A Response to Dr. Jerger regarding “On Diagnostic Accuracy in Audiology: Central Site of Lesion and Central Auditory Processing Disorder Studies”

2017 ◽  
Vol 28 (01) ◽  
pp. 102-102 ◽  
Author(s):  
Andrew J. Vermiglio
Keyword(s):  
Diagnostic Accuracy ◽  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder

On Diagnostic Accuracy in Audiology: Central Site of Lesion and Central Auditory Processing Disorder Studies

2016 ◽  
Vol 27 (02) ◽  
pp. 141-156 ◽  
Author(s):  
Andrew J. Vermiglio
Keyword(s):  
Diagnostic Accuracy ◽  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Index Test ◽  
Test Results ◽  
Reference Standard ◽  
Central Auditory Processing Disorder ◽  
Target Condition ◽  
Independent Verification

Background: In the field of audiology a test protocol (index test) is used to determine the presence or absence of a target condition. The value of an index test rests in its diagnostic accuracy. Results from an index test must be verified through the use of a reference standard. The clinician and researcher should determine the quality and applicability of diagnostic accuracy studies. The Standards for Reporting of Diagnostic Accuracy (STARD) statement was published in response to the low quality of research conducted across many fields of study. It provides guidelines for the development and interpretation of diagnostic accuracy studies. Purpose: The primary purpose of this article is to assess the degree to which the main principles of diagnostic accuracy studies are used for the detection of central auditory nervous system lesions and a central auditory processing disorder (CAPD). The secondary purpose is to compare the design of these studies to select key guidelines from the STARD statement. The third purpose of this article is to present an argument against the reassignment of diagnostic accuracy values of a particular index test for one target condition (e.g., a central site of lesion) to a different target condition (e.g., a CAPD). Results: A review of diagnostic accuracy literature on the detection of a central site of lesion reveals the use of a reference standard for the independent verification of the index test results. However, diagnostic accuracy studies involving index tests for the detection of a CAPD show that independent verification of index test results is nonexistent or at best questionable. Conclusion: For a particular index test, while the diagnostic accuracy for detection of a central site of lesion may have been determined appropriately, it is inappropriate to reassign these diagnostic accuracy values to a different diagnostic target such as a CAPD.

The Importance of Modality Specificity in Diagnosing Central Auditory Processing Disorder

2005 ◽  
Vol 14 (2) ◽  
pp. 112-123 ◽  
Author(s):  
Anthony T. Cacace ◽  
Dennis J. McFarland
Keyword(s):  
Auditory Processing ◽  
Discriminant Validity ◽  
Explanatory Power ◽  
Large Body ◽  
Critical Discussion ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Scientific Disciplines ◽  
Modality Specificity

Purpose: This article argues for the use of modality specificity as a unifying framework by which to conceptualize and diagnose central auditory processing disorder (CAPD). The intent is to generate dialogue and critical discussion in this area of study. Method: Research in the cognitive, behavioral, and neural sciences that relates to the concept of modality specificity was reviewed and synthesized. Results: Modality specificity has a long history as an organizing construct within a diverse collection of mainstream scientific disciplines. The principle of modality specificity was contrasted with the unimodal inclusive framework, which holds that auditory tests alone are sufficient to make the CAPD diagnosis. Evidence from a large body of data demonstrated that the unimodal framework was unable to delineate modality-specific processes from more generalized dysfunction; it lacked discriminant validity and resulted in an incomplete assessment. Consequently, any hypothetical model resulting from incomplete assessments or potential therapies that are based on indeterminate diagnoses are themselves questionable, and caution should be used in their application. Conclusions: Improving specificity of diagnosis is an imperative core issue to the area of CAPD. Without specificity, the concept has little explanatory power. Because of serious flaws in concept and design, the unimodal inclusive framework should be abandoned in favor of a more valid approach that uses modality specificity.

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