Distribution characteristics of air-bone gaps : evidence of bias in manual audiometry

dc.contributor.authorMargolis, Robert H.
dc.contributor.authorWilson, Richard H.
dc.contributor.authorPopelka, Gerald R.
dc.contributor.authorEikelboom, Robert H.
dc.contributor.authorSwanepoel, De Wet
dc.contributor.authorSaly, George L.
dc.date.accessioned2016-05-05T14:23:30Z
dc.date.issued2016-03
dc.description.abstractOBJECTIVES : Five databases were mined to examine distributions of airbone gaps obtained by automated and manual audiometry. Differences in distribution characteristics were examined for evidence of influences unrelated to the audibility of test signals. DESIGN : The databases provided air- and bone-conduction thresholds that permitted examination of air-bone gap distributions that were free of ceiling and floor effects. Cases with conductive hearing loss were eliminated based on air-bone gaps, tympanometry, and otoscopy, when available. The analysis is based on 2,378,921 threshold determinations from 721,831 subjects from five databases. RESULTS : Automated audiometry produced air-bone gaps that were normally distributed suggesting that air- and bone-conduction thresholds are normally distributed. Manual audiometry produced air-bone gaps that were not normally distributed and show evidence of biasing effects of assumptions of expected results. In one database, the form of the distributions showed evidence of inclusion of conductive hearing losses. CONCLUSIONS : Thresholds obtained by manual audiometry show tester bias effects from assumptions of the patient’s hearing loss characteristics. Tester bias artificially reduces the variance of bone-conduction thresholds and the resulting air-bone gaps. Because the automated method is free of bias from assumptions of expected results, these distributions are hypothesized to reflect the true variability of air- and boneconduction thresholds and the resulting air-bone gaps.en_ZA
dc.description.departmentSpeech-Language Pathology and Audiologyen_ZA
dc.description.embargo2017-03-31
dc.description.librarianhb2016en_ZA
dc.description.sponsorshipPortions of this work were supported by Grant RC3DC010986 from the National Institute of Deafness and Other Communication Disorders and by contract No. VA118-12-C-0029 from the US Department of Veterans Affairs. The Rehabilitation Research and Development Service of the US Department of Veterans Affairs supported this work through the Auditory and Vestibular Dysfunction Research Enhancement Award Program (REAP) and a Senior Research Career Scientist award to the second author.en_ZA
dc.description.urihttp://journals.lww.com/ear-hearingen_ZA
dc.identifier.citationMargolis, RH, Wilson, RH, Popelka, GR, Eikelboom, RH, Swanepoel, DW & Saly, GL 2016, 'Distribution characteristics of air-bone gaps : evidence of bias in manual audiometry', Ear and Hearing, vol. 37, no. 2, pp. 177-188.en_ZA
dc.identifier.issn0196-0202 (print)
dc.identifier.issn1538-4667 (online)
dc.identifier.other10.1097/AUD.0000000000000246
dc.identifier.urihttp://hdl.handle.net/2263/52497
dc.language.isoenen_ZA
dc.publisherLippincott Williams and Wilkinsen_ZA
dc.rights© 2015 Wolters Kluwer Health / Lippincott Williams & Wilkins. This is a non-final version of an article published in final form in Ear and Hearing, vol. 37, no. 2, pp. 177-188, 2016. doi : 10.1097/AUD.0000000000000246.en_ZA
dc.subjectAir-bone gapen_ZA
dc.subjectAir conductionen_ZA
dc.subjectAudiometryen_ZA
dc.subjectBiasen_ZA
dc.subjectBone conductionen_ZA
dc.subjectPure-tone audiometryen_ZA
dc.titleDistribution characteristics of air-bone gaps : evidence of bias in manual audiometryen_ZA
dc.typePostprint Articleen_ZA

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