APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
Recently, demand for and supply of short-form patient-reported outcome measures (PROMs) have rise... more Recently, demand for and supply of short-form patient-reported outcome measures (PROMs) have risen throughout the world healthcare. Our contribution to meeting that demand has been translating and culturally adapting the Chronic Otitis Media Questionnaire-12 (COMQ-12) for adults into Serbian and enhancing its psychometric base on the relatively large Serbian COM caseload. Chronic otitis media can seriously affect quality of life progressively and in long-term, and it remains the major source of hearing problems in the developing world. The translated questionnaire was given twice to 60 adult patients with chronic otitis media of three types (inactive, active mucosal and active squamous disease) and to 60 healthy volunteers. Both patients and volunteers also filled the generic Short-Form 36 questionnaire (SF-36). Conventional statistical procedures were used in strategically driven development of scoring. Additionally, item responses were scaled by linear mapping against the provisio...
QUESTION: In young children with persistent otitis media with effusion (OME), does prompt inserti... more QUESTION: In young children with persistent otitis media with effusion (OME), does prompt insertion of tympanostomy tubes protect against or minimise subsequent developmental impairment at 3 years more than delayed insertion? Design Randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with follow up to 3 years of age. Setting 2 hospitals and 6 private paediatric group practices in and around Pittsburgh, Pennsylvania, USA.
Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis me... more Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibio...
A definition of hearing aid candidature is required for planning and other purposes. The number o... more A definition of hearing aid candidature is required for planning and other purposes. The number of candidates in the population actually receiving an adequate fitting would provide the major index of whether audiology services achieve their major public health goal. Many diverse factors determine the benefit that an individual receives from a hearing aid, and hence could in principle be included in some composite criterion for appropriate candidature reflecting the cost-effectiveness of patterns of provision. However, the complexity of universal capture, on those fitted with hearing aids, of data giving full auditory and demographic characteristics is beyond current routine NHS information systems. The most powerful known determinant established to date both of auditory disability and benefit is average hearing threshold level (HTL). Hearing threshold levels are hence both a necessary part of the fitting process and, given the data from the National Study of Hearing, a sufficient basis for computing population prevalences of hearing characteristics and service uptake in the major demographic strata. We report epidemiological data on consultation about problems with ears or hearing and uptake of hearing aids, which lead us to recommend a two-part candidature criterion on hearing threshold levels (0.5-4.0 kHz average): EITHER (a) better ear HTL > or = 35 dB OR (b) (15 dB < or = better ear HTL < 35 dB) WHEN worse ear HTL > or = 45 dB. The asymmetric component (b) may appear contentious, but is directly supported both by the epidemiological data and by further clinical data on benefit measured as performance on speech-in-noise tests. The proposed criterion is not over-liberal in clinical or related technological terms, but against the high prevalence of impairments in the population, the current provision and uptake of hearing aids in the UK still appear modest (about 3.3% in the population, and just under one-third of those qualifying by our criterion). Whatever the means of providing hearing aids, authorities charged with meeting the needs of their populations require such statistical indicators to know whether service delivery is appropriately geared. They should not use such an indicator as a basis of entitlement, as there are certainly individuals outside the criterion who receive benefit from their hearing aids. Equally, technological progress could expand the boundaries of candidature.
About 5% of those presenting at an ENT clinic with ear or hearing complaints are found to have no... more About 5% of those presenting at an ENT clinic with ear or hearing complaints are found to have normal pure-tone thresholds. Many of this group complain specifically of difficulties understanding speech in background noise. We have termed this complaint 'Obscure Auditory Dysfunction' (OAD). Previous research on OAD (Saunders and Haggard, 1992) on a sample of 50 patients and 50 matched controls showed that 83% of the deviance (binary variance) in membership of group (OAD/control) could be explained by four variables, with three underlying factors. These four variables are performance threshold in noise for speech; discrepancy between this and a self-adjusted signal-to-noise ratio value (i.e. a measure of auditory confidence); dichotic listening performance; and performance on a psychoacoustic test, the threshold for detecting a tone in a spectrally notched noise. This paper reports a study on a further 59 new OAD patients and 64 unmatched controls, using the tests in the form present in the test package, plus certain others. For routine practice, slightly differing implementations of the auditory test techniques were used. Compared to the earlier sample, the new sample had poorer measures of speech reception threshold in noise and they considered themselves more handicapped by their OAD state; however there was no significant difference between the two samples on the other performance variables. Overall, the results demonstrate the robustness of the conclusions reached from the previous study, as the test-variable determinants of OAD status (i.e. case-control differences) were similar. The items on the OAD interview questionnaire which had shown significant differences between OADs and controls were also similar for the two OAD samples, giving a consistent picture of patient profile. These were: difficulties learning to read or write as a child (which relates to dichotic listening scores); adult ear problems; and tinnitus (which relate to the psychoacoustic scores). This necessary replication confirms the validity of the three-factor model of OAD status and the utility of the clinical test package based upon it.
