Confidence Limits for Maximum Word-Recognition Scores

1995 ◽  
Vol 38 (2) ◽  
pp. 490-502 ◽  
Author(s):  
Judy R. Dubno ◽  
Fu-Shing Lee ◽  
Alan J. Klein ◽  
Lois J. Matthews ◽  
Chan F. Lam
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Confidence Limit ◽  
Lower Boundary ◽  
Clinical Judgments ◽  
Wide Range ◽  
Northwestern University ◽  
Cochlear Hearing Loss ◽  
Aged Subjects ◽  
Measure Word

Clinical judgments are often made regarding whether maximum word-recognition scores (PB max ) are appropriate in relation to degree of sensorineural hearing loss. In order to determine if word recognition is significantly poorer than expected, it is necessary to consider the lower boundary of PB max associated with a particular degree of hearing loss for speech materials commonly used to measure word recognition. The purpose of this experiment was to define a confidence limit for PB max from Northwestern University Test #6 (NU-6) word-recognition scores obtained from a large group of young and aged subjects with confirmed cochlear hearing loss. Word-recognition scores at several speech levels were obtained from 407 ears with a wide range of pure-tone averages. Because the characteristics of the distribution of maximum scores are not known, a procedure was developed using computer simulations to approximate the distribution of word-recognition scores corresponding to PB max and determine the 95% confidence limit (CL). Results of the simulation were confirmed by comparing means and standard deviations of PB max derived from experimental and simulation data. Percentages of young and aged subjects with scores outside the 95% CL are equal to their proportions in the entire subject sample. If PB max determined from a score-level psychometric function is poorer than the 95% CL, PB max may be considered “disproportionately” poor in relation to the degree of hearing loss. One score measured at a single arbitrary suprathreshold level that is poorer than the 95% CL suggests that the score may underestimate PB max and that word recognition should be measured at additional levels to obtain a more reasonable estimate of the listener’s maximum word-recognition score.

scholarly journals A Comparison of Presentation Levels to Maximize Word Recognition Scores

2009 ◽  
Vol 20 (06) ◽  
pp. 381-390 ◽  
Author(s):  
Lesli A. Guthrie ◽  
Carol L. Mackersie
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Maximum Level ◽  
Computer Assisted ◽  
Phoneme Recognition ◽  
Presentation Level ◽  
Wide Range ◽  
Severe Group ◽  
The Mean ◽  
Intensity Functions

Background: While testing suprathreshold word recognition at multiple levels is considered best practice, studies on practice patterns do not suggest that this is common practice. Audiologists often test at a presentation level intended to maximize recognition scores, but methods for selecting this level are not well established for a wide range of hearing losses. Purpose: To determine the presentation level methods that resulted in maximum suprathreshold phoneme-recognition scores while avoiding loudness discomfort. Research Design: Performance-intensity functions were obtained for 40 participants with sensorineural hearing loss using the Computer-Assisted Speech Perception Assessment. Participants had either gradually sloping (mild, moderate, moderately severe/severe) or steeply sloping losses. Performance-intensity functions were obtained at presentation levels ranging from 10 dB above the SRT to 5 dB below the UCL (uncomfortable level). In addition, categorical loudness ratings were obtained across a range of intensities using speech stimuli. Scores obtained at UCL – 5 dB (maximum level below loudness discomfort) were compared to four alternative presentation-level methods. The alternative presentation-level methods included sensation level (SL; 2 kHz reference, SRT reference), a fixed-level (95 dB SPL) method, and the most comfortable loudness level (MCL).For the SL methods, scores used in the analysis were selected separately for the SRT and 2 kHz references based on several criteria. The general goal was to choose levels that represented asymptotic performance while avoiding loudness discomfort. The selection of SLs varied across the range of hearing losses. Results: Scores obtained using the different presentation-level methods were compared to scores obtained using UCL – 5 dB. For the mild hearing loss group, the mean phoneme scores were similar for all presentation levels. For the moderately severe/severe group, the highest mean score was obtained using UCL − 5 dB. For the moderate and steeply sloping groups, the mean scores obtained using 2 kHz SL were equivalent to UCL − 5 dB, whereas scores obtained using the SRT SL were significantly lower than those obtained using UCL − 5 dB. The mean scores corresponding to MCL and 95 dB SPL were significantly lower than scores for UCL − 5 dB for the moderate and the moderately severe/severe group. Conclusions: For participants with mild to moderate gradually sloping losses and for those with steeply sloping losses, the UCL – 5 dB and the 2 kHz SL methods resulted in the highest scores without exceeding listeners' UCLs. For participants with moderately severe/severe losses, the UCL − 5 dB method resulted in the highest phoneme recognition scores.

