Cas Smits

Cas Smits
Amsterdam University Medical Center | VUmc · Department of Otolaryngology/Head and Neck Surgery

Professor

About

114
Publications
32,011
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
3,498
Citations

Publications

Publications (114)
Article
Full-text available
Osteogenesis Imperfecta (OI), known as “brittle bone disease,” presents a rare genetic disorder characterized by bone fragility, often accompanied by skeletal deformities and extraskeletal complications. OI is primarily associated with collagen type I defects, responsible for the syndromic nature of the disease affecting a broad range of tissues. A...
Article
Objectives: Wireless sound transfer methods for cochlear implant sound processors have become popular for remote self-assessed hearing tests. The aim of this study was to determine (1) spectral differences in stimuli between different wireless sound transfer options and (2) the effect on outcomes of speech recognition tests in noise. Design: In...
Article
Previous research has shown that learning effects are present for speech intelligibility in temporally modulated (TM) noise, but not in stationary noise. The present study aimed to gain more insight into the factors that might affect the time course (the number of trials required to reach stable performance) and size [the improvement in the speech...
Preprint
Understanding speech in noisy settings is one of the biggest challenges for individuals with hearing loss. Traditional speech-in-noise tests play a crucial role in screening for and diagnosing hearing loss, but are resource-intensive to develop, limiting accessibility, particularly in low and middle-income countries. This four-part study introduces...
Article
Full-text available
Introduction: Recently, the HEAR-aware app was developed to support adults who are eligible for hearing aids (HAs) but not yet ready to use them. The app serves as a self-management tool, offering assistance for a range of target behaviors (TBs), such as communication strategies and emotional coping. Employing Ecological Momentary Assessment and In...
Article
Objectives The aim of the present study was to investigate whether prediction models built by de Graaff et al. (2020) can be used to improve speech recognition in experienced adult postlingual implanted Cochlear CI users. de Graaff et al. (2020) found relationships between elevated aided thresholds and a not optimal electrical dynamic range (<50 CL...
Article
Objective: The aim of the current study was to investigate the use of manually and automatically switching programs in everyday day life by adult cochlear implant (CI) users. Design: Participants were fitted with an automatically switching sound processor setting and 2 manual programs for 3-week study periods. They received an extensive counsell...
Article
Objectives: (1) to determine whether the standard Dutch word lists for speech audiometry are equally intelligible in normal-hearing listeners (Experiment 1), (2) to investigate whether synthetic speech can be used to create word lists (Experiment 1) and (3) to determine whether the list effect found in Experiment 1 can be reduced by combining two...
Conference Paper
Full-text available
Standard pure tone audiometry measures hearing thresholds up to 8 kHz. Recent studies have shown that speech information above 8 kHz ("extended high frequencies"; EHFs) improves speech recognition. However, it is unclear whether the EHF benefit depends on the complexity of the speech stimuli. Previously we investigated the added value of EHF inform...
Article
Full-text available
Objectives: The HEAR-aware project targets adults ≥50 years who were recently diagnosed with hearing loss and declined hearing aids, but were open for support via a smartphone app on different target behaviors (TBs). The HEAR-aware app, based on Ecological Momentary Assessment and Ecological Momentary Intervention (EMA, EMI), contains educational...
Conference Paper
Background Age related hearing loss has been associated with increased prevalence and incidence of dementia. Underlying mechanisms that connect hearing loss with dementia remain largely unclear. Methods We studied the association of hearing loss and other risk markers for dementia in two cohorts with normal cognition and different age: 65 particip...
Article
Full-text available
Objective: The aim is to recommend a minimum standard set of clinician-reported outcome measures (CROMs) and patient-reported outcome measures (PROMs) on hearing for people with osteogenesis imperfecta (OI). This project is part of the larger "Key4OI" project initiated by the "Care4BrittleBones foundation" of which the goal is to improve quality o...