A sensorineural hearing loss is usually considered more disabling than a conductive loss of equiv... more A sensorineural hearing loss is usually considered more disabling than a conductive loss of equivalent air conduction hearing level, due to the associated impairments in resolution which amplification does not overcome. In noise this generalization holds; however, in quiet, the generalization holds only for high intensity levels of presentation. Determination of isoperformance curves for word identification shows that at low stimulus levels the patient with conductive hearing loss suffers the greater disability for a given hearing loss. The crossover point between these regions, (i.e., where a single predictor from hearing level correctly predicts equal disability for conductives and sensorineurals) is in the region of 85 dB SPL--a level which approximates typical raised voice levels used when communicating under difficult circumstances. Given the long-standing distinction between conductive and sensorineural pathology, prediction of disability from dB HL as a general clinical substitute for actual disability measurement has rested upon a fortunate coincidence.
ABSTRACT Two groups differing in musical ability were tested in three psychoacoustical tasks; rec... more ABSTRACT Two groups differing in musical ability were tested in three psychoacoustical tasks; recognition memory for a single formant frequency, discrimination for a single formant frequency and discrimination for a low periodicity pitch. The memory task and the periodicity pitch task separated the two groups more successfully than did the spectral discrimination task. Musical subjects were relatively better at discriminating the low fundamental pitch of complex sounds. Although it is not possible to say which is cause and which effect, use of waveform periodicities appears related to musicality.
Http Dx Doi Org 10 1080 02664760802443962, Mar 1, 2009
A common assumption for data analysis in functional magnetic resonance imaging is that the respon... more A common assumption for data analysis in functional magnetic resonance imaging is that the response signal can be modelled as the convolution of a haemodynamic response (HDR) kernel with a stimulus reference function. Early approaches modelled spatially constant HDR kernels, but more recently spatially varying models have been proposed. However, convolution limits the flexibility of these models and their ability to capture spatial variation. Here, a range of (nonlinear) parametric curves are fitted by least squares minimisation directly to individual voxel HDRs (i.e., without using convolution). A ‘constrained gamma curve’ is proposed as an efficient form for fitting the HDR at each individual voxel. This curve allows for spatial variation in the delay of the HDR, but places a global constraint on the temporal spread. The approach of directly fitting individual parameters of HDR shape is demonstrated to lead to an improved fit of response estimates.
Audiology Official Organ of the International Society of Audiology, 1995
There is evidence that children with recent histories of otitis media (OM) have poorer binaural h... more There is evidence that children with recent histories of otitis media (OM) have poorer binaural hearing than children with no such histories. In order to investigate whether these deficits persist into adulthood, young adults were selected for auditory testing on the basis of responses to a questionnaire on childhood OM. Binaural performance measures were obtained for the binaural masking level difference, binaural loudness summation and lateralisation of binaural clicks. Although subjects with OM histories reported more auditory disabilities in adulthood, there were no significant differences in binaural performance between OM history subjects and controls. It is suggested that binaural deficits resulting from OM do not usually persist into adulthood.
The Journal of the Acoustical Society of America, Feb 1, 1970
In initial position, a low rising pitch indicates a closed glottis and high falling pitch a glott... more In initial position, a low rising pitch indicates a closed glottis and high falling pitch a glottis that is still partly open. ... In initial position, a low rising pitch indicates a closed glottis and high falling pitch a glottis that is still partly open. ...
