Effectiveness of three central auditory processing (CAP) tests in identifying cerebral lesions

The effectiveness of three central auditory processing (CAP) tests was evaluated using clinical decision analysis (CDA) procedures. The tests under study were the Dichotic Digits Test (DDT), the Auditory Duration Patterns Test (ADPT), and the P300 evoked potential test (P300). Subjects with normal hearing, sensorineural hearing loss (SNHL), and central lesions provided the data for CDA analyses. To identify the most effective test, we used the conventional CDA parameters of hit rate (sensitivity), false-positive rate (1 - false-positive rate = specificity), and A' (test performance at specific hit/false-positive combinations). Further, we illustrated the extension of the conventional CDA parameters to posterior probability determination, which incorporates disorder prevalence to compute the likelihood of a patient having a disorder when a test result is positive (Pr[D/+]) or not having a disorder when the test result is negative (Pr[N/-]). Last, we used the CDA parameter of hit rate and disorder prevalence to determine cost effectiveness.