Still Go Clubbing or to Bars or Go Rave at Music Festivals?

[maltese]

rocket scientists

I used to be a Junior Rocket Scientist! For real!

My previous employer allowed me to choose my job title and I thought it's ridiculous. After a month I realized how stupid it looks on my CV and changed it to Junior Software Engineer.

My friend still works as a Senior Ninja....

 

[Bill Bauer]

Bill, your "stat analysis" is completely biased from the beginning since the respondents of your poll each have their own definition of "loud event". If one wants to make serious analyses, it's important to at least define accurately the terms they use in the poll they will base the analyses on.

Please leave rocket science to rocket scientists

My goal was to determine whether the risk was above 0.1% (the risk that I personally find acceptable). I think that despite all of the uncertainty, it is clear that the risk is certainly above 1-5%.

I think it is clear that a "attending a loud event" refers to attending some place where loud music is playing (concert, pub, wedding, etc.), or where there are crowds of loud people. To interpret this poll, just try to predict what an average person would refer to as "loud".

By the way, using your logic, we should not have any polls on this forum. Every person had a different number of those hairs in the ear that got damaged (and they got damaged to a different degree). So what happened to other people is not relevant to your personal case.

 

[Julien87]

I don't mind that you use polls Bill, that can be informative. But your attempt at drawing general conclusions from them are just, from my point of view, ridiculous. Anyway, that's your time, if you want to spend it on those analyses, do it.

 

[maltese]

Stats is not my field, but I had published papers in stats journals. You didn't pay attention to the following text in my message:

It is a relatively small sample with only 24 observations (there is a total of 32 observations there, but 8 people haven't attended loud events, so they don't count). You will be surprised to find out that statisticians would refer to a sample with 30 or more observations as a "large sample:"
"...at least when large samples are used, such as N ≥ 30."

We are trying to estimate population proportion. Condition 3 on page 106 of
https://projecteuclid.org/download/pdf_1/euclid.ss/1009213286
states that confidence intervals may be used if n*p_hat>5, where p_hat is the sample proportion (in our case the proportion in our sample who got a permanent spike). According to the paper above, condition 3 is a statement that can be found in some popular stats textbooks. In our case n*p_hat = 24*8/24 = 8>5. The paper goes on to critisize this condition. I will come back to their critique momentarily. If that condition 3 is true, then we can use the confidence interval calculators on
http://www.sample-size.net/confidence-interval-proportion/
I set N = 24, x = 8, and CL = 99. I am looking for a 99% confidence interval. The online calculator is providing us with two sets of confidence intervals. One is
Lower bound = 0.119
Upper bound = 0.614
The other one is
Lower bound = P - (Zα*SEM) = 0.085
Upper bound = P + (Zα*SEM) = 0.581
The above are 99% confidence intervals. For an interpretation of the meaning of a confidence interval, see
http://www.mathbootcamps.com/interpreting-confidence-intervals/
To paraphrase, we are 99% confident that the fraction of tinnitus sufferers who will get a permanent spike after attending a loud event is between 8.5% and 58% (I am using the second interval we computed above). This statement takes the sample size into account. As a result of that relatively small sample size, we ended up with a 99% confidence interval that is wider.

[What follows will be of interest to people who took a "baby stats" university course where you learned to use a confidence interval for the population proportion whenever np>5 and nq>5.

Now, if we want to be as conservative as possible, we will look at Figure 4 on https://projecteuclid.org/download/pdf_1/euclid.ss/1009213286
It gives us "Coverage of the nominal 99% standard interval for fixed
n=20 and variable p". Here, "coverage" means the true confidence of the confidence interval, when you use the formula for a 99% confidence interval. You will see that when the true population proportion p is larger than about 17%, the confidence is not 99%, it is actually somewhere between 89% and 98%. When the true p is between about 10% and 17%, the confidence can get as low as 88%. Note that this is true when the sample size is 20. Our sample size is 24. To be conservative, we can conclude that we are 90% confident that the fraction of tinnitus sufferers who will get a permanent spike after attending a loud event is between 8.5% and 58%.]

You will notice that in my post, I was very conservative - I assumed that my poll implied a probability of 5%. We can be 90%-99% sure that it is actually above 8.5%. Note that 58% is inside of our 99% confidence interval. Taking into account the sample size, we can be 90%-99% sure that given the results of this poll, the probability of getting a permanent spike might be as high as 58%.


We are a subset of T sufferers who are bothered by T enough to register for this forum. This means that whoever is reading the thread with that poll is part of the population the poll is trying to study. In other words, that confidence interval might not apply to a randomly selected T sufferer, but it applies to YOU.

As previously stated, it's an estimate of a probability of worsening your T if your lifestyle includes loud events. Your post is misleading.

My RSI is bothering me when I type so I'll keep this short.

It's your life. You know your body, your ears. You know how loud it is around you (I know you have an app for that ) and you know your risk tolerance. You know capabilities of your hearing protection. You know the risks (spike), you know how much you care about event X. You can make a decision for yourself. Do you want to stay at home for the rest of your life? You're free to do so.

