A scale for hearing aid benefit measures and auditory disability

Quoting disability scores or measures of hearing aid benefit based on percent correct word identification or on dB signal-to-noise ratio at criterion performance poses a communication problem as scientists and clinicians may have no intuitive understanding of the scales involved. In particular, percent correct does not allow direct comparison of differences obtained at different performance levels, for example by different subject groups. In circumstances where the better ear hearing levels are known to be a major determinant of disability, it is both possible and legitimate to transform performance measures such as percent correct into a dB HL equivalent. In two sets of data from clinical research projects this relationship is shown to be linear, allowing a particularly simple transformation and giving an already understood scale. This transformation procedure has been cross-validated against the acoustic gain used in a sample of patients with conductive losses where the hearing loss is purely an attenuation. The procedure is offered as a metric for expressing the benefits of management.     

A scale for evaluating results of rhinoplasty

A system was developed to numerically grade noses before and after rhinoplasty. Based on the use of photographs, it permits objective assessment of the amount of improvement resulting from operation. By extension, it could be used to rate surgical proficiency.     

Rhinoplasty: French validation of the MiRa scale

AimsThe aim of this study was to translate the MiRa scale into French and validate its use for French-speaking surgeons.Material and methodsISPOR and WHO recommendations were used to carry out the translation process from English to French in five steps. The MiRa scale is a validated analysis scale of nasal dysmorphoses. Few tools are available in French for French-speaking surgeons. ISPOR and WHO recommendations were used to complete the five-step translation process from English into French. To assess the reliability of the MiRa scale–French version, we statistically compared intra-observer repeatability (comparison of scores obtained when one observer assessed each patient twice at a one-month interval) and inter-observer repeatability (comparison of scores obtained when 2 observers assessed the same patient) using the Wilcoxon test and the intraclass correlation coefficient (ICC) (α = 5%).ObjectivesOur goal was to obtain a translation of the idea or concept rather than a literal translation to enable good intra- and inter-observer repeatability.ResultsEach step allowed us to make changes gradually working towards a conceptual translation equivalent to the original version.ConclusionThe MiRa scale is the only aesthetic analysis scale validated in the literature for nasal dysmorphoses. The combined use of two sets of translation recommendations, with a five-step translation-back-translation process, made it possible to obtain a French version perfectly in line with the original. This version is usable by French-speakers.     

Time scale for periosteal readhesion after brow lift

OBJECTIVES/HYPOTHESIS: The objective was to determine the time interval after brow lift required to achieve periosteal readhesion to the skull with preoperative strength [corrected]. STUDY DESIGN: Randomized prospective analysis of variance with repeated measures. METHODS: Twenty-one New Zealand white rabbits, each serving as its own control, underwent subperiosteal elevation on one side of the skull. The elevated periosteum was lifted and fixed to a resorbable screw, and the contralateral periosteum was left untouched. Adhesion characteristics were subsequently examined at postoperative days 5, 6, 7, 8, 10, 12, and 17. Seven subjects were assessed histologically to determine attachment of periosteum to underlying bone. Fourteen subjects underwent biomechanical analysis of the bone-periosteum interface using the following three measures of periosteal readhesion strength: ultimate shear strength, shear stiffness, and shear energy [corrected]. RESULTS: Blinded histological analysis showed a qualitative increase in the number of markers of periosteal healing on days 8 to 12 for the operated sides. Analysis of ultimate shear strength and shear stiffness demonstrated a significant relationship to postoperative day (P <.001). The ultimate shear strength and shear stiffness of the operated side approached that of the nonoperated side by postoperative days 12 and 8, respectively. Shear energy was significantly lower for all time points on the operated side as compared with the control (P <.02). CONCLUSION: Periosteal readhesion after surgical elevation approaches preoperative strength by the twelfth postoperative day.     

Variations in posttonsillectomy hemorrhage rates are scale invariant

Background: Scale invariance is a property of scientific laws or objects that change in a prescribed fashion if measurements are scaled, and is often represented by a power‐law relationship. Power laws suggest that events of a large magnitude will be rare, while small events will be much more common, and that a simple mathematical law relates “severity” with frequency. Scale invariance has been demonstrated in scientific fields including physics, social science, and economics. The authors use the complication of a posttonsillectomy hemorrhage to test whether this property is a feature of surgical complications. Methods: Non‐identifiable data were obtained regarding posttonsillectomy hemorrhage and subcategorized by calendar month, and the percentage rate of posttonsillectomy hemorrhage was calculated. The data were then transformed using a logarithmic function. This transformed data were plotted and a linear regression analysis was performed. Results: The 13‐year period studied included 6,381 tonsillectomy procedures. The logarithm of the frequency of a given rate range of posttonsillectomy hemorrhage (y) was linearly related to the logarithm of the geometric mean of the rate range (x). The best‐fit straight line was y = ?1.3996× + 2.0624 with R² = 0.851, n = 10, r = 0.922, and P < .001. Conclusions: The authors found that the incidence of posttonsillectomy hemorrhage is scale invariant. The practical implication is that the observation of rare incidences of large hemorrhage rates may not be due to a unique circumstance or a particular operative fault. To reduce the incidence of extreme rates of postoperative hemorrhage, a review of the entire process of tonsillectomy would be required. Scale‐invariance analysis may represent a novel tool that should be considered when reviewing surgical complications.     

