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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 賴飛羆 | |
| dc.contributor.author | Yuan-Chia Chu | en |
| dc.contributor.author | 朱原嘉 | zh_TW |
| dc.date.accessioned | 2021-06-17T07:08:21Z | - |
| dc.date.available | 2019-07-31 | |
| dc.date.copyright | 2019-07-31 | |
| dc.date.issued | 2019 | |
| dc.date.submitted | 2019-07-23 | |
| dc.identifier.citation | [1] F. H. Bess, J. Dodd-Murphy, and R. A. Parker, 'Children with minimal sensorineural hearing loss: prevalence, educational performance, and functional status,' Ear and hearing, vol. 19, no. 5, pp. 339-354, 1998.
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/72859 | - |
| dc.description.abstract | 學童潛藏性聽損會造成學童個人語言學習及發展的遲緩，導致溝通情緒及教育的問題，進而造成社會國家嚴重損失。然而，聽損學童們常常不容易在初期被查覺，往往都是等到聽不清楚時才就醫治療，造成無法回復的困境。有鑑於此，準確、便利及普及化之早期聽力檢測工具將有助於潛藏性聽損患者之發覺，以達到早期治療之目的。學童們的潛藏性聽損，於聽力篩檢活動中常見的原因包括：耳垢阻塞、積液性中耳炎、單側感音性聽障、噪音感音性聽障、和延遲感音性聽障等各種情況，因此要早期發現和診斷聽損學童是件頗具挑戰性的工作。
純音聽力篩檢，建議使用於大規模學童們的聽力篩檢活動中，根據目前文獻報告公認為最佳的黃金準則，可取代耳聲傳射檢查及鼓室圖等常用的聽力篩檢工具。純音聽力篩檢檢查 (PTS)：乃利用四個不同頻率和音量的測試音，即為500 Hz 25分貝、1000、2000、4000Hz 皆為20 分貝，來檢測學童是否有聽損情形？當全部都聽到且有反應時為【通過】，視為正常聽力；否則為【不通過】，視為聽力可能有異常。當檢測為【不通過】時，必須追蹤其聽力、再篩檢、或進一步做診斷性聽力評估。例行性純音聽力篩檢，是目前大規模學童們聽力篩檢活動中，最常被使用的聽力檢測工具，可以早期發現和診斷學童聽損的情形。 然而，以純音聽力篩檢方式對學童進行聽力篩檢已經有諸多研究，但是方法並未整合，比如American Speech Language Hearing Association (ASHA)以及 American Academy of Pediatrics (AAP) 建議使用20 dB音量的純音聽力闔值500 Hz、 1000 Hz、2000 Hz及4000 Hz。 針對上述幾項的缺點，我們開發出微型化聽力檢測裝置-聽力量值App，應用於智慧型手機與平板電腦。驗證聽力量值App於學童，聽力量值App檢測結果與純音聽力檢查平均聽閾值相同，期能成為學童居家自我檢測、追蹤聽力、協助聽能復建之應用工具。並且結合雲端監控，實測驗證於台北市某國小，針對學童進行聽力檢測，並同步建立聽力大數據資料庫，利用SMART Visual Statistics 網頁應用程式，並依修正式Siegel準則分類病患的聽損等級，可以預測病患的預後情形及調整治療的策略。進而希望透過此系統讓潛藏性聽損使用者進行居家自我檢測、追蹤聽力狀況協助聽能復健。 | zh_TW |
| dc.description.abstract | Hearing impairment may retard the child development in language and learning ability, and have serious consequences of emotional and communication disturbances hindering the affected children from normal growth. An effective screening to identify the diseased children for prompt treatment therefore becomes very important.