Article
Full-text available
Purpose The Netherlands Longitudinal Study on Hearing (NL-SH) was set up to examine associations of hearing ability with psychosocial, work and health outcomes in working age adults. Participants Inclusion started in 2006 and is ongoing. Currently the sample comprises 2800 adults with normal and impaired hearing, aged 18–70 years at inclusion. Fiv...
Article
Objective: Appropriate speech-in noise assessment is challenging in multilingual populations. This study aimed to assess whether first preferred language affected performance on an English Digits-in-noise (DIN) test in the local Asian multilingual population, controlling for hearing threshold, age, sex, English fluency and educational status. A se...
Article
Background Hearing loss in older adults is associated with increased dementia risk. Underlying mechanisms that connect hearing loss with dementia remain largely unclear. Methods We studied the association of hearing loss and biomarkers for dementia risk in two age groups with normal cognition: 65 participants from the European Medical Information...
Article
Full-text available
The one-up one-down adaptive (staircase or up-down) procedure is often used to estimate the speech recognition threshold (SRT) in speech-in-noise testing. This article provides a brief historical overview of the one-up one-down procedure in psychophysics, discussing the groundbreaking early work that is still relevant to clinical audiology and scie...
Article
Full-text available
Objectives The objective of this study is (1) to assess whether the presentation level of the antiphasic digits-in-noise (DIN) test affects the speech recognition threshold (SRT), (2) to evaluate how accurately simulated unilateral and bilateral conductive hearing loss is detected (CHL) and (3) to determine whether increasing the presentation level...
Article
Full-text available
Objectives The objective of this study was to examine the uptake, user characteristics, and performance of the free WHO smartphone hearing screening test ( hearWHO) as a global hearing health promotion initiative. Method We retrospectively examined the data of 242 626 tests conducted by adults (> 18 years) on the hearWHO app between February 2019...
Article
Full-text available
Objectives: Tinnitus is highly prevalent, but only a few risk factors for developing tinnitus are known and little is known about factors associated with the degree of annoyance of new-onset tinnitus. Longitudinal analysis can reveal risk factors associated with the development of tinnitus and might lead to targeted prevention. The aim of this stu...
Article
Full-text available
Purpose This study compared the test characteristics, test–retest reliability, and test efficiency of three novel digits-in-noise (DIN) test procedures to a conventional antiphasic 23-trial adaptive DIN (D23). Method One hundred twenty participants with an average age of 42 years (SD = 19) were included. Participants were tested and retested with...
Article
Objectives: The digits-in-noise test (DIN) is a popular self-test measure that has traditionally been used to screen for hearing loss by providing either a pass or refer result. Standard approaches either tested each ear monaurally or used a binaural diotic version where identical digits and noise were presented simultaneously to both ears. Recent...
Article
Objectives: In pure-tone audiometry, hearing thresholds are typically measured up to 8 kHz. Recent research has shown that extended high-frequency (EHF; frequencies >8 kHz) speech information improves speech recognition. However, it is unclear whether the EHF benefit is present for different types of speech material. This study assesses the added...
Article
Full-text available
In France 58% of persons with hearing loss still do not wear hearing aids. Pure-tone audiometry is the traditional gold standard in assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. The antiphasic digits-in-noise (DIN) test does not require calibrated material and can run on a standa...
Article
Full-text available
Globally, more than 1.5 billion people have hearing loss. Unfortunately, most people with hearing loss reside in low- and middle-income countries (LMICs) where traditional face-to-face services rendered by trained health professionals are few and unequally dispersed. The COVID-19 pandemic has further hampered the effectiveness of traditional servic...
Article
Full-text available
Speech-in-noise tests use fixed signal-to-noise ratio (SNR) procedures to measure the percentage of correctly recognized speech items at a fixed SNR or use adaptive procedures to measure the SNR corresponding to 50% correct (i.e., the speech recognition threshold, SRT). A direct comparison of these measures is not possible yet. The aim of the prese...
Article
Background: Digits-in-noise (DIN) tests have become popular for hearing screening over the past 15 years. Several recent studies have highlighted the potential utility of DIN as a school-aged hearing test. However, age may influence test performance in children due to maturation. In addition, a new antiphasic stimulus paradigm has been introduced,...
