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Abstract
Reported are the results of meta-analyses of data derived collectively from a sample of 56 published research studies on electric response audiometry (ERA) using auditory steady-state responses (ASSRs). Several specific methodological issues were examined and hypotheses were posited to rigorously test common conclusions drawn from the ASSR literature on the accuracy of ASSR-ERA. Explanatory variables for analyses were type of population (normally hearing and hearing-impaired), type of modulation, number of sweeps acquired during response analysis, electrode montage, and modulation rate (80 vs. 40 Hz). No explanatory variables were found to be significantly related to the degree of disparity between thresholds obtained by ASSR-ERA versus behavioral audiometry in the normally hearing population. Conversely, all but one explanatory variable (i.e. electrode montage) was found to be significantly related to mean threshold differences in the hearing-impaired and combined populations. Results both substantiate some of common conclusions drawn from the literature but call others into question, helping to identify those methodological issues which appear to, or not to, significantly affect the accuracy of estimating threshold using ASSR measurement. In addition to these findings, another practical outcome of this study was the development of various summary tables of the data analysed from the literature sampled.
| Abbreviations | ||
| AM | = | Amplitude modulated |
| ANOVA | = | Analysis of variance |
| ABR | = | Auditory brainstem response |
| ASSR | = | Auditory steady-state response |
| BMF | = | Binaural-multiple frequency |
| BSF | = | Binaural-single frequency |
| c-ABR | = | Click ABR |
| CI | = | Confidence interval |
| CINAHL | = | Cumulative index to nursing and allied health |
| ERA | = | Electrical response audiometry |
| MTDs | = | Mean threshold differences |
| MLR | = | Middle-latency response |
| MM | = | Mixed modulated |
| MMF | = | Monaural-multiple frequency |
| MSF | = | Monaural-single frequency |
| SNR | = | Signal-to-noise ratio |
| SDs | = | Standard deviations |
| SE | = | Standard error |
| WLS | = | Weighted least squares |
| Abbreviations | ||
| AM | = | Amplitude modulated |
| ANOVA | = | Analysis of variance |
| ABR | = | Auditory brainstem response |
| ASSR | = | Auditory steady-state response |
| BMF | = | Binaural-multiple frequency |
| BSF | = | Binaural-single frequency |
| c-ABR | = | Click ABR |
| CI | = | Confidence interval |
| CINAHL | = | Cumulative index to nursing and allied health |
| ERA | = | Electrical response audiometry |
| MTDs | = | Mean threshold differences |
| MLR | = | Middle-latency response |
| MM | = | Mixed modulated |
| MMF | = | Monaural-multiple frequency |
| MSF | = | Monaural-single frequency |
| SNR | = | Signal-to-noise ratio |
| SDs | = | Standard deviations |
| SE | = | Standard error |
| WLS | = | Weighted least squares |
Sumario
Se reportan los resultados de un meta-análisis de datos obtenidos colectivamente de una muestra de 56 estudios de investigación, publicados sobre la audiometría por respuestas eléctricas (ERA), usando respuestas auditivas de estado estable. (ASSRs). Se examinaron algunos temas metodológicos específicos y se postularon hipótesis para evaluar rigurosamente las conclusiones comunes establecidas en la literatura que trata las ASSR, sobre la precisión de ASSR/ERA. Se plantearon variables explicativas para el análisis de población (normo-oyentes e hipoacúsicos), tipo de modulación, número de rastreos durante el análisis de la respuesta, montaje de los electrodos y tasa de modulación (80 vs. 40 Hz). No se encontraron variables explicativas que pudieran ser relacionadas significativamente con el grado de disparidad entre umbrales obtenidos con ASSR/ERA y los de la audiometría conductual en población de normo-oyentes. Por el contrario, todas menos una variable explicativa (p.e. el montaje de electrodos) se encontró significativamente relacionada con las diferencias medias de umbral en los hipoacúsicos o en poblaciones combinadas. Los resultados apoyan algunas de las conclusiones comunes obtenidas en la literatura, pero ponen otras en duda, con lo que se apoya la identificación de temas metodológicos que parecen o no, afectar significativamente la precisión de los umbrales estimados con el uso de las mediciones con ASSR. Además de estos hallazgos, otro resultado práctico de este estudio fue el desarrollo de varias tablas que resumen los datos analizados en la muestra de la literatura.