Pure tone screening (PTS) - not otoacoustic emission screening or tympanometry, is the golden standard for school-age children's hearing screening programs. In the PTS protocol for children, four fixed test tones are applied to each ears at a specified stimulation level at frequencies associated with speech perception. The application of the pre-determined hearing criteria produces a 'pass' or 'fail' test result for the selected ear, where the follow-up re-screening or further diagnostic hearing test assessment was performed if the result is 'fail.' However, conventional PTS only gives pass/fail results for the ears screened, and is lack of hearing state assessment or test values to be recorded for follow-up. To improve the limitations of PTS, we herein report the successful development of a new method of hearing measurement. There have been plenty of studies on hearing screening of school children with PTS, but the hearing screening methods have not been integrated. For example, the American Speech-Language-Hearing Association (ASHA) and the American Academy of Audiology gave professional recommendations for screening at 20 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. In 2003, the American Academy of Pediatrics (AAP) also recommended 20 dB screening at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. The aims of the present study are thus to describe more possible outcomes with significance as follows: 1st aim: To integrate the pre-treatment hearing grades with the recovery report from hearing impairment based on the modified Siegel criteria A total of 110 patients with sudden sensorineural hearing loss (SSNHL) treated with combination of systemic and intra-tympanic steroid therapy were collected for the present study. Hearing improvement, including complete recovery (CR), partial recovery (PR) and slight improvement (SI), was observed in 56 patients. Patients with pre-treatment hearing grade 3 had the highest improvement rate (88.2%=30/34). Patients with combined steroid therapy administered at onset stage had better overall hearing improvement rates than the rescue group. Treatment given in the first 14 days yielded a better rate of hearing improvement than delayed treatment given beyond 14 days, especially for patients with a pre-treatment hearing grade of 5. 2nd aim: To build web-based patient survival and risk analysis into the SMART Visual Statistics System SMART Visual Statistics System (SMART VS) is a comprehensive set of easy-to-understand statistical tests that support the analysis of nominal, ordinal, interval or ratio variables, standard deviation, maximum, minimum and percentage. In this article, the development of the original data source and transport mechanism Extract-Transform-Load (ETL) was described for data cleansing, extraction, transformation and loading. We also built a convenient data representation that could be customized to fit in with specific trial design. 3rd aim: To develop a new mobile phone-based hearing screening method for school-age children: cross-sectional validation study A total of 85 subjects (170 ears), including 38 boys and 47 girls aged between 11 and 12 years with an average (SD) of 11 (0.5) years, participated in the trial. Both screening methods produced comparable pass and failure results (pass in 168 ears and failure in 2 ears). Smartphone-based screening accurately detected moderate or worse hearing loss (average PTA>25 dB) to achieve 100% sensitivity and specificity. In summary, using the modified Siegel criteria, we demonstrated the prognostic significance of pre-treatment hearing grade in SSNHL patients with combined intra-tympanic steroid therapy. SMART VS can be used for risk-adjusted baseline cohorts and randomized controlled trials. The Ear Scale App as a smartphone-based self-hearing test demonstrates a high level of consistency with traditional PTS at the sound processing booth. Our findings suggest that smartphone-based hearing screening can be used in school-age populations. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-17T07:08:21Z (GMT). No. of bitstreams: 1 ntu-108-D04945002-1.pdf: 4543400 bytes, checksum: 70fa49f06bb79855488a25dfcc02939a (MD5) Previous issue date: 2019 | en |
