ABSTRACT
Pure-tone thresholds are used to estimate hearing acuity and, when measured longitudinally, can characterize age-related changes in hearing. Measured at multiple-frequencies, multiple-irregular time points, for right and left ears, these longitudinal studies of age-related hearing loss produce data of inherent complexity due to: 1) multivariate outcomes at different frequencies; 2) longitudinal measurements taken at subject-specific time intervals; and 3) inter-ear correlations due to clustering and nesting. To address limitations in existing methods, we propose a multivariate generalized linear mixed model (mGLMM) and assess its performance. We demonstrate its application using a unique dataset from a cohort study of age-related hearing loss.
Conflict of interest
The authors have declared no conflict of interest.
Acknowledgments
This work was supported (in part) by grant P50 DC000422 from the National Institutes of Health, National Institute on Deafness and Other Communication Disorders (NIH/NIDCD) and by the South Carolina Clinical and Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, through NIH grant UL1 RR029882. This investigation was conducted in a facility constructed with support from the NIH Research Facilities Improvement Program, grant C06 RR14516. The authors gratefully acknowledge the clinical support of Paul R. Lambert, MD, editorial assistance by Emily Franko-Tobin, and assistance with data collection by Christine Strange, Elizabeth Poth, and past research audiologists. We also thank the reviewers for constructive feedback.