Normative Data for the Maryland CNC Test

2014 ◽  
Vol 25 (08) ◽  
pp. 775-781 ◽  
Author(s):  
Lisa Lucks Mendel ◽  
William D. Mustain ◽  
Jessica Magro
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Pure Tone ◽  
Normative Data ◽  
Medical Center ◽  
Recognition Score ◽  
Veterans Administration ◽  
Administration Medical ◽  
Wide Range ◽  
Intensity Functions

Background: The Maryland consonant-vowel nucleus-consonant (CNC) Test is routinely used in Veterans Administration medical centers, yet there is a paucity of published normative data for this test. Purpose: The purpose of this study was to provide information on the means and distribution of word-recognition scores on the Maryland CNC Test as a function of degree of hearing loss for a veteran population. Research Design: A retrospective, descriptive design was conducted. Study Sample: The sample consisted of records from veterans who had Compensation and Pension (C&P) examinations at a Veterans Administration medical center (N = 1,760 ears). Data Collection and Analysis: Audiometric records of veterans who had C&P examinations during a 10 yr period were reviewed, and the pure-tone averages (PTA4) at four frequencies (1000, 2000, 3000, and 4000 Hz) were documented. The maximum word-recognition score (PBmax) was determined from the performance-intensity functions obtained using the Maryland CNC Test. Correlations were made between PBmax and PTA4. Results: A wide range of word-recognition scores were obtained at all levels of PTA4 for this population. In addition, a strong negative correlation between the PBmax and the PTA4 was observed, indicating that as PTA4 increased, PBmax decreased. Word-recognition scores decreased significantly as hearing loss increased beyond a mild hearing loss. Although threshold was influenced by age, no statistically significant relationship was found between word-recognition score and the age of the participants. Conclusions: Results from this study provide normative data in table and figure format to assist audiologists in interpreting patient results on the Maryland CNC test for a veteran population. These results provide a quantitative method for audiologists to use to interpret word-recognition scores based on pure-tone hearing loss.

scholarly journals Confidence Limits of Word Identification Scores Derived Using Nonlinear Quantile Regression

2021 ◽  
Vol 25 ◽  
pp. 233121652098311
Author(s):  
Vijaya K. Narne ◽  
Sören Möller ◽  
Anne Wolff ◽  
Sabina S. Houmøller ◽  
Gérard Loquet ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Quantile Regression ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Word Identification ◽  
Lower Boundary ◽  
Word List ◽  
Sensorineural Hearing ◽  
Wide Range ◽  
The One

The relation between degree of sensorineural hearing loss and maximum speech identification scores (PBmax) is commonly used in audiological diagnosis and rehabilitation. It is important to consider the relation between the degree of hearing loss and the lower boundary of PBmax, as the PBmax varies largely between subjects at a given degree of hearing loss. The present study determines the lower boundary by estimating the lower limit of the one-tailed 95% confidence limit (CL) for a Dantale I, word list, in a large group of young and older subjects with primarily sensorineural hearing loss. PBmax scores were measured using Dantale I, at 30 dB above the speech reception threshold or at the most comfortable level from 1,961 subjects with a wide range of pure-tone averages. A nonlinear quantile regression approach was applied to determine the lower boundary (95% CL) of PBmax scores. At a specific pure-tone average, if the measured PBmax is poorer than the lower boundary (95% CL) of PBmax, it may be considered disproportionately poor.

scholarly journals A Comparison of Word-Recognition Performances on the Auditec and VA Recorded Versions of Northwestern University Auditory Test No. 6 by Young Listeners with Normal Hearing and by Older Listeners with Sensorineural Hearing Loss Using a Randomized Presentation-Level Paradigm