Epworth嗜睡量表简体中文版信度和效度评价

目的 探讨Epworth嗜睡量表(Epworth sleepiness scale,ESS)简体中文版的信度和效度.方法以585例疑似阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者及103例确诊并进行手术的OSAHS患者为研究对象,多道睡眠图(PSG)监测前填写ESS量表简体中文版,进行手术的患者术后6个月以上再次进行了PSG监测和填写ESS量表.从585例患者中选取2010年7至8月间的51例患者重新进行ESS量表评分(时间至少间隔1周).结果 ESS量表简体中文版总的Cronbach'α系数为0.814;ESS总分重测信度为0.679,表中各项条目信度为0.473～0.698(P<0.01);分半信度R=0.817(P<0.01).ESS量表效度分析中,区分效度用呼吸暂停低通气指数(AHI)指标来区分单纯鼾症和轻、中及重度OSAHS患者,单纯鼾症与不同病情程度的OSAHS患者ESS量表总评分及各个项目评分差异有统计学意义(P<0.05).用最低血氧饱和度(LSaO2)指标来区分正常血氧饱和度、轻、中及重度低血氧饱和度患者,正常血氧饱和度与不同程度低氧血症患者ESS量表总评分及各个项目评分差异有统计学意义(P<0.05).因素分析中有4个公因子,累积贡献率达74.270%,每项条目负荷大于0.4;各因子分值与ESS量表总分进行相关分析发现除开车等红绿灯或遇堵车停几分钟时与其他各因子的相关性较低外,其他因子之间及ESS总分之间相关性均较高(P<0.01).量表评估与临床诊断的一致率较差(Kappa值为0.099,P<0.01),预测效度差(r=0.138,P<0.01).手术前后ESS总分由15.0[10;20]分降到4[1;6]分(M[P25;P75]),手术治疗有效、无效患者在手术前后ESS总分的差异均有统计学意义(Z=-7.528,P<0.01;Z=-4.382,P<0.01).结论 Epworth嗜睡量表简体中文版具有较好的信度和效度,可以作为白天嗜睡程度自我评估工具.

Abstract：

Objective To investigate the reliability and validity of the simplified Chinese version of Epworth sleepiness scale(ESS). Methods Five hundred and eighty-five patients with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and 103 OSAHS patients who underwent operations were included in this study. The ESS was filled before polysomnography (PSG) monitoring under the direction of professional technicians. The patients who underwent operations did both PSG and ESS tests more than 6 months after operation. Fifty-one patients who underwent PSG at our hospital from July to August, 2010 were chosen to assess the ESS test-retest reliability on two separate occasions at least more than one week. Results The total Cronbach's Alpha of ESS was 0. 814. The test-retest reliability of ESS total scores was 0.679 and for each item was from 0.473 to 0.698 ( P ＜ 0.01 ). Split-half reliability was 0.817 ( P ＜ 0.01 ). In the analysis of discriminant validity with apnea hypopnea index (AHI), the ESS total scores and each item's scores had significant differences in severity in OSAHS patients and simple snoring patients( P ＜ 0.05 ), and this was also true in different degrees of lowest saturation of arterial oxygen ( LSaO2 ) patients and normal LSaO2 patients(P＜0.05). The factor analysis of construct validity showed that 4 factors were extracted.The cumulative proportion was 74.270%. The loading was higher than 0. 4 among every item. The correlation coefficiency of overall ESS scores and each item's scores was relatively high except the last item.The ESS had low consistency with clinical diagnosis(κ =0.099,P ＜0.01 ) and the predictive validity was not good (r =0.138, P ＜0.01 ). As for 103 patients who had operations, the initial assessment of total ESS scores were 15.0[10;20] ( M[P25 ;P75] ) ,and improved to 4[1 ;6] after operation. The patients who got effective results had significant difference in the total ESS scores before and after operation ( Z = - 7.528,P＜0.01) ,so was the patients who got ineffective results(Z= -4.382, P＜0.01) . Conclusions The simplified Chinese version of ESS had a good reliability and validity. It can be used to evaluate the chance of dozing in the daytime.     

中小学生听力筛查量表的编制

目的为我国4～16岁中小学生修订《中小学生听力筛查量表》,为及时发现听力障碍儿童提供可靠的筛查工具。方法采用量表修订的基本程序编制量表,由专家问卷法和Saaty权重计算法对量表进行修订。结果专家意见一致性系数W=0.91236,协调系数经检验后有显著性。专家权威系数Cr=0.72。指标权重一致性指数CI=0.063,所有指标的权重可以接受。随机一致性比率CR=0.043,判断矩阵有满意的一致性。结论该量表的13个指标质量符合量表编制的基本要求,可以进行下一步信度和效度检验。     

The INFVo perceptual rating scale for substitution voicing: development and reliability

