comparable intervals. Conclusions APD-measured respiratory resistance, including separate assessments for the inspiratory and expiratory phases, has strong test–retest reliability during RTB and after exercising. This suggests that the APD is a useful measurement tool for the assessment of airway function in patients suspected of having PVFM.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zahra Barakchian ◽  
Anjali Raja Beharelle ◽  
Todd A. Hare

AbstractFood choice paradigms are commonly used to study decision mechanisms, individual differences, and intervention efficacy. Here, we measured behavior from twenty-three healthy young adults who completed five repetitions of a cued-attribute food choice paradigm over two weeks. This task includes cues prompting participants to explicitly consider the healthiness of the food items before making a selection, or to choose naturally based on whatever freely comes to mind. We found that the average patterns of food choices following both cue types and ratings about the palatability (i.e. taste) and healthiness of the food items were similar across all five repetitions. At the individual level, the test-retest reliability for choices in both conditions and healthiness ratings was excellent. However, test-retest reliability for taste ratings was only fair, suggesting that estimates about palatability may vary more from day to day for the same individual.


2020 ◽  
Vol 31 (06) ◽  
pp. 412-441 ◽  
Author(s):  
Richard H. Wilson ◽  
Victoria A. Sanchez

Abstract Background In the 1950s, with monitored live voice testing, the vu meter time constant and the short durations and amplitude modulation characteristics of monosyllabic words necessitated the use of the carrier phrase amplitude to monitor (indirectly) the presentation level of the words. This practice continues with recorded materials. To relieve the carrier phrase of this function, first the influence that the carrier phrase has on word recognition performance needs clarification, which is the topic of this study. Purpose Recordings of Northwestern University Auditory Test No. 6 by two female speakers were used to compare word recognition performances with and without the carrier phrases when the carrier phrase and test word were (1) in the same utterance stream with the words excised digitally from the carrier (VA-1 speaker) and (2) independent of one another (VA-2 speaker). The 50-msec segment of the vowel in the target word with the largest root mean square amplitude was used to equate the target word amplitudes. Research Design A quasi-experimental, repeated measures design was used. Study Sample Twenty-four young normal-hearing adults (YNH; M = 23.5 years; pure-tone average [PTA] = 1.3-dB HL) and 48 older hearing loss listeners (OHL; M = 71.4 years; PTA = 21.8-dB HL) participated in two, one-hour sessions. Data Collection and Analyses Each listener had 16 listening conditions (2 speakers × 2 carrier phrase conditions × 4 presentation levels) with 100 randomized words, 50 different words by each speaker. Each word was presented 8 times (2 carrier phrase conditions × 4 presentation levels [YNH, 0- to 24-dB SL; OHL, 6- to 30-dB SL]). The 200 recorded words for each condition were randomized as 8, 25-word tracks. In both test sessions, one practice track was followed by 16 tracks alternated between speakers and randomized by blocks of the four conditions. Central tendency and repeated measures analyses of variance statistics were used. Results With the VA-1 speaker, the overall mean recognition performances were 6.0% (YNH) and 8.3% (OHL) significantly better with the carrier phrase than without the carrier phrase. These differences were in part attributed to the distortion of some words caused by the excision of the words from the carrier phrases. With the VA-2 speaker, recognition performances on the with and without carrier phrase conditions by both listener groups were not significantly different, except for one condition (YNH listeners at 8-dB SL). The slopes of the mean functions were steeper for the YNH listeners (3.9%/dB to 4.8%/dB) than for the OHL listeners (2.4%/dB to 3.4%/dB) and were <1%/dB steeper for the VA-1 speaker than for the VA-2 speaker. Although the mean results were clear, the variability in performance differences between the two carrier phrase conditions for the individual participants and for the individual words was striking and was considered in detail. Conclusion The current data indicate that word recognition performances with and without the carrier phrase (1) were different when the carrier phrase and target word were produced in the same utterance with poorer performances when the target words were excised from their respective carrier phrases (VA-1 speaker), and (2) were the same when the carrier phrase and target word were produced as independent utterances (VA-2 speaker).


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