2019 ◽  
Vol 30 (05) ◽  
pp. 370-395 ◽  
Author(s):  
Richard H. Wilson
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Sensorineural Hearing Loss ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Similar Data ◽  
Repeated Measures Design ◽  
Northwestern University ◽  
Word Lists ◽  
The Individual

AbstractThe Auditec of St. Louis and the Department of Veterans Affairs (VA) recorded versions of the Northwestern University Auditory Test No. 6 (NU-6) are in common usage. Data on young adults with normal hearing for pure tones (YNH) demonstrate equal recognition performances on the two versions when the VA version is presented 5 dB higher but similar data on older listeners with sensorineural hearing loss (OHL) are lacking.To compare word-recognition performances on the Auditec and VA versions of NU-6 presented at six presentation levels with YNH and OHL listeners.A quasi-experimental, repeated-measures design was used.Twelve YNH (M = 24.0 years; PTA = 9.9-dB HL) and 36 OHL listeners (M = 71.6 years; PTA = 26.7-dB HL) participated in three, one-hour sessions.Each listener received 100 stimulus words that were randomized by 6 presentation levels for each of two speakers (YNH, −2 to 28-dB SL; OHL, −2 to 38-dB SL). The sessions were limited to 25 practice and 400 experimental words. Digital versions of the 16, 25-word tracks for each session were alternated between speakers.Each of the 48 listeners had higher recognition performances on the Auditec version of NU-6 than on the VA version. The respective overall recognition performances on the Auditec and VA versions were 71.4% and 64.1% (YNH) and 68.7% and 58.2% (OHL). At the highest presentation levels, recognition performances on the two versions differed by only 0.5% (YNH) and 3.3% (OHL). At the 50% correct point, performances on the Auditec version were 3.2 dB (YNH) and 6.1 dB (OHL) better than those on the VA version. The slopes at the 50% points on the mean functions for both speakers were about 4.9%/dB (YNH) and 3.0%/dB (OHL); however, the slopes evaluated from the individual listener data were steeper, 5.2 to 5.3%/dB (YNH) and 3.3 to 3.5%/dB (OHL). When the individual data were transformed from dB SL to dB HL, the differences between the two listener groups were emphasized. The four functions (2 speakers by 2 listener groups) were plotted for each of the 48 participants and each of the 200 words, which revealed the gamut of relations among the datasets. Examination of the data for each speaker across test sessions, in the traditional 50-word lists, and in the typically used 25-word lists of Randomization A revealed no differences of clinical concern. Finally, introspective reports from the listeners revealed that 91.7% and 83.3% of the YNH and OHL listeners, respectively, thought the Auditec speaker was easier to understand than the VA speaker. Recognition performances on each participant and on each word are presented.

A Demonstration of Improved Precision of Word Recognition Scores

2014 ◽  
Vol 57 (2) ◽  
pp. 543-555 ◽  
Author(s):  
Robert S. Schlauch ◽  
Elizabeth S. Anderson ◽  
Christophe Micheyl
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Recognition Test ◽  
List Length ◽  
Pure Tone ◽  
Word List ◽  
Effect Sizes ◽  
Northwestern University ◽  
Resampling Procedure ◽  
Pure Tone Threshold

Purpose The purpose of this study was to demonstrate improved precision of word recognition scores (WRSs) by increasing list length and analyzing phonemic errors. Method Pure-tone thresholds (frequencies between 0.25 and 8.0 kHz) and WRSs were measured in 3 levels of speech-shaped noise (50, 52, and 54 dB HL) for 24 listeners with normal hearing. WRSs were obtained for half-lists and full lists of Northwestern University Test No. 6 (Tillman & Carhart, 1966) words presented at 48 dB HL. A resampling procedure was used to derive dimensionless effect sizes for identifying a change in hearing using the data. This allowed the direct comparison of the magnitude of shifts in WRS (%) and in the average pure-tone threshold (dB), which provided a context for interpreting the WRS. Results WRSs based on a 50-word list analyzed by the percentage of correct phonemes were significantly more sensitive for identifying a change in hearing than the WRSs based on 25-word lists analyzed by percentage of correct words. Conclusion Increasing the number of items that contribute to a WRS significantly increased the test's ability to identify a change in hearing. Clinical and research applications could potentially benefit from a more precise word recognition test, the only basic audiologic measure that estimates directly the distortion component of hearing loss and its effect on communication.

