| ObjectiveAcoustic hypersensitivity refers to a disease phenomenon that is uncomfortable to the external voice acceptable to normal people.It is a new disease proposed in recent years.It is clinically common but not yet widely recognized,and there is no recognized effective treatment.Professor Liu Peng is good at using Chinese medicine to treat acoustic hypersensitivity.However,acoustic hypersensitivity is a subjective feeling.Without objective detection indicators,how to assess its severity becomes a clinical problem.There is no mature method at present-Reasonable evaluation of the severity of acoustic hypersensitivity is a great significance for clinical decision-making and evaluation of efficacy,and is also conducive to promoting the clinical research of Chinese medicine on acoustic hypersensitivity.Indicators of acoustic hypersensitivity severity(IAHS)is an evaluation method proposed by the instructor Professor Liu Peng on the basis of years of clinical practice.The previous clinical observations show that it is simple to use,easy to grasp,and the results are evaluated with patients.The actual perceived severity is very close.Based on this study,the reliability,validity and responsiveness of IAHS were further studied to investigate its clinical applicability.MethodsFrom January 2018 to December 2018,the patients who are 18 years old or older and willing to cooperate with the ENT department and the ward of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine will be included in the study.The IAHS is used to score the acoustic hypersensitivity severity,and the pure tone threshold is measured and the loudness discomfort threshold is checked.The collected data was established in Excel using Excel and analyzed by SPSS 20.0.The analysis includes IAHS’s test-retest reliability,internal consistency reliability,convergence validity,response,and minimum clinical meaningful change score.In the single factor analysis,the chi-square test was used for the count data,the T-test or rank sum test,analysis of variance were used for the measurement data,and the multivariate analysis used correlation analysis or multiple analysis.Results1.General Information 247 patients who met the criteria were included.Among them,104 males(42.1%)and 143 females(57.9%),male to female ratio 1:1.4.The age is 18-75 years old and the average age is 40.84±13.09 years old.The course of disease was 1 day to 20 years,and the average course of disease was 15.25±34.96 months,with a median of 3 months.Simple acoustic hypersensitivity in 31 cases(12.55%),216 cases(87.45%)with acoustic hypersensitivity combined with tinnitus.According to the severity of sound sensitivity,1 case(4.40%),grade Ⅱ(65.32%),grade 127(51.42%),grade IV(51.42%),grade IV(20.65%),grade V 3 Example(1.21%).The average time taken to evaluate using IAHS was 3.96 ± 1.61 minutes.2.Reliability ①Test-retest reliability:Two testers applied IAHS to the same patient after 1-3 hours interval.The correlation coefficient of the two evaluation results was 0.956,indicating that IAHS has good test-retest reliability.②Internal consistency reliability:Using the SPSS20.0 statistical software,the Cronbach coefficient a of the IAHS is calculated to be 0.65.Since IAHS has only six entries,this result indicates a good internal consistency reliability.3.Validity The VAS score of the patient’s self-perceived acoustic hypersensitivity was used as a standard control to examine the efficacy and validity of IAHS.The results showed that the correlation coefficient between the IAHS score and the VAS score of the patient’s self-perceived acoustic hypersensitivity was 0.845,indicating that IAHS has good validity.4.Responsiveness①Subjective sensory consistency:The conscious changes in sensation of the patients after treatment were divided into four groups:significantly improved,improved,no change,and aggravated.The results showed that there were statistical changes in IAHS scores before and after treatment in any of the four groups.The difference in learning(P<0.05),and the correlation coefficient between the change of IAHS score before and after treatment and the change of VAS score of patients’ self-perception was 0.931,which was strongly correlated,indicating that IAHS can reflect the change of patient severity.②Effect Size(ES):According to the patient’s self-perception,the changes of the disease after treatment were divided into three groups:improvement,no change,and deterioration.The ES values of the three groups were calculated according to the ES formula.The results of the improvement group and the recombination ES value were respectively For 1.32 and-1.23,the absolute values of both are>0.8,and the ES value of the unchanged group is 0.04<0.2,indicating that IAHS can sensitively reflect the changes of the condition.5.Minimum Clinical Meaningful Change Score(MCMCS)The MCMCS value of IAHS was calculated to be 1.50 points using the 95%confidence interval method,and the MCMCS value of IAHS was calculated to be 1.27 points using the 1/2 standard deviation method.The results were very close.Since the IAHS score is an integer,the MCMCS value of its IAHS can be set to 2 points.The implication is that if the IAHS score is reduced by ≥ 2 points after treatment,it can be considered effective.Another statistical result showed that if the relative number of changes in IAHS scores before and after treatment was used as a measure,the reduction of IAHS score after treatment by≥10%could be considered effective.Conclusion1.IAHS has good reliability and validity,indicating that the results of IAHS for acoustic hypersensitivity severity assessment are accurate and reliable.2.IAHS has a good response and can sensitively reflect the changes in the severity of the patient’s acoustic hypersensitivity.A score change of≥ 2 points or ≥10%before and after treatment can be used as a therapeuticcally effective evaluation standard.According to IAHS,the degree of discrimination of acoustic hypersensitivity is better,which can be used as a reference for clinical decision-making and efficacy evaluation of Chinese medicine treatment.3.IAHS has the characteristics of comprehensive and concise,operability,short evaluation time,good clinical practical value,and can be used as an evaluation tool for TCM treatment of acoustic sensitive clinical research,which is worthy of further research and application. |
