Ear and Hearing最新文献

{"title":"Relationship Between Auditory Distraction and Emotional Dimensionality for Non-Speech Sounds.","authors":"Shae D Morgan, Erin M Picou, Elizabeth D Young, Samantha J Gustafson","doi":"10.1097/AUD.0000000000001643","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001643","url":null,"abstract":"<p><strong>Objectives: </strong>If task-irrelevant sounds are present when someone is actively listening to speech, the irrelevant sounds can cause distraction, reducing word recognition performance and increasing listening effort. In some previous investigations into auditory distraction, the task-irrelevant stimuli were non-speech sounds (e.g., laughter, animal sounds, music), which are known to elicit a variety of emotional responses. Variations in the emotional response to a task-irrelevant sound could influence the distraction effect. The goal of this study was to examine the relationship between the arousal (exciting versus calming) or valence (positive versus negative) of task-irrelevant auditory stimuli and auditory distraction. Using non-speech sounds that have been used previously in a distraction task, we sought to determine whether stimulus characteristics of arousal or valence affected word recognition or verbal response times (which serve as a measure of behavioral listening effort). We anticipated that the perceived arousal and valence of task-irrelevant stimuli would be related to distraction from target stimuli.</p><p><strong>Design: </strong>In an online listening task, 19 young adult listeners rated the valence and arousal of non-speech sounds, which previously served as task-irrelevant stimuli in studies of auditory distraction. Word recognition and verbal response time data from these previous studies were reanalyzed using the present data to evaluate the effect of valence or arousal stimulus category on the distraction effect in quiet and in noise. In addition, correlation analyses were conducted between ratings of valence, ratings of arousal, word recognition performance, and verbal response times.</p><p><strong>Results: </strong>The presence of task-irrelevant stimuli affected word recognition performance. This effect was observed generally in quiet and for stimuli rated as exciting (in noise) or calming (in quiet). The presence of task-irrelevant stimuli also affected reaction times. Background noise increased verbal response times by approximately 35 msec. In addition, all task-irrelevant stimuli, regardless of valence or arousal category, increased verbal response times by more than 200 msec relative to the condition with no task-irrelevant stimuli. Valenced stimuli caused the largest distraction effect on response times; there was no difference in the distraction effect on verbal response times based on the stimulus arousal category. Correlation analyses between valence ratings and dependent variables (word recognition and reaction time) revealed that, in quiet, there was a weak, but statistically significant, relationship between valence ratings (absolute deviation from neutral) and word recognition scores; the more valenced a stimulus, the more distracting it was in terms of word recognition performance. This significant relationship between valence and word recognition was not evident when participants completed the","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Ear and Hearing Reviewers: Thank You.","authors":"Ruth Y Litovsky","doi":"10.1097/AUD.0000000000001647","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001647","url":null,"abstract":"","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech and Non-Speech Auditory Task Performance by Non-Native English Speakers.","authors":"Bridget McNamara, Douglas S Brungart, Rebecca E Bieber, Ian Phillips, Alyssa J Davidson, Sandra Gordon-Salant","doi":"10.1097/AUD.0000000000001648","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001648","url":null,"abstract":"<p><strong>Objectives: </strong>The goal of this study was to determine if performance on speech and non-speech clinical measures of auditory perception differs between two groups of adults: self-identified native speakers of English and non-native speakers of English who speak Spanish as a first language. The overall objective was to establish whether auditory perception tests developed for native English speakers are appropriate for bilingual Spanish-speaking adults who self-identify as non-native speakers of English. A secondary objective was to determine whether relative performance on English- and Spanish-language versions of a closed-set speech perception in noise task could accurately predict native-like performance on a battery of English language-dependent tests of auditory perception.</p><p><strong>Design: </strong>Participants were young, normal-hearing adults who self-identified as either native speakers of American English (n = 50) or as non-native speakers of American English (NNE; n = 25) who spoke Spanish as their first language. Participants completed a battery of perceptual tests, including speech tests (e.g., Quick Speech-in-Noise, time-compressed reverberant Quick Speech-in-Noise, etc.) and non-speech tests (Gaps in Noise, Frequency Pattern test, Duration Pattern test, Masking Level Difference). The English version of the Oldenburg Sentence test (OLSA) was administered to both groups; NNE participants also completed the Spanish version of the OLSA.