Use of Low-Pass Noise in Word-Recognition Testing

1976 ◽  
Vol 19 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Ronald L. Cohen ◽  
Robert W. Keith
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Sound Pressure ◽  
Signal To Noise Ratio ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Signal To Noise ◽  
Low Pass ◽  
Cochlear Hearing Loss ◽  
High Sound

This study attempted to determine whether word-recognition scores obtained in noise were more sensitive to the presence of a hearing loss than recognition scores obtained in quiet. Subjects with normal hearing, high-frequency cochlear hearing loss, and flat cochlear hearing loss were tested in quiet and in the presence of a 500-Hz low-pass noise. Two signal-to-noise conditions were employed, −4 dB and −12 dB. Words were presented at 40 dB SL in one experiment and at 96 dB SPL for normal-hearing subjects in a second experiment. The results indicated that, while the word-recognition scores of groups were similar in quiet, the more negative the signal-to-noise ratio, the greater the separation of group scores, with hearing-impaired subjects having poorer recognition scores than normal-hearing subjects. When the speech and noise were presented at high SPLs, however, the normal-hearing subjects had poorer word recognition than those with flat cochlear losses. The results are interpreted as indicating greater spread of masking in normal-hearing than hearing-impaired subjects at high sound pressure levels.

Measurements of Loudness Growth in 1/2-Octave Bands for Children and Adults With Normal Hearing

1999 ◽  
Vol 8 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Melisa R. Ellis ◽  
Michael K. Wynne
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Age Groups ◽  
Lower Boundary ◽  
Normal Hearing ◽  
Boundary Values ◽  
Simple Modification ◽  
Point Data ◽  
Loudness Growth

The loudness growth in 1/2-octave bands (LGOB) procedure has been shown previously to provide valid estimates of loudness growth for adults with normal hearing and those with hearing loss (Allen, Hall, & Jeng, 1990), and it has been widely incorporated into fitting strategies for adult hearing aid users by a hearing aid manufacturer. Here, we applied a simple modification of LGOB to children and adults with normal hearing and then compared the loudness growth functions (as obtained from end-point data) between the two age groups. In addition, reliability data obtained within a single session and between test sessions were compared between the two groups. Large differences were observed in the means between the two groups for the lower boundary values, the upper boundary values, and the range between boundaries both within and across all frequencies. The data obtained from children also had greater variance than the adult data. In addition, there was more variability in the data across test sessions for children. Many test-retest differences for children exceeded 10 dB. Adult test-retest differences were generally less than 10 dB. Although the LGOB with the modifications used in this study may be used to measure loudness growth in children, its poor reliability with this age group may limit its clinical use for children with hearing loss. Additional work is needed to explore whether loudness growth measures can be adapted successfully to children and whether these measures contribute worthwhile information for fitting hearing aids to children.

scholarly journals ON DIVERSITY OF CONFIGURATIONS GENERATED BY EXCITABLE CELLULAR AUTOMATA WITH DYNAMICAL EXCITATION INTERVALS

2012 ◽  
Vol 23 (12) ◽  
pp. 1250085 ◽  
Author(s):  
ANDREW ADAMATZKY
Keyword(s):  
Cellular Automata ◽  
Lower Boundary ◽  
Morphological Diversity ◽  
Excitable Media ◽  
Stationary Waves ◽  
Future Studies ◽  
Time Dynamics ◽  
Wide Range ◽  
Localized Excitations ◽  
Upper Boundary

Excitable cellular automata with dynamical excitation interval exhibit a wide range of space-time dynamics based on an interplay between propagating excitation patterns which modify excitability of the automaton cells. Such interactions leads to formation of standing domains of excitation, stationary waves and localized excitations. We analyzed morphological and generative diversities of the functions studied and characterized the functions with highest values of the diversities. Amongst other intriguing discoveries we found that upper boundary of excitation interval more significantly affects morphological diversity of configurations generated than lower boundary of the interval does and there is no match between functions which produce configurations of excitation with highest morphological diversity and configurations of interval boundaries with highest morphological diversity. Potential directions of future studies of excitable media with dynamically changing excitability may focus on relations of the automaton model with living excitable media, e.g. neural tissue and muscles, novel materials with memristive properties and networks of conductive polymers.

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