In this paper, an experimental study of inter-judge consistency for the different dimensions of a recently proposed new scale for the rating of substitution voices is presented. The IINFVo rating scale tries to score five parameters, namely impression, intelligibility, noise, fluency and voicing. Each parameter is scored between 0 (very good substitution voicing) and 10 (very deviant substitution voicing) on a visual analogue scale. Inter-judge consistencies were measured among semi-professional as well as among professional jury members. The consistencies among semi-professionals, expressed as Pearson correlation coefficients, ranged from moderate to good (0.57–0.68), whereas those among professionals were good to excellent (0.82–0.87) and compared favourably to consistency figures published for traditional perceptual evaluation scales such as the GRBAS scale for laryngeal dysphonia. Since there is a strong correlation between the scores of impression and intelligibility, and since intelligibility is hard to score by non-native listeners, we suggest taking the mean of the two scores as the impression of a modified dimensional INFVo rating scale. Our experiments demonstrate that the INFVo rating scale has good potential to become a routine perceptual evaluation method in a multidimensional assessment protocol for substitution voicing.     

Translation and validation of the drooling impact scale questionnaire into Brazilian Portuguese

IntroductionInadequate drooling can cause serious clinical, functional and social problems. Validated questionnaires to evaluate drooling impact on quality of life are lacking in Brazilian Portuguese.ObjectivesTo translate and validate the drooling impact scale to Brazilian Portuguese.MethodsThe drooling impact scale was translated to Brazilian Portuguese and back- translated to English to assess potential conceptual differences. Brazilian Portuguese version of drooling impact scale was applied to a 40 patients’ sample of sialorrhea presenting pediatric patients (up to 20 years of age). Chronbach’s alpha, exploratory factorial analysis and confirmatory factorial analysis were then proceeded with data collected.ResultsThe mean drooling impact scale value for the whole population was 51.77 (SD = 16.13). The internal consistency obtained with Cronbach’s alpha indicated a value of 0.72 for the entire sample. The Bartlett’s test of sphericity was significant (p < 0.0001), confirming correlation among variables tested. Kaiser-Meyer-Olkin measure of sampling adequacy revealed a value of 0.72, indicating that the correlation matrix was reasonably suitable for factor analysis. Regarding exploratory factorial analysis, parallel analysis suggested a two-factor solution that was used for confirmatory factorial analysis. The first factor was responsible for 33.78% of the variance with an Eigenvalue of 3.38. The second factor explained 16.1% of the variance with an Eigenvalue of 1.61. At confirmatory factorial analysis, the two-factor model showed consistently better adjustments parameters than the one-factor model.ConclusionThe drooling impact scale has been successfully translated to Brazilian Portuguese language, showing adequate internal validity. Validation of this instrument allows physicians and other personnel involved in the care of these patients to perform a better management of patients experiencing drooling. With this tool, we are now able to guide routines and provide guidelines both before and after the different kinds of treatments in order to improve the general well-being of the patient and his family.     

Epworth嗜睡量表和微觉醒指数在单纯鼾症患者病情评估的价值

目的 探讨Epworth嗜睡量表(ESS)和微觉醒指数在单纯鼾症患者病情评估的价值。 方法 经多导睡眠监测(PSG)确诊的358例单纯鼾症患者,按嗜睡程度分为3组,即嗜睡轻度组(ESS≤12)、中度组(13≤ESS≤17)、重度组(18≤ESS),分别对各组间微觉醒指数(MAI)、睡眠呼吸暂停低通气指数(AHI)、呼吸暂停指数(AI)、低通气指数(HI)、最低血氧饱和度(LSaO₂)、体质量指数(BMI)进行比较。ESS与MAI进行相关性分析。 结果 轻度嗜睡组286例,中度嗜睡组43例,重度嗜睡组29例,3组间AHI、AI、HI、LSaO₂、BMI差异无统计学意义(P>0.05),轻度组与重度组、中度组与重度组间微觉醒指数差异有统计学意义(U=-8.030, -5.604, P<0.05),轻度组与中度组微觉醒指数差异无统计学意义(U=-1.623, P>0.05),ESS与MAI呈正相关(r=0.331, P<0.05)。 结论 Epworth嗜睡量表和微觉醒指数对单纯鼾症患者病情评估有重要价值。     

Tinnitus severity measured by a subjective scale, audiometry and clinical judgement

Tinnitus is discussed, with particular reference to the problem of assessing severity. The authors argue that tinnitus severity can only usefully be determined by measuring the impact of tinnitus on an individual, and therefore propose a scale to estimate severity in these terms. Data presented on 112 members of a tinnitus self-help group, demonstrated the reliability of a Subjective Tinnitus Severity Scale (S.T.S.S.), with a coefficient alpha of 0.84. This indicates a high degree of internal consistency, i.e.: statistically this scale is measuring aspects of a single dimension. The validity was established in a separate sample of 30 clinic attenders, where mean S.T.S.S. scores were found to correlate highly with two independent clinical ratings of severity (r2 = 0.76, p less than 0.001, and r2 = 0.73, p less than 0.001). Additionally, in these patients S.T.S.S. scores were significantly associated with several audiometric variables, although the correlations were of low magnitude.