</p><p><strong>Results: </strong>Analyses indicate that the native speakers of the American English group performed significantly better than the NNE group on all speech-based tests and on the two pattern recognition tests. There was no difference between groups on the remaining non-speech tests. For the NNE group, a difference of more than 2 SD on group-normalized scores for the English and Spanish OLSA accurately predicted poorer than normal performance on two or more tests of auditory perception with a language-dependent component either in the instructions or the stimuli.</p><p><strong>Conclusions: </strong>The results indicate that a number of English-based tests designed to assess auditory perception may be inappropriate for some Spanish-English bilingual adults. That is, some bilingual adults may perform worse than expected on tests that involve perceiving spoken English, in part because of linguistic differences, and not because of unusually poor auditory perception. The results also support the use of preliminary speech-in-noise screening tests in each of a bilingual patient's languages to establish if auditory perception tests in English are appropriate for a given individual. If a non-native English speaker's screening performance is worse in English than in the native language, one suggested strategy is to select auditory perceptual tests that are impacted minimally or not at all by linguistic differences.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring N400 Predictability Effects During Sustained Speech Comprehension: From Listening-Related Fatigue to Speech Enhancement Evaluation.","authors":"Cheng-Hung Hsin, Chia-Ying Lee, Yu Tsao","doi":"10.1097/AUD.0000000000001635","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001635","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the predictability effect on the N400 as an objective measure of listening-related fatigue during speech comprehension by: (1) examining how its characteristics (amplitude, latency, and topographic distribution) changed over time under clear versus noisy conditions to assess its utility as a marker for listening-related fatigue, and (2) evaluating whether these N400 parameters could assess the effectiveness of speech enhancement (SE) systems.</p><p><strong>Design: </strong>Two event-related potential experiments were conducted on 140 young adults (aged 20 to 30) assigned to four age-matched groups. Using a between-subjects design for listening conditions, participants comprehended spoken sentences ending in high- or low-predictability words while their brain activity was recorded using electroencephalography. Experiment 1 compared the predictability effect on the N400 in clear and noise-masked conditions, while experiment 2 examined this effect under two enhanced conditions (denoised using the transformer- and minimum mean square error-based SE models). Electroencephalography data were divided into two blocks to analyze the changes in the predictability effect on the N400 over time, including amplitude, latency, and topographic distributions.</p><p><strong>Results: </strong>Experiment 1 compared N400 effects across blocks under different clarity conditions. Clear speech in block 2 elicited a more anteriorly distributed N400 effect without reduction or delay compared with block 1. Noisy speech in block 2 showed a reduced, delayed, and posteriorly distributed effect compared with block 1. Experiment 2 examined N400 effects during enhanced speech processing. Transformer-enhanced speech in block 1 demonstrated significantly increased N400 effect amplitude compared to noisy speech. However, both enhancement methods showed delayed N400 effects in block 2.</p><p><strong>Conclusions: </strong>This study suggests that temporal changes in the N400 predictability effect might serve as objective markers of sustained speech processing under different clarity conditions. During clear speech comprehension, listeners appear to maintain efficient semantic processing through additional resource recruitment over time, while noisy speech leads to reduced processing efficiency. When applied to enhanced speech, these N400 patterns reveal both the immediate benefits of SE for semantic processing and potential limitations in supporting sustained listening. These findings demonstrate the potential utility of the N400 predictability effect for understanding sustained listening demands and evaluating SE effectiveness.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Middle Ear Status on Rotary Chair Outcomes in Children.","authors":"Manuel Vicente, Nour El-Hidek, Jessie N Patterson, Gabrielle R Merchant, Kristen L Janky","doi":"10.1097/AUD.0000000000001644","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001644","url":null,"abstract":"<p><strong>Objective: </strong>Middle ear dysfunction is common in young children. There are varying reports on the effects of middle ear dysfunction on the vestibular system; however, it is unknown the extent to which abnormal middle ear function affects vestibular function tests, which could lead to misdiagnosis and improper medical management. Therefore, the purpose of this study is to evaluate how middle ear status affects rotary chair outcomes in young children (6 months to 6 years).