{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:58:45Z","timestamp":1774486725895,"version":"3.50.1"},"reference-count":33,"publisher":"Acoustical Society of America (ASA)","issue":"3","content-domain":{"domain":["pubs.aip.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,3,1]]},"abstract":"<jats:p>This study evaluated the accuracy of acoustic response tests in predicting conductive hearing loss in 161 ears of subjects from the age of 2 to 10 yr, using as a \u201cgold standard\u201d the air\u2013bone gap to classify ears as normal or impaired. The acoustic tests included tympanometric peak-compensated static admittance magnitude (SA) and tympanometric gradient at 226 Hz, and admittancereflectance (YR) measurements from 0.5 to 8 kHz. The performance of individual, frequencyspecific, YR test variables as predictors was assessed. By applying logistic regression (LR) and discriminant analysis (DA) techniques to the multivariate YR response, two univariate functions were calculated as the linear combinations of YR variables across frequency that best separated normal and impaired ears. The tympanometric and YR tests were also combined in a multivariate manner to test whether predictive efficacy improved when 226-Hz tympanometry was added to the predictor set. Conductive hearing loss was predicted based on air\u2013bone gap thresholds at 0.5 and 2 kHz, and on a maximum air\u2013bone gap at any octave frequency from 0.5 to 4 kHz. Each air\u2013bone gap threshold ranged from 5 to 30 dB in 5-dB steps. Areas under the relative operating characteristic curve for DA and LR were larger than for reflectance at 2 kHz, SA and Gr. For constant hit rates of 80% and 90%, both DA and LR scores had lower false-alarm rates than tympanometric tests\u2013LR achieved a false-alarm rate of 6% for a sensitivity of 90%. In general, LR outperformed DA as the multivariate technique of choice. In predicting an impairment at 0.5 kHz, the reflectance scores at 0.5 kHz were less accurate predictors than reflectance at 2 and 4 kHz. This supports the hypothesis that the 2\u20134-kHz range is a particularly sensitive indicator of middle-ear status, in agreement with the spectral composition of the output predictor from the multivariate analyses. When tympanometric and YR tests were combined, the resulting predictor performed slightly better or the same as the predictor calculated from the use of the YR test alone. The main conclusion is that these multivariate acoustic tests of the middle ear, which are analyzed using a clinical decision theory, are effective predictors of conductive hearing loss.<\/jats:p>","DOI":"10.1121\/1.426713","type":"journal-article","created":{"date-parts":[[2002,7,26]],"date-time":"2002-07-26T14:06:35Z","timestamp":1027692395000},"page":"1749-1764","update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":72,"title":["Prediction of conductive hearing loss based on acoustic ear-canal response using a multivariate clinical decision theory"],"prefix":"10.1121","volume":"105","author":[{"given":"Pawel","family":"Piskorski","sequence":"first","affiliation":[{"name":"Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska\u200968131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas H.","family":"Keefe","sequence":"additional","affiliation":[{"name":"Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska\u200968131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey L.","family":"Simmons","sequence":"additional","affiliation":[{"name":"Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska\u200968131"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Gorga","sequence":"additional","affiliation":[{"name":"Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska\u200968131"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"231","reference":[{"key":"2023071403055413500_bam75","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/0022-2496(75)90001-2","article-title":"The area above the ordinal dominance graph and the area below the receiver operating characteristic graph","volume":"12","year":"1975","journal-title":"J. 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