Clinical applicability of adaptive speech testing : a comparison of the administration time, accuracy, efficiency and reliability of adaptive speech tests with conventional speech audiometry.

摘要

Adaptive procedures are a common method of investigating sensory abilities in researchsettings; however, their use in clinical settings is more limited. Little research has been doneinvestigating the implementation of adaptive procedures into Audiological speech tests, andto date, no studies have compared and evaluated adaptive speech tests with current clinicalspeech audiometry. This study investigated the advantages of using both closed-set and opensetadaptive speech tests in the clinical Audiology setting, with respect to administration time,accuracy, efficiency and reliability. Preliminary testing of the two major adaptive procedures(staircase and maximum-likelihood procedures) was conducted using a selection of differentparameters chosen on the basis of the results of previous research (Kaernbach, 1991; García-Pérez, 1998) to determine the optimal procedures and parameters for use in clinical speechtests. Focus was given to the staircase procedures, with comparisons made between testsusing variations in step size – constant step sizes and larger step sizes at the beginning – anddifferent termination criteria. It was found that both adaptive closed-set staircase tests (withboth step size variations) performed similarly, whereas the adaptive open-set staircase testwith larger step sizes at the beginning showed advantages over the equivalent constant stepsize test in terms of administration time, accuracy and efficiency. The maximum-likelihoodQUEST procedure showed advantages over the staircase procedures in terms ofadministration time; however, the reliability of both this test and conventional speechaudiometry was poor, indicating that these tests are not the most suitable tests for a clinicalsetting. Subsequent clinical testing of the optimal adaptive speech tests using participantswith varying degrees of hearing loss found that administration time was similar betweenconventional speech audiometry and the adaptive closed-set staircase tests when the optimaltermination criteria identified in the Preliminary Testing Phase were employed. The adaptiveopen-set staircase test with larger step sizes at the beginning showed the best accuracy of anyof the tests when using the pure-tone average as a reference, while the efficiency of all theadaptive staircase tests was similar. Overall, the results highlight some of the potentialadvantages of adaptive speech testing in the clinical Audiology setting; however, furtherstudies are required to determine the specific parameters that achieve the best results.