</p><p><strong>Design: </strong>Twenty-one children with middle ear dysfunction (mean: 30 months, 11 males) and 36 control children with normal middle ear function (mean: 33 months, 19 males) participated. All participants completed tympanometry, wideband tympanometry, and sinusoidal harmonic acceleration rotary chair testing at 0.01, 0.04, and 0.16 Hz. The primary outcomes were rotary chair gain, phase, and symmetry.</p><p><strong>Results: </strong>For rotary chair gain, there was a significant frequency by group interaction. As expected, gain increased with increases in frequency; however, there were larger gain increases in the middle ear dysfunction group for 0.04 and 0.16 Hz. There was no significant effect of middle ear dysfunction on rotary chair phase or symmetry. Although 6 subjects (29%) had rotary chair phase leads that were greater than 2 SDs from the control mean, there were no significant group-level differences in phase; there was also no effect of severity of middle ear dysfunction on any rotary chair outcomes.</p><p><strong>Conclusions: </strong>Rotary chair in the presence of middle ear dysfunction is valid; however, isolated phase abnormalities can be present that are not explained by severity of middle ear dysfunction. Tympanometry and/or wideband tympanometry is recommended before rotary chair. In the event phase abnormalities are present coupled with abnormal tympanometry and/or wideband tympanometry, rotary chair testing could be repeated once the middle ear normalizes to rule out contributions from middle ear dysfunction.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Level-Adjusted Cochlear Frequency-to-Place Map for Estimating Tonotopic Frequency Mismatch With a Cochlear Implant.","authors":"Elad Sagi, Mario A Svirsky","doi":"10.1097/AUD.0000000000001641","DOIUrl":"10.1097/AUD.0000000000001641","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a level-adjusted correction to the current standard relating anatomical cochlear place to characteristic frequency (CF) in humans, and to re-evaluate anatomical frequency mismatch in cochlear implant (CI recipients considering this correction. It is proposed that a level-adjusted place-frequency function may represent a more relevant tonotopic benchmark for CIs in comparison to the current standard.</p><p><strong>Design: </strong>The present analytical study compiled data from 15 previous animal studies that reported isointensity responses from cochlear structures at different stimulation levels. Extracted outcome measures were CFs and centroid-based best frequencies at 70 dB SPL input from 47 specimens spanning a broad range of cochlear locations. A simple relationship was used to transform these measures to human estimates of characteristic and best frequencies, and nonlinear regression was applied to these estimates to determine how the standard human place-frequency function should be adjusted to reflect best frequency rather than CF. The proposed level-adjusted correction was then compared with average place-frequency positions of commonly used CI devices when programmed with clinical settings.</p><p><strong>Results: </strong>The present study showed that the best frequency at 70 dB SPL (BF70) tends to shift away from CF. The amount of shift was statistically significant (signed-rank test z = 5.143, p < 0.001), but the amount and direction of shift depended on cochlear location. At cochlear locations up to 600° from the base, BF70 shifted downward in frequency relative to CF by about 4 semitones on average. Beyond 600° from the base, BF70 shifted upward in frequency relative to CF by about 6 semitones on average. In terms of spread (90% prediction interval), the amount of shift between CF and BF70 varied from relatively no shift to nearly an octave of shift. With the new level-adjusted place-frequency function, the amount of anatomical frequency mismatch for devices programmed with standard-of-care settings is less extreme than originally thought and may be nonexistent for all but the most apical electrodes.</p><p><strong>Conclusions: </strong>The present study validates the current standard for relating cochlear place to CF, and introduces a level-adjusted correction for how best frequency shifts away from CF at moderately loud stimulation levels. This correction may represent a more relevant tonotopic reference for CIs. To the extent that it does, its implementation may potentially enhance perceptual accommodation and speech understanding in CI users, thereby improving CI outcomes and contributing to advancements in the programming and clinical management of CIs.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Fitting Hearing Aids: Effects of Starting Response and Field Experience.","authors":"Arthur Boothroyd, Dhiman Sengupta, Shaelyn Painter, Elena Shur, Harinath Garudadri, Carol Mackersie","doi":"10.1097/AUD.0000000000001642","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001642","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the effects of changing from a prescribed to a generic starting response on self-fitting outcome and behavior before and after a brief field experience.