Purpose: The analysis of Ecological Momentary Assessment (EMA) data can be difficult to conceptualize due to the complexity of how the data are collected. The goal of this tutorial is to provide an overview of statistical considerations for analyzing observational data arising from EMA studies. Method: EMA data are collected in a variety of ways, complicating the statistical analysis. We focus on fundamental statistical characteristics of the data and general purpose statistical approaches to analyzing EMA data. We implement those statistical approaches using a recent study involving EMA. Results: The linear or generalized linear mixed-model statistical approach can adequately capture the challenges resulting from EMA collected data if properly set up. Additionally, while sample size depends on both the number of participants and the number of survey responses per participant, having more participants is more important than the number of responses per participant. Conclusion: Using modern statistical methods when analyzing EMA data and adequately considering all of the statistical assumptions being used can lead to interesting and important findings when using EMA. Supplemental Material https://doi.org/10.23641/asha.17155961
Objectives: 1) Identify the etiologies and risk factors of the patient cohort and determine the degree to which they reflected the incidence for children with hearing loss and 2) quantify practice management patterns in three catchment areas of the United States with available centers of excellence in pediatric hearing loss Design: Medical information for 307 children with bilateral, mild to severe hearing loss was examined retrospectively. Children were participants in the Outcomes of Children with Hearing Loss (OCHL) study, a five-year longitudinal study that recruited subjects at three different sites. Children aged 6 months to 7 years at time of OCHL enrollment were participants in this study. Children with cochlear implants, children with severe or profound hearing loss, and children with significant cognitive or motor delays were excluded from the OCHL study and, by extension, from this analysis. Medical information was gathered using medical records and participant intake forms, the latter reflecting a caregiver's report. A comparison group included 134 children with normal hearing. A chi-square test on two-way tables was used to assess for differences in referral patterns by site for the children who are hard of hearing (CHH). Linear regression was performed on gestational age and birth weight as continuous variables. Risk factors were assessed using ttests. The alpha value was set at p < 0.05.Results: Neonatal intensive care unit stay, mechanical ventilation, oxygen requirement, aminoglycoside exposure, and family history were correlated with hearing loss. For this study cohort, congenital cytomegalovirus (CMV), strep positivity, bacterial meningitis, extracorporeal
Objectives:The purpose of this study was to investigate differences in auditory environments and hearing aid feature activation between younger listeners with normal hearing and older listeners with hearing loss in an urban and rural location. We hypothesized that (1) urban dwellers and younger listeners would encounter more diverse and demanding auditory environments than rural dwellers and older listeners, respectively; (2) the advanced hearing aid features (noise reduction and directional microphone) of urban dwellers and younger listeners would be activated more frequently than rural dwellers and older listeners, respectively. Design:The design of this study was cross-sectional with repeated measures. A total of 12 older adults with hearing loss (OHL-U) and 11 younger adults with normal hearing (YNH-U) were recruited from an urban area (Berkeley, California) and 13 older adults with hearing loss (OHL-R) and 10 YNH-U were recruited from a rural area (Iowa City, Iowa). Participants wore hearing aids that recorded data about their listening environments and completed ecological momentary assessments for 1 week. Results:The YNH-U group experienced higher sound pressure levels and hearing aid features were activated more frequently than in the OHL groups. The OHL-R group experienced significantly less diverse sound pressure levels than the YNH-U group. The YNH-R group had sound levels between the YNH-U group and the OHL groups but without significant differences from any other group. The YNH groups showed a greater likelihood of hearing aid feature activation than the OHL-R group.Conclusions: Demographics affect auditory environments and the activation of hearing aid features. Younger urban dwellers have the most diverse or demanding auditory environments and hearing aid feature activation, and older, rural dwellers with hearing loss have the least diverse or demanding auditory environments and hearing aid feature activation. Future studies of real-world auditory environments and audiology intervention effectiveness should consider location in recruitment and interpretation of results.
This study investigated the effect of presentation level on spectral-ripple detection for listeners with and without sensorineural hearing loss (SNHL). Participants were 25 listeners with normal hearing and 25 listeners with SNHL. Spectral-ripple detection thresholds (SRDTs) were estimated at three spectral densities (0.5, 2, and 4 ripples per octave, RPO) and three to four sensation levels (SLs) (10, 20, 40, and, when possible, 60 dB SL). Each participant was also tested at 90 dB sound pressure level (SPL). Results indicate that level affected SRDTs. However, the effect of level depended on ripple density and hearing status. For all listeners and all RPO conditions, SRDTs improved from 10 to 40 dB SL. In the 2- and 4-RPO conditions, SRDTs became poorer from the 40 dB SL to the 90 dB SPL condition. The results suggest that audibility likely controls spectral-ripple detection at low SLs for all ripple densities, whereas spectral resolution likely controls spectral-ripple detection at high SLs and ripple densities. For optimal ripple detection across all listeners, clinicians and researchers should use a SL of 40 dB SL. To avoid absolute-level confounds, a presentation level of 80 dB SPL can also be used.
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