Article
Full-text available
Objectives The number of bilateral adult cochlear implant (CI) users and bimodal CI users is expanding worldwide. The addition of a hearing aid (HA) in the contralateral non-implanted ear (bimodal) or a second CI (bilateral) can provide CI users with some of the benefits associated with listening with two ears. Our was to examine whether bilateral...
Article
Full-text available
Introduction: Risk factors for cardiovascular disease (CVD) are associated with sensorineural hearing loss. CVD risk factors are known to cluster and interact, thereby increasing the cumulative risk for CVD. Previously, using the database of the Netherlands Longitudinal Study on Hearing (NL-SH), an association was found between a history of smokin...
Article
Full-text available
Objectives: Dislocation of the magnet inside the implanted component of a cochlear implant (CI) can be a serious risk for patients undergoing a magnetic resonance imaging (MRI) exam. CI manufacturers aim to reduce this risk either via the design of the implant magnet or magnet housing, or by advising a compression bandage and cover over the magnet...
Article
Full-text available
Probabilistic models to quantify context effects in speech recognition have proven their value in audiology. Boothroyd and Nittrouer [J. Acoust. Soc. Am. 84, 101-114 (1988)] introduced a model with the j-factor and k-factor as context parameters. Later, Bronkhorst, Bosman, and Smoorenburg [J. Acoust. Soc. Am. 93, 499-509 (1993)] proposed an elabora...
Chapter
In the chapter, the authors address the prescient need to update accepted care models of cochlear implant (CI) fitting and long-term maintenance to better utilize self-care and tele-medicine possibilities, thus shifting the focus of CI maintenance to the recipient. There is a strong evidence base that such a move will better meet the needs of CI us...
Article
Full-text available
Purpose An alarming two thirds of adults aged 50 years or over with hearing impairment who could benefit from hearing aids do not own any, leaving these adults with no support to self-manage their hearing problems. In the HEAR-aware project, it is hypothesized that self-management can be facilitated via a smartphone app if its educational content i...
Article
Full-text available
In the field of rare bone diseases in particular, a broad care team of specialists embedded in multidisciplinary clinical and research environment is essential to generate new therapeutic solutions and approaches to care. Collaboration among clinical and research departments within a University Medical Center is often difficult to establish, and ma...
Article
Full-text available
Objective: COVID-19 has been prohibitive to traditional audiological services. No- or low-touch audiological assessment outside a sound-booth precludes test batteries including bone conduction audiometry. This study investigated whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss (SNHL) using pure-tone air co...
Article
Full-text available
Purpose This study investigated user characteristics, help-seeking behavior, and follow-up actions of people who failed an app-based digits-in-noise hearing screening test, considering their stage of change. Method Test and user characteristics of 3,092 listeners who failed the test were retrospectively analyzed. A posttest survey determining foll...
Article
Full-text available
Objectives: The objective of this study was to identify parameters which are related to speech recognition in quiet and in noise of cochlear implant (CI) users. These parameters may be important to improve current fitting practices. Design: Adult CI users who visited the Amsterdam UMC, location VUmc, for their annual follow-up between January 20...
Article
Full-text available
Objectives: The digits-in-noise test (DIN) has become increasingly popular as a consumer-based method to screen for hearing loss. Current versions of all DINs either test ears monaurally or present identical stimuli binaurally (i.e., diotic noise and speech, NoSo). Unfortunately, presentation of identical stimuli to each ear inhibits detection of...
Article
Full-text available
Objectives: Previous findings of longitudinal cohort studies indicate that acceleration in age-related hearing decline may occur. Five-year follow-up data of the Netherlands Longitudinal Study on Hearing (NL-SH) showed that around the age of 50 years, the decline in speech recognition in noise accelerates compared with the change in hearing in you...