</p><p><strong>Method: </strong>Twenty adult hearing-aid users with mild-to-moderate hearing loss used a smartphone interface to adjust level and spectral tilt of the output of a wearable master hearing aid while listening to prerecorded speech, presented at 65 dB SPL, in quiet. A prescribed starting response was based on the participant's own audiogram. A generic starting response was based on an audiogram for a typical mild-to-moderate hearing loss and was the same for all participants. Initial self-fittings from the two starting responses took place in the lab. After a brief field experience, involving conversation, self-hearing, and ambient noise, with readjustment as needed, self-fittings from the two starting responses were repeated in the lab. Starting responses, self-fitted responses, and adjustment steps were logged in the master hearing aid for subsequent evaluation of real-ear output spectra and for assessment of self-fitting behavior.</p><p><strong>Results: </strong>Neither starting response nor field experience had a significant effect on mean self-fitted output in the lab (p = 0.506 and 0.149, respectively). However, the SD of individual starting-response effects on high-frequency self-fitted output fell by around 50% after the field experience (p = 0.006). The effect of starting response on self-fitting behavior was limited to number of adjustment steps, which was higher for the generic start (p = 0.014). The effect of field experience on self-fitting behavior was limited to a 50% reduction in self-fitting time (p < 0.001). This reduction was attributable mainly to less time spent listening after each adjustment step (p = 0.019).</p><p><strong>Conclusions: </strong>The findings support the conclusion that, for a population with mild-to-moderate hearing loss, a generic starting response can be a viable option for over-the-counter self-fitting hearing aids. They highlight, however, the need for practice and experience with novel self-fitting hearing aids and the fact that self-fitting may not be suitable for all.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Speech Perception in Noise Through Home-Based Competing Talker Training.","authors":"Mira Van Wilderode, Nathan Van Humbeeck, Ralf T Krampe, Astrid van Wieringen","doi":"10.1097/AUD.0000000000001631","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001631","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the effectiveness of a competing talker training paradigm (2TT-Flemish). The primary objectives were the assessment of on-task learning and the transfer to untrained tasks.</p><p><strong>Design: </strong>A total of 60 participants (54-84 years, mean age = 69.4) with speech-in-noise problems participated in the study. The study used a randomized controlled design with three groups: an immediate training group, a delayed training group, and an active control group. The immediate training group trained from the very beginning, while delayed training started after 4 weeks. The active control group listened to audiobooks for the first 4 weeks. All participants underwent 4 weeks of competing talker training. Outcome measures included speech perception in noise, analytical tasks (modulation detection and phoneme perception in noise), and inhibitory control. In addition, a listening-posture dual task assessed whether training freed up cognitive resources for a concurrently performed task. Finally, we assessed whether training induced self-reported benefits regarding hearing, listening effort, communication strategies, emotional consequences, knowledge, and acceptance of hearing loss. Outcome measures were assessed every 4 weeks over a 12-week period. The present study aimed to investigate the effectiveness of competing talker training in a stratified randomized controlled trial.</p><p><strong>Results: </strong>Overall compliance to the training was good and increased with age. We observed on-task improvements during the 4 weeks of training in all groups. Results showed generalization toward speech-in-noise perception, persisting for at least 4 weeks after the end of training. No transfer toward more analytical tasks or inhibitory control was observed. Initial dual-task costs in postural control were reliably reduced after competing talker training suggesting a link between improved listening skills and cognitive resource allocation in multitask settings. Our results show that listeners report better knowledge about their hearing after training.</p><p><strong>Conclusions: </strong>After training with the 2TT-Flemish, results showed on-task improvements and generalization toward speech-in-noise. Improvements did not generalize toward basic analytical tasks. Results suggest that competing talker training enables listeners to free up cognitive resources, which can be used for another concurrent task.