Obscure Auditory Dysfunction (OAD) is explained by a combination of hearing-related deficits and ... more Obscure Auditory Dysfunction (OAD) is explained by a combination of hearing-related deficits and personality factors Saunders & Haggard (1992). In this study, we determine which factors are associated specifically with OAD and which are associated with the seeking of medical attention in general. We achieved this by obtaining a second patient group with a parallel syndrome to OAD, called "chronic pelvic pain without obvious organic pathology" (CPPWOOP). CPPWOOP patients complain of lower abdominal pain that is not explainable by conventional medical tests. Fifteen CPPWOOPs underwent the OAD test battery. For the analyses they were retrospectively matched to 15 of the original OADs and their matched controls. The three groups were compared by analysis of variance and Kruskall-Wallis analyses. The CPPWOOPs and controls performed significantly better than OADs on hearing-related variables, but did not differ from each other, whereas the OADs and CPPWOOPs were significantly more anxious than the controls, but did not differ from each other. We conclude that anxiety-related traits are associated with the seeking of medical attention in general, whereas the hearing-related deficits we measured are associated specifically with OAD. Anxiety-related traits should, therefore, be considered when dealing with marginal pathologies, but in depth investigation may also reveal an organic basis; therefore, patients should not be dismissed as simply neurotic.
Purpose To investigate the statistical relationship between the OM8-30 health-related quality of ... more Purpose To investigate the statistical relationship between the OM8-30 health-related quality of life measure for children with otitis media with effusion (OME) and measures of health utility (Health Utilities Index [HUI] Mark 3 and Mark 2) and to develop models to estimate HUI3 and HUI2 health utilities from OM8-30 scores. Methods A placebo-controlled, randomised trial (GNOME) evaluating intranasal mometasone in 217 children with OME provided concurrent responses to OM8-30 and HUI at three time points. Ordinary least squares (OLS), generalised linear models and two-step regression analyses were used to predict HUI3 and HUI2 utilities based on OM8-30 facet and domain scores. Results OLS models including all nine OM8-30 facets with or without predicted hearing level (HL) produced the best predictions of HUI3 utilities (mean absolute error: 0.134 with HL and 0.132 without; R 2 : 0.63 with HL and 0.596 without). An OLS model predicting HUI3 utilities based on the two OM8-30 domain scores, reported hearing difficulties, predicted HL, age and sex also produced accurate predictions. Conclusion Regression equations predicting HUI3 and HUI2 utilities based on OM8-30 facet and domain scores have been developed. These provide an empirical basis for estimating quality-adjusted life years (QALYs) for interventions in children with OME.
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
Recently, demand for and supply of short-form patient-reported outcome measures (PROMs) have rise... more Recently, demand for and supply of short-form patient-reported outcome measures (PROMs) have risen throughout the world healthcare. Our contribution to meeting that demand has been translating and culturally adapting the Chronic Otitis Media Questionnaire-12 (COMQ-12) for adults into Serbian and enhancing its psychometric base on the relatively large Serbian COM caseload. Chronic otitis media can seriously affect quality of life progressively and in long-term, and it remains the major source of hearing problems in the developing world. The translated questionnaire was given twice to 60 adult patients with chronic otitis media of three types (inactive, active mucosal and active squamous disease) and to 60 healthy volunteers. Both patients and volunteers also filled the generic Short-Form 36 questionnaire (SF-36). Conventional statistical procedures were used in strategically driven development of scoring. Additionally, item responses were scaled by linear mapping against the provisio...
QUESTION: In young children with persistent otitis media with effusion (OME), does prompt inserti... more QUESTION: In young children with persistent otitis media with effusion (OME), does prompt insertion of tympanostomy tubes protect against or minimise subsequent developmental impairment at 3 years more than delayed insertion? Design Randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with follow up to 3 years of age. Setting 2 hospitals and 6 private paediatric group practices in and around Pittsburgh, Pennsylvania, USA.
Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis me... more Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibio...