Preprint
Full-text available
Objective: The digits-in-noise test (DIN) has become increasingly popular as a consumer-based method to screen for hearing loss. Current versions of all DINs either test ears monaurally or present identical stimuli binaurally (i.e., diotic noise and speech, NoSo). Unfortunately, presentation of identical stimuli to each ear inhibits detection of un...
Article
MRI in patients with a cochlear implant: how to proceed An increasing number of cochlear implantations are being performed for the treatment of severe sensorineural hearing loss. Implant-associated complications leading to malfunction are of major importance since patients are strongly dependent on their cochlear implant (CI) for communication. Her...
Article
Full-text available
Speech recognition was measured in 24 normal-hearing subjects for unprocessed speech and for speech processed by a cochlear implant Advanced Combination Encoder (ACE) coding strategy in quiet and at various signal-to noise ratios (SNRs). All signals were low- or high-pass filtered to avoid ceiling effects. Surprisingly, speech recognition performan...
Article
Full-text available
Purpose Various directional hypotheses for the observed links between aging, hearing, and cognition have been proposed: (a) cognitive load on perception hypothesis, (b) information degradation hypothesis, (c) sensory deprivation hypothesis, and (d) common cause hypothesis. Supporting evidence for all 4 hypotheses has been reported. No studies have...
Article
Full-text available
The number of CI users has grown rapidly, resulting in an increased workload for CI centres and a need for new and innovative ways to provide healthcare to users of a CI. A telehealth application was developed with a functionality to self‐administer speech recognition tests at home, which was evaluated in 10 newly‐implanted patients. Speech recogni...
Chapter
In the chapter, the authors address the prescient need to update accepted care models of cochlear implant (CI) fitting and long-term maintenance to better utilize self-care and tele-medicine possibilities, thus shifting the focus of CI maintenance to the recipient. There is a strong evidence base that such a move will better meet the needs of CI us...
Article
Full-text available
Purpose The introduction of connectivity technologies in hearing implants allows new ways to support cochlear implant (CI) users remotely. Some functionalities and services that are traditionally only available in an in-clinic care model can now also be accessed at home. This study explores the feasibility of a prototype of a tablet computer applic...
Article
Full-text available
Purpose The smartphone digits-in-noise hearing test, called hearZA, was made available as a self-test in South Africa in March 2016. This study determined characteristics and test performance of the listeners who took the test. Method A retrospective analysis of 24,072 persons who completed a test between March 2016 and August 2017 was conducted....
Article
Full-text available
Self speech recognition tests in quiet and noise at home are compared to the standard tests performed in the clinic. Potential effects of stimuli presentation modes (loudspeaker or audio cable) and assessment (clinician or self-assessment at home) on test results were investigated. Speech recognition in quiet was assessed using the standard Dutch t...
Article
Full-text available
Background: Speech-in-noise tests have become a valuable part of the audiometric test battery providing an indication of a listener’s ability to function in background noise. A simple digits-in-noise (DIN) test could be valuable to support diagnostic hearing assessments, hearing aid fittings and counselling for both paediatric and adult populations...
Article
Full-text available
Objectives: The main purpose of this study was to examine developmental effects for speech recognition in noise abilities for normal-hearing children in several listening conditions, relevant for daily life. Our aim was to study the auditory component in these listening abilities by using a test that was designed to minimize the dependency on nona...
Article
Full-text available
Purpose This letter to the editor is in response to a research note by Jin, Kates, and Arehart (2017), “Sensitivity of the Speech Intelligibility Index to the Assumed Dynamic Range,” published in June 2017 by the Journal of Speech, Language, and Hearing Research. Conclusion The authors argue that the approach and line of reasoning in the Jin et al...
Article
Full-text available
Objectives: This study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing-impaired adults without hearing aids, and normally hearing adults. Design: Cross-sectional observational study, using both self-reported survey data and a speech-in-noise test. Setting:...
Article
Full-text available
Not all of the variance in speech-recognition performance of cochlear implant (CI) users can be explained by biographic and auditory factors. In normal-hearing listeners, linguistic and cognitive factors determine most of speech-in-noise performance. The current study explored specifically the influence of visually measured lexical-access ability c...