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language Complexities for Deaf and Hard of Hearing Individuals in Their Pursuit of a Career in Science, Technology, Engineering, Mathematics, and Medicine: Perspectives From an LSL/ASL User.","authors":"Henry J Adler","doi":"10.1097/AUD.0000000000001637","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001637","url":null,"abstract":"<p><p>A research scientist with 35 years of experience in the field of hearing research, the author writes that his own experiences have provided a perspective that may be valuable for both future d/Deaf and Hard of Hearing (D/HH) individuals and their peers with typical hearing in their pursuit of a career in Science, Technology, Engineering, Mathematics, and Medicine (STEMM). The author first describes the role of Hearing Inclusive-Association for Research in Otolaryngology in enhancing inclusivity and accessibility for D/HH scientists in the field of Hearing Research. Second, the challenges faced by D/HH scientists arise from the difficulties of working with peers with typical hearing, resulting in less inclusivity and accessibility for the D/HH scientists. The next section deals with solutions to these challenges, including American Sign Language interpreters, websites that give advice on inclusivity and accessibility, and technological advances such as assistive listening devices and smartphones with a capacity for auto captioning. The solutions, however, are fraught with issues such as limited budgets and misperception. Fourth, the author argues that the experiences necessary for a career in STEMM may require a higher-than-expected degree of collaboration with peers with typical hearing outside the laboratory. Finally, studies on successful D/HH scientists in STEMM fields should include experiences of obtaining successful research funding.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Predictive Strength of Better-Ear Four-Frequency Pure-Tone Average With the Addition of the Tinnitus and Hearing Survey-Hearing Subscale.","authors":"Gregory M Ellis, Rebecca Bieber, Alyssa Davidson, LaGuinn Sherlock, Michele Spencer, Douglas Brungart","doi":"10.1097/AUD.0000000000001633","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001633","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of this project was to quantify the relative efficacy of a four-frequency pure-tone average in the better ear (PTA4), the Hearing subscale of the Tinnitus and Hearing Survey (THS-H), and a combination of the two in predicting speech-in-noise performance, hearing aid recommendation, and hearing aid use among United States service members (SMs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A two-analysis retrospective study was performed. The first analysis examined the degree to which better-ear PTA4 alone, THS-H alone, and better-ear PTA4 in conjunction with THS-H predicted performance on a speech-in-noise test, the modified rhyme test. Three binomial mixed-effects models were fitted using better-ear PTA4 alone, THS-H alone, and both measures as primary predictors of interest. Age and sex were included as covariates in all models. The models were compared to one another using Chi-square goodness-of-fit tests and the best-fitting model was examined. Data from 5988 SMs were analyzed in the first analysis. The second analysis examined the degree to which better-ear PTA4 alone, THS-H alone, and better-ear PTA4 in conjunction with THS-H predicted two hearing aid-related outcomes: recommendation for hearing aids by a clinician and hearing aid use. Three receiver operating characteristic curves were fit for each question for better-ear PTA4 alone, THS-H alone, and better-ear PTA4 + THS-H. The area under the curve was bootstrapped to generate confidence intervals to compare the three measures. Data from 8001 SMs were analyzed in the second analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the first analysis, all three models explained more variance than chance; however, the better-ear PTA4 + THS-H model was a significantly better fit than either the better-ear PTA4 alone or the THS-H alone models. Significant main effects of better-ear PTA4 and THS-H indicated that proportion correct decreased as better-ear PTA4 and THS-H increased. A significant interaction was observed such that proportion correct decreased more rapidly if both better-ear PTA4 and THS-H were increasing in tandem. In the second analysis, better-ear PTA4 + THS-H showed good predictive discrimination of a prior hearing aid recommendation. For predicting hearing aid use, better-ear PTA4 was the only predictor with an area under the curve bootstrapped confidence interval that overlapped 0.50, indicating better-ear PTA4 alone is a chance predictor for hearing aid use. Both THS-H alone and better-ear PTA4 + THS-H predicted hearing aid use better than chance, but had poor discrimination overall.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Adding the THS-H to the better-ear PTA4 improves predictions of speech intelligibility in noise, has good predictive strength for hearing aid recommendations, and predicts hearing aid use better than chance. This study provides evidence for using surveys in conjunction with objective data when evaluating hearing ability and recommending int","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}