| dc.description.tableofcontents | 口試委員會審定書 #
誌謝 i 中文摘要 ii ABSTRACT iv CONTENTS vii LIST OF FIGURES x LIST OF TABLES xi Chapter 1 Introduction 1 1.1 Hearing Impairment in Children 1 1.2 Pediatric Hearing Screening Procedures 1 1.3 Sudden Sensorineural Hearing Loss (SSNHL) 3 1.4 Statistical Software for Survival Analysis 3 1.5 Pure-tone Hearing Screening (PTS) 4 1.6 Specific Aims 8 1.6.1 Hearing Grading and Hearing Recovery System Established 9 1.6.2 Developing Survival Analysis Web-based System 9 1.6.3 Developing Hearing Screening Mobile Phone–Based App 10 Chapter 2 Materials and Methods for Hearing Grading and Hearing Recovery System 11 2.1 Patients and Indications 11 2.2 Main Outcomes Measured by Using the Modified Siegel’s Criteria 14 2.3 Statistics 14 Chapter 3 Materials and Methods for Survival Analysis Web-based System 16 3.1 SMART Visual Statistics System Overview 16 3.2 Metadata for Data Management and Survival Analysis 19 3.3 Differences in The Characteristics of The Research Objects by Statistical Tests 21 3.4 Survival Analysis of Differences in Survival Time 24 3.5 Demonstration Datasets 26 Chapter 4 Materials and Methods for Hearing Screening Mobile Phone-Based App 27 4.1 Study Setting and Participants 27 4.2 Measurements 28 4.2.1 Pure-Tone Screening Procedures in a Sound-Treated Booth 28 4.2.2 iOS Auto Audiometry App 28 4.2.3 iOS Automated Audiometry Calibration 32 4.3 Statistics 33 Chapter 5 Results 34 5.1 Comparison between Two Hearing Screening Methods 34 5.1.1 What Modified Siegel’s Criteria Indicate: Pre-treatment Hearing Grades and Post-treatment Recovery Outcomes 34 5.1.2 Applications - Prediction of Hearing Outcomes Using the Modified Siegel’s Criteria 37 5.2 Survival Analysis and Metadata Management Web-based System Test 40 5.2.1 Survival Analysis and Metadata Management 40 5.2.2 Procedure for Survival Analyses in Open Data 41 5.3 Hearing Impairment Confirmed in Ear Scale App 47 5.3.1 Comparison between Conventional Pure-Tone Screening and Ear Scale App 47 5.3.2 Validation of The Ear Scale App's Built-in Hearing Scale Test 51 5.3.3 Accuracy of Ear Scale App Calibration at All Hearing Scale Test Grades 52 Chapter 6 Discussion 54 6.1 The Preliminary Findings for Modified Siegel’s Criteria 54 6.2 The First Trial to Integrate Standard Procedures and Metadata Management for Survival Analysis 56 6.2.1 Findings 56 6.2.2 Future Work 58 6.3 The First Proposed Method To Stratify Hearing Test Results of Smartphone for School-age Children 58 6.3.1 The Implications for Ear Scale App 58 6.3.2 The Limitations of Ear Scale App 61 Chapter 7 Conclusion 62 REFERENCES 64 APPENDIX Appendix A. Abbreviations 77 APPENDIX Appendix B. Ear Scale Cloud backend details 78 | |
| dc.language.iso | en | |
| dc.subject | 網頁應用程式 | zh_TW |
| dc.subject | 存活分析 | zh_TW |
| dc.subject | 純音聽力檢查 | zh_TW |
| dc.subject | 行動應用程式 | zh_TW |
| dc.subject | 遠距醫療 | zh_TW |
| dc.subject | 聽力測試 | zh_TW |
| dc.subject | 聽力量值法 | zh_TW |
| dc.subject | Web Apps | en |
| dc.subject | Survival | en |
| dc.subject | Pure-tone | en |
| dc.subject | Audiometry | en |
| dc.subject | Mobile apps | en |
| dc.subject | Telemedicine | en |
| dc.subject | Hearing tests | en |
| dc.title | 開發微型化聽力檢測裝置應用於學童之交叉驗證研究 | zh_TW |
| dc.title | A Mobile Phone–Based Approach for Hearing Screening of School-Age Children: Cross-Sectional Validation Study | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 107-2 | |
| dc.description.degree | 博士 | |
| dc.contributor.oralexamcommittee | 歐陽彥正,周承復,蕭旭君,陳澤雄,鐘玉芳 | |
| dc.subject.keyword | 聽力量值法,聽力測試,遠距醫療,行動應用程式,純音聽力檢查,存活分析,網頁應用程式, | zh_TW |
| dc.subject.keyword | Hearing tests,Telemedicine,Mobile apps,Audiometry,Pure-tone,Survival,Web Apps, | en |
| dc.relation.page | 81 | |
| dc.identifier.doi | 10.6342/NTU201901774 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2019-07-24 | |
| dc.contributor.author-college | 電機資訊學院 | zh_TW |
| dc.contributor.author-dept | 生醫電子與資訊學研究所 | zh_TW |
| 顯示於系所單位： | 生醫電子與資訊學研究所 | |
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