A definition of hearing aid candidature is required for planning and other purposes. The number o... more A definition of hearing aid candidature is required for planning and other purposes. The number of candidates in the population actually receiving an adequate fitting would provide the major index of whether audiology services achieve their major public health goal. Many diverse factors determine the benefit that an individual receives from a hearing aid, and hence could in principle be included in some composite criterion for appropriate candidature reflecting the cost-effectiveness of patterns of provision. However, the complexity of universal capture, on those fitted with hearing aids, of data giving full auditory and demographic characteristics is beyond current routine NHS information systems. The most powerful known determinant established to date both of auditory disability and benefit is average hearing threshold level (HTL). Hearing threshold levels are hence both a necessary part of the fitting process and, given the data from the National Study of Hearing, a sufficient basis for computing population prevalences of hearing characteristics and service uptake in the major demographic strata. We report epidemiological data on consultation about problems with ears or hearing and uptake of hearing aids, which lead us to recommend a two-part candidature criterion on hearing threshold levels (0.5-4.0 kHz average): EITHER (a) better ear HTL > or = 35 dB OR (b) (15 dB < or = better ear HTL < 35 dB) WHEN worse ear HTL > or = 45 dB. The asymmetric component (b) may appear contentious, but is directly supported both by the epidemiological data and by further clinical data on benefit measured as performance on speech-in-noise tests. The proposed criterion is not over-liberal in clinical or related technological terms, but against the high prevalence of impairments in the population, the current provision and uptake of hearing aids in the UK still appear modest (about 3.3% in the population, and just under one-third of those qualifying by our criterion). Whatever the means of providing hearing aids, authorities charged with meeting the needs of their populations require such statistical indicators to know whether service delivery is appropriately geared. They should not use such an indicator as a basis of entitlement, as there are certainly individuals outside the criterion who receive benefit from their hearing aids. Equally, technological progress could expand the boundaries of candidature.
About 5% of those presenting at an ENT clinic with ear or hearing complaints are found to have no... more About 5% of those presenting at an ENT clinic with ear or hearing complaints are found to have normal pure-tone thresholds. Many of this group complain specifically of difficulties understanding speech in background noise. We have termed this complaint 'Obscure Auditory Dysfunction' (OAD). Previous research on OAD (Saunders and Haggard, 1992) on a sample of 50 patients and 50 matched controls showed that 83% of the deviance (binary variance) in membership of group (OAD/control) could be explained by four variables, with three underlying factors. These four variables are performance threshold in noise for speech; discrepancy between this and a self-adjusted signal-to-noise ratio value (i.e. a measure of auditory confidence); dichotic listening performance; and performance on a psychoacoustic test, the threshold for detecting a tone in a spectrally notched noise. This paper reports a study on a further 59 new OAD patients and 64 unmatched controls, using the tests in the form present in the test package, plus certain others. For routine practice, slightly differing implementations of the auditory test techniques were used. Compared to the earlier sample, the new sample had poorer measures of speech reception threshold in noise and they considered themselves more handicapped by their OAD state; however there was no significant difference between the two samples on the other performance variables. Overall, the results demonstrate the robustness of the conclusions reached from the previous study, as the test-variable determinants of OAD status (i.e. case-control differences) were similar. The items on the OAD interview questionnaire which had shown significant differences between OADs and controls were also similar for the two OAD samples, giving a consistent picture of patient profile. These were: difficulties learning to read or write as a child (which relates to dichotic listening scores); adult ear problems; and tinnitus (which relate to the psychoacoustic scores). This necessary replication confirms the validity of the three-factor model of OAD status and the utility of the clinical test package based upon it.
A sensorineural hearing loss is usually considered more disabling than a conductive loss of equiv... more A sensorineural hearing loss is usually considered more disabling than a conductive loss of equivalent air conduction hearing level, due to the associated impairments in resolution which amplification does not overcome. In noise this generalization holds; however, in quiet, the generalization holds only for high intensity levels of presentation. Determination of isoperformance curves for word identification shows that at low stimulus levels the patient with conductive hearing loss suffers the greater disability for a given hearing loss. The crossover point between these regions, (i.e., where a single predictor from hearing level correctly predicts equal disability for conductives and sensorineurals) is in the region of 85 dB SPL--a level which approximates typical raised voice levels used when communicating under difficult circumstances. Given the long-standing distinction between conductive and sensorineural pathology, prediction of disability from dB HL as a general clinical substitute for actual disability measurement has rested upon a fortunate coincidence.
ABSTRACT Two groups differing in musical ability were tested in three psychoacoustical tasks; rec... more ABSTRACT Two groups differing in musical ability were tested in three psychoacoustical tasks; recognition memory for a single formant frequency, discrimination for a single formant frequency and discrimination for a low periodicity pitch. The memory task and the periodicity pitch task separated the two groups more successfully than did the spectral discrimination task. Musical subjects were relatively better at discriminating the low fundamental pitch of complex sounds. Although it is not possible to say which is cause and which effect, use of waveform periodicities appears related to musicality.
