Bias in scoring auditory brainstem responses

Abstract

ABR waveforms from 50 multi-handicapped children were analysed by nine judges in an investigation of scoring bias. Prior to estimating threshold for each subject, the judges were provided with either true or false ABR thresholds. This preliminary information was true in 25 of the cases and false in the other 25. The same ABR waveforms were evaluated one week later, but true/false biasing thresholds were reversed. Results revealed that while the more experienced judges were more accurate in their assessments, they were not necessarily less biased. The effects of bias were more predominant in those cases where the estimation of threshold was the most difficult.

Diagnostic challenges and safety considerations in cochlear implantation under the age of 12 months

“…However, the determination of the obtained waveforms and the estimated level of hearing can be subjective processes, which may, in large part, rely on the examiner's experience [11][12][13]. Even after applying the strictest diagnostic criteria and obtaining more than one waveforms in each stimulus, challenges with regard to the accuracy of the investigation, especially in difficult cases, may be encountered [14]. Moreover, ABRs assess a narrow frequency range; therefore cases with useful residual hearing (i.e.…”

Objective threshold estimation and measurement of the residual background noise in auditory evoked potentials of goldfish

“…Multiple trained observers are not highly consistent, however. Both the present study and studies of trained audiologists ͑Arnold, 1985; Gans et al, 1992;Vidler and Parker, 2004;Lv et al, 2007͒ have reported poor agreement between observers in judging AEP threshold. In the present study, we reported that disagreement between all three observers was found for 20% of all threshold judgments, which is higher than what Lv et al ͑2007͒ reported for three experienced audiologists ͑one out of twelve judgments in their Fig.…”

“…Typically, subjective response determination relies on visual inspection of the repeatability of replicate AEP averages using a subjective yes/no decision, occasionally based on expected minimal response amplitudes ͑e.g., Boettcher, 2002͒ and/or within a particular latency window ͑e.g., Ramcharitar and Popper, 2004͒. The heavy reliance on visual inspection techniques in the animal AEP literature is especially unfortunate because unsatisfactory interobserver agreements of visual inspection have been shown in several independent studies of experienced observers or clinicians ͑Arnold, 1985; Gans et al, 1992;Vidler and Parker, 2004;Lv et al, 2007͒. Unfortunately, the use of such unreliable subjective threshold determination techniques raises the possibility that hypothesis testing could be compromised by confirmation bias, particularly in the absence of double-blind protocols ͑Nicker-son, 1998͒.…”

Hearing threshold assessment post grommet insertion. Is it reliable?

“…We assumed that their interpretation was accurate, having eliminated the risk of bias through blinded assessment of the results by a third, independent senior audiologist. 1 Both tests have been previously used experimentally to determine changes in hearing levels and, in particular, the phenomenon of temporary threshold shift. 2 -5 The results of the transient evoked otoacoustic emission (TEOAE) tests would suggest that, despite creation of apparently ideal conditions for their measurement (i.e.…”