Data Standards in Audiology: A Mixed-Methods Exploration of Community Perspectives and Implementation Considerations

Objective: The purpose of this study was to explore options for data standardisation in audiology and document the global audiology community's current knowledge and views of data standards, explore their needs and preferences, and develop recommendations for data standardisation as a result. Design: A mixed-methods approach, combining a structured survey with an in-depth exploration of themes by experts during a special session on "Big Data and Data Standards in Audiology" at the 2024 Virtual Conference of Computational Audiology. Study Sample: The survey sample consisted of 82 members of the global audiology community; five experts joined the panel discussion. Results: Survey results emphasized the need for data standardisation in audiology aimed at facilitating research and improving patient care. Knowledge of existing initiatives was low: 38% were aware of initiatives. Yet, 90% envisioned contributing to them moving forward. The panel discussion explored emerging standardisation initiatives in audiology (OMOP, openEHR, HIMSA's Noah standard), challenges (e.g., data quality and privacy), and opportunities (e.g., conversion between approaches and synergies with other medical fields). Conclusions: The community support identified in this study could be leveraged to further develop standardisation initiatives for audiology, ensuring alignment between initiatives and with other medical fields.

Discrimination loss vs. SRT: A model-based approach towards harmonizing speech test interpretations

Objective: Speech tests aim to estimate discrimination loss or speech recognition threshold (SRT). This paper investigates the potential to estimate SRTs from clinical data that target at characterizing the discrimination loss. Knowledge about the relationship between the speech test outcome variables--conceptually linked via the psychometric function--is important towards integration of data from different databases. Design: Depending on the available data, different SRT estimation procedures were compared and evaluated. A novel, model-based SRT estimation procedure was proposed that deals with incomplete patient data. Interpretations of supra-threshold deficits were assessed for the two interpretation modes. Study sample: Data for 27009 patients with Freiburg monosyllabic speech test (FMST) and audiogram (AG) results from the same day were included in the retrospective analysis. Results: The model-based SRT estimation procedure provided accurate SRTs, but with large deviations in the estimated slope. Supra-threshold hearing loss components differed between the two interpretation modes. Conclusions: The model-based procedure can be used for SRT estimation, and its properties relate to data availability for individual patients. All SRT procedures are influenced by the uncertainty of the word recognition scores. In the future, the proposed approach can be used to assess additional differences between speech tests.

Integrating audiological datasets via federated merging of Auditory Profiles

Audiological datasets contain valuable knowledge about hearing loss in patients, which can be uncovered using data-driven, federated learning techniques. Our previous approach summarized patient information from one audiological dataset into distinct Auditory Profiles (APs). To cover the complete audiological patient population, however, patient patterns must be analyzed across multiple, separated datasets, and finally, be integrated into a combined set of APs. This study aimed at extending the existing profile generation pipeline with an AP merging step, enabling the combination of APs from different datasets based on their similarity across audiological measures. The 13 previously generated APs (NA=595) were merged with 31 newly generated APs from a second dataset (NB=1272) using a similarity score derived from the overlapping densities of common features across the two datasets. To ensure clinical applicability, random forest models were created for various scenarios, encompassing different combinations of audiological measures. A new set with 13 combined APs is proposed, providing well-separable profiles, which still capture detailed patient information from various test outcome combinations. The classification performance across these profiles is satisfactory. The best performance was achieved using a combination of loudness scaling, audiogram and speech test information, while single measures performed worst. The enhanced profile generation pipeline demonstrates the feasibility of combining APs across datasets, which should generalize to all datasets and could lead to an interpretable population-based profile set in the future. The classification models maintain clinical applicability. Hence, even if only smartphone-based measures are available, a given patient can be classified into an appropriate AP.