Http Dx Doi Org 10 1080 02664760802443962, Mar 1, 2009
A common assumption for data analysis in functional magnetic resonance imaging is that the respon... more A common assumption for data analysis in functional magnetic resonance imaging is that the response signal can be modelled as the convolution of a haemodynamic response (HDR) kernel with a stimulus reference function. Early approaches modelled spatially constant HDR kernels, but more recently spatially varying models have been proposed. However, convolution limits the flexibility of these models and their ability to capture spatial variation. Here, a range of (nonlinear) parametric curves are fitted by least squares minimisation directly to individual voxel HDRs (i.e., without using convolution). A ‘constrained gamma curve’ is proposed as an efficient form for fitting the HDR at each individual voxel. This curve allows for spatial variation in the delay of the HDR, but places a global constraint on the temporal spread. The approach of directly fitting individual parameters of HDR shape is demonstrated to lead to an improved fit of response estimates.
Audiology Official Organ of the International Society of Audiology, 1995
There is evidence that children with recent histories of otitis media (OM) have poorer binaural h... more There is evidence that children with recent histories of otitis media (OM) have poorer binaural hearing than children with no such histories. In order to investigate whether these deficits persist into adulthood, young adults were selected for auditory testing on the basis of responses to a questionnaire on childhood OM. Binaural performance measures were obtained for the binaural masking level difference, binaural loudness summation and lateralisation of binaural clicks. Although subjects with OM histories reported more auditory disabilities in adulthood, there were no significant differences in binaural performance between OM history subjects and controls. It is suggested that binaural deficits resulting from OM do not usually persist into adulthood.
The Journal of the Acoustical Society of America, Feb 1, 1970
In initial position, a low rising pitch indicates a closed glottis and high falling pitch a glott... more In initial position, a low rising pitch indicates a closed glottis and high falling pitch a glottis that is still partly open. ... In initial position, a low rising pitch indicates a closed glottis and high falling pitch a glottis that is still partly open. ...
Obscure Auditory Dysfunction (OAD) is explained by a combination of hearing-related deficits and ... more Obscure Auditory Dysfunction (OAD) is explained by a combination of hearing-related deficits and personality factors Saunders & Haggard (1992). In this study, we determine which factors are associated specifically with OAD and which are associated with the seeking of medical attention in general. We achieved this by obtaining a second patient group with a parallel syndrome to OAD, called "chronic pelvic pain without obvious organic pathology" (CPPWOOP). CPPWOOP patients complain of lower abdominal pain that is not explainable by conventional medical tests. Fifteen CPPWOOPs underwent the OAD test battery. For the analyses they were retrospectively matched to 15 of the original OADs and their matched controls. The three groups were compared by analysis of variance and Kruskall-Wallis analyses. The CPPWOOPs and controls performed significantly better than OADs on hearing-related variables, but did not differ from each other, whereas the OADs and CPPWOOPs were significantly more anxious than the controls, but did not differ from each other. We conclude that anxiety-related traits are associated with the seeking of medical attention in general, whereas the hearing-related deficits we measured are associated specifically with OAD. Anxiety-related traits should, therefore, be considered when dealing with marginal pathologies, but in depth investigation may also reveal an organic basis; therefore, patients should not be dismissed as simply neurotic.
Purpose To investigate the statistical relationship between the OM8-30 health-related quality of ... more Purpose To investigate the statistical relationship between the OM8-30 health-related quality of life measure for children with otitis media with effusion (OME) and measures of health utility (Health Utilities Index [HUI] Mark 3 and Mark 2) and to develop models to estimate HUI3 and HUI2 health utilities from OM8-30 scores. Methods A placebo-controlled, randomised trial (GNOME) evaluating intranasal mometasone in 217 children with OME provided concurrent responses to OM8-30 and HUI at three time points. Ordinary least squares (OLS), generalised linear models and two-step regression analyses were used to predict HUI3 and HUI2 utilities based on OM8-30 facet and domain scores. Results OLS models including all nine OM8-30 facets with or without predicted hearing level (HL) produced the best predictions of HUI3 utilities (mean absolute error: 0.134 with HL and 0.132 without; R 2 : 0.63 with HL and 0.596 without). An OLS model predicting HUI3 utilities based on the two OM8-30 domain scores, reported hearing difficulties, predicted HL, age and sex also produced accurate predictions. Conclusion Regression equations predicting HUI3 and HUI2 utilities based on OM8-30 facet and domain scores have been developed. These provide an empirical basis for estimating quality-adjusted life years (QALYs) for interventions in children with OME.
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Papers by Mark Haggard