Article
Full-text available
Objectives: This study determined the effect of hearing loss and English-speaking competency on the South African English digits-in-noise hearing test to evaluate its suitability for use across native (N) and non-native (NN) speakers. Design: A prospective cross-sectional cohort study of N and NN English adults with and without sensorineural hea...
Article
Full-text available
Objectives: To review literature on the use of manual and automatically switching multimemory devices by hearing aid and CI recipients, and to investigate if recipients appreciate and adequately use the ability to switch between programmes in various listening environments. Design: Literature was searched using PubMed, Embase and ISI/Web of Scie...
Article
Full-text available
Objective: Speech-in-noise hearing screening tests have become increasingly popular. These tests follow an adaptive procedure with a fixed number of presentations to estimate the speech reception threshold. The speech reception threshold is compared with an established cutoff signal to noise ratio (SNR) for a pass result or refer result. A fixed S...
Article
Objective: This study addresses the outcome of cochlear implantation in addition to hearing aid use in patients with asymmetric sensorineural hearing loss. Study design: Prospective longitudinal study. Setting: Tertiary referral center. Patients: Seven adults with asymmetric sensorineural hearing loss, i.e., less than 30% aided speech recogn...
Article
Full-text available
The number of cochlear implant (CI) users is increasing annually, resulting in an increase in the workload of implant centers in ongoing patient management and evaluation. Remote testing of speech recognition could be time-saving for both the implant centers as well as the patient. This study addresses two methodological challenges we encountered i...
Article
Background: Impaired auditory speech perception abilities in deaf children with hearing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (CI) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels. This holds especially for children in spoken lang...
Article
Objectives: The aim of this study was to establish the longitudinal relationship between hearing ability in noise and psychosocial health outcomes (i.e., loneliness, anxiety, depression, distress, and somatization) in adults aged 18 to 70 years. An additional objective was to determine whether a change in hearing ability in noise over a period of...
Article
Full-text available
Objective: The objective of this study was to develop and validate a smartphone-based digits-in-noise hearing test for South African English. Design: Single digits (0-9) were recorded and spoken by a first language English female speaker. Level corrections were applied to create a set of homogeneous digits with steep speech recognition functions...
Article
Full-text available
Purpose We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum. Method Cross-sectional data from 2,352 adults with and without hearing impairment,...
Article
Full-text available
Background: Children treated for retinoblastoma with carboplatin have an increased risk for ototoxicity. Impaired hearing may have major consequences for these children, because they often suffer from reduced vision. Previous studies have shown limited information on the incidence and severity of carboplatin-induced ototoxicity and the used audiol...
Article
Objective: The Dutch digits-in-noise test (NL DIN) and the American-English version (US DIN) are speech-in-noise tests for diagnostic and clinical usage. The present study investigated differences between NL DIN and US DIN speech reception thresholds (SRTs) for a group of native Dutch-speaking listeners. Design: In experiment 1, a repeated-measu...
Article
Objective: The main objective was to investigate the effect of linguistic abilities (lexical-access ability and vocabulary size) on different measures of speech-in-noise recognition in normal-hearing listeners with various levels of language proficiency. Design: Speech reception thresholds (SRTs) were measured for sentences in steady-state (SRTs...
Article
Full-text available
The objective of this study was to determine whether hearing ability in adults is associated with medication use in general, the use of specific types of medication, or polypharmacy. In this exploratory study, data of the National Longitudinal Study on Hearing (n = 2,160) were used. In total, 62% of the participants reported using any medication in...
Article
The first aim of the present study was to determine the change in speech recognition in noise over a period of 5 years in participants aged 18 to 70 years at baseline. The second aim was to investigate whether age, gender, educational level, the level of initial speech recognition in noise, and reported chronic conditions were associated with a cha...
Article
Full-text available
To evaluate the effect of stapedotomy in cochlear implant candidates with far-advanced otosclerosis (FAO).