In this review, two studies are used to compare thethreshold estimates from auditory steady-state response (ASSR) tests to clickor toneburst-evoked auditory brainstem responses (ABRs), to determine if ASSRscan be used to estimate pure-tone threshold in infants or children at risk forhearing loss and normal-hearing adults.
The first study, which was a retrospective study, showedthat pure-tone threshold could be predicted by both the click-evoked ABR(c-ABR) and the ASSR threshold estimates, for infants and children with hearingthresholds from normal to severe-to-profound range. The correlations of c-ABRwith pure-tone thresholds were moderately robust. As was expected, thedifferences between the ABR and ASSR correlation were small.
The correlationsbetween the c-ABR threshold and the ASSR thresholds were also statisticallysignificant. The high correlation of c-ABR with the pure- tone audiogram alsolies in the nature of pure-tone test results. The second study, which was a prospective study ofnormal-hearing adults, provided evidence that the toneburst-evoked ABR (tb-ABR)and the modulated tone-evoked ASSR thresholds were similar but that thestimulus used (tone burst versus AM + FM tone) and detection method (algorithmversus visual detection) affected the threshold determination.
Strengths· The title of the article was appropriate and clear, as wellas the the abstract; it was specific, representative of the article, and in thecorrect form.· The purpose of the article was made clear in theintroduction.· Both studies were adequately described, in terms of methods,results, and discussion.· In the first study, caseswere excluded if the interval between the ABR, ASSR, and behavioral thresholdtests was greater than 24 months.
· In the first study,participants had different type of hearing loss (sensorineural, conduction,mixed, and normal hearing) with different degrees of hearing loss (near-normal,mild hearing loss, moderate hearing loss, or severe-to-profound hearing losses)· In the second study, The ASSR and tb-ABR tests werecarried out in a darkened, custom-built, sound-treated room. Weaknesses· Only titles of the studieswere stated. The author,name of journal, date of publication, etc. were not included.· In the first study, forABR, it was stated that there is a possibility that some observer bias may havecrept into the response judgments. · In the first study, MRLswere determined in a clinical, not a laboratory, setting. which resulted instrictly short time to perform multiple measures of threshold at any onefrequency or to evaluate reliability.
· In the first study, behavioralthreshold measures and evoked potential threshold estimates were separated intime by weeks or months, so the likelihood of progressive hearing loss existedfor some infants’ data.· In the second study, onlyone ear was tested for each participant.