Faculty Bibliography

OBJECTIVES: To examine the conclusions and possible misinterpretations that may or may not be drawn from the 'outcome-matching method,' a study design recently used in the cochlear implant literature. In this method, subject groups are matched not only on potentially confounding variables but also on an outcome measure that is closely related to the outcome measure under analysis. For example, subjects may be matched according to their speech perception scores in quiet, and their speech perception in noise is compared. DESIGN: The present study includes two components, a simulation study and a questionnaire. In the simulation study, the outcome-matching method was applied to pseudo-randomly generated data. Simulated speech perception scores in quiet and in noise were generated for two comparison groups, in two imaginary worlds. In both worlds, comparison group A performed only slightly worse in noise than in quiet, whereas comparison group B performed significantly worse in noise than in quiet. In Imaginary World 1, comparison group A had better speech perception scores than comparison group B. In Imaginary World 2, comparison group B had better speech perception scores than comparison group A. The outcome-matching method was applied to these data twice in each imaginary world: 1) matching scores in quiet and comparing in noise, and 2) matching scores in noise and comparing in quiet. This procedure was repeated 10,000 times. The second part of the study was conducted to address the level of misinterpretation that could arise from the outcome-matching method. A questionnaire was administered to 54 students in a senior level course on speech and hearing to assess their opinions about speech perception with two different models of cochlear implant devices. The students were instructed to fill out the questionnaire before and after reading a paper that used the outcome-matching method to examine speech perception in noise and in quiet with those two cochlear implant devices. RESULTS: When pseudorandom scores were matched in quiet, comparison group A's scores in noise were significantly better than comparison group B's scores. Results were different when scores were matched in noise: in this case, comparison group B's scores in quiet were significantly better than comparison group A's scores. Thus, the choice of outcome measure used for matching determined the result of the comparison. Additionally, results of the comparisons were identical regardless of whether they were conducted using data from Imaginary World 1 (where comparison group A is better) or from Imaginary World 2 (where comparison group B is better). After reading the paper that used the outcome-matching method, students' opinions about the two cochlear implants underwent a significant change even though, according to the simulation study, this opinion change was not warranted by the data. CONCLUSIONS: The outcome-matching method can provide important information about differences within a comparison group, but it cannot be used to determine whether a given device or clinical intervention is better than another one. Care must be used when interpreting the results of a study using the outcome-matching method

It is well known that discrimination response variability increases with stimulus intensity, closely related to Weber's Law. It is also an axiom that sensation magnitude increases with stimulus intensity. Following earlier researchers such as Thurstone, Garner, and Durlach and Braida, we explored a new method of exploiting these relationships to estimate the power function exponent relating sound pressure level to loudness, using the accuracy with which listeners could identify the intensity of pure tones. The log standard deviation of the normally distributed identification errors increases linearly with stimulus range in decibels, and the slope, a, of the regression is proportional to the loudness exponent, n. Interestingly, in a demonstration experiment, the loudness exponent estimated in this way is greater for females than for males

The power function exponent for loudness is traditionally determined by means of a process of magnitude estimation. It is demonstrated in this paper that the exponent can also be obtained by using the procedure of absolute identification of sound intensity. It has been shown that subjects' responses to tones of a given intensity are distributed in a normal distribution whose variance depends on the range, R, over which the tones are distributed. By means of a standard statistical transformation, the normal density in log space is converted to the corresponding probability density in linear space. The power function exponent can then be obtained directly from the linear probability density. We also suggest that there is a direct relationship between the information calculated from experiments on absolute identification of sound intensity and the neurophysiological, poststimulus histogram measured in a nerve fiber in the auditory nerve

This paper considers the information transmitted in absolute judgments as encoded in a stimulus-response matrix (e.g., see Garner and Hake, 1951). When transmitted information is plotted against the number of stimulus categories in the matrix, one obtains a curve that increases monotonically toward a plateau, which is the maximum information transmittable per stimulus for the particular range of stimuli employed. We demonstrate that although the maximum information transmitted is an attribute of the stimulus continuum itself, the shape of the curve is an empirical property of the stimulus-response matrix, which is determined, in part, by maintaining a constant stimulus category width. Therefore, in principle, each curve of information transmitted vs number of stimulus categories can be determined by a single point: the rightmost point on the graph.