This post can only do more harm than good. People who are severely depressed or anxious look at your post and all they'll see is that there's 58% chance of worsening their condition if they leave the house. Because that's how depressed brain works. Guess how I know.

Among tinnitus sufferers, it's common knowledge that noise exposure can lead to problems. There's no reason to put a number on that, a number that's based on incomplete information and is hence biased.

You're going to scare people, without providing them with any new information.

I can only feel sorry for kids who get this, it's really easy to get peer pressured into doing stupid stuff when you're a teen...

 

[Bill Bauer]

But your attempt at drawing general conclusions from them are just, from my point of view, ridiculous.

The general conclusion is: attending loud events carries significant risk of getting a permanent spike.

Are you saying that given the results of that poll, there is a significant chance that the probability of one getting a permanent spike is lower than 1%? Since the answer to this question is clearly "no", are you saying that 1% chance of getting a Permanent spike can't be called "a significant risk"?

 

[Bill Bauer]

I know you have an app for that

I don't. I don't own a smart phone. Actually, I have never owned a cell phone.

 

[Bill Bauer]

This post can only do more harm than good. People who are severely depressed or anxious look at your post and all they'll see is that there's 58% chance of worsening their condition if they leave the house. Because that's how depressed brain works. Guess how I know.

All they have to do is not attend concerts and any places where loud music is playing. If many people read this and act accordingly, then some will be saved from getting a Permanent spike, so the text in italics font is clearly wrong.

 

[maltese]

The general conclusion is: attending loud events carries significant risk of getting a permanent spike.

NO. STOP.

You can not conclude that from this poll. You need a sample of people who never attended a loud event (after T), compute the probability from there and then show that the difference is statistically significant

 

[maltese]

All they have to do is not attend concerts and any places where loud music is playing. If many people read this and act accordingly, then some will be saved from getting a Permanent spike, so the text in italics font is clearly wrong.

I'm just encouraging you to think about the impact your words have on other people. A few months ago, a room with people talking and laughing would cause significant pain for me and therefore I'd see a few people talking as a typical "loud event" as I had to wear "heavy duty" earplugs. And yeah, I'd spike from that.

 

[maltese]

@Bill Bauer For now, all you have is "people who have tinnitus have a significant chance of worsening with time", which is NOT true either because your sample is highly biased (doesn't include people who don't attend loud events).

 

[Michael Leigh]

I'm just encouraging you to think about the impact your words have on other people. A few months ago, a room with people talking and laughing would cause significant pain for me and therefore I'd see a few people talking as a typical "loud event" as I had to wear "heavy duty" earplugs. And yeah, I'd spike from that.

I agree with you @maltese Whilst you mean well @Bill Bauer it's this kind of scaremongering that reinforces the negative thinking in people that normal everyday sounds can be harmful, which they are not. Tinnitus is a condition that many people habituate to and carry on to lead a fulfilling life. Hyperacusis, can be completely cured in most cases, but not if one is constantly overprotecting the ears and afraid of normal everyday sounds. Attending a nightclub where loud music is played, I agree this is not everyday normal sounds. However, I see no reason why someone with noise induced tinnitus, that has habituated can't attend such venues as long as they are careful. Life is for living not to be living in constant fear of every little sound in the environment.

Michael

 

[maltese]

Attending a nightclub where loud music is played, I agree this is not everyday normal sounds. However, I see no reason why someone with noise induced tinnitus, that has habituated can't attend such venues as long as they are careful.

I'd be careful with nightclubs - there are loud venues and LOUD venues.

But I agree. For me, it's not about loud places here. I actually agree with @Bill Bauer that they're dangerous... It's about unnecessary fear.

 

[Michael Leigh]

I'd be careful with nightclubs - there are loud venues and LOUD venues.

But I agree. For me, it's not about loud places here. I actually agree with @Bill Bauer that they're dangerous... It's about unnecessary fear.

Indeed, as I said @Bill Bauer means well and his heart is in the right place. However, he is still new to tinnitus and has hyperacusis. It can affect people in many different ways but in time will get better.

Michael

 

[Jomo]

you also are not considering the type of protection these people had in the pole. were they using custom plugs? if not how well were they fitted? did they stand in front of a speaker at the event? did they keep their protection on the whole time? how soon after onset did they attend the club? how loud was the bass? if the person understands the difference between a spike and fleeting tinnitus? did they take any drugs? or even how well do they protect their ears on a daily basis? maybe something else triggered the spike.

 

[Bill Bauer]

As previously stated, it's an estimate of a probability of worsening your T if your lifestyle includes loud events. Your post is misleading.

What we were talking about is the probability of worsening your T if your lifestyle includes loud events. The poll implies that we can be confident that this probability is above 5%. If you are one of the people who thinks that a 5% chance of a permanently louder T is something that is unacceptable, your lifestyle shouldn't include loud events. What is the problem with this logic?

 

[maltese]

What we were talking about is the probability of worsening your T if your lifestyle includes loud events. The poll implies that we can be confident that this probability is above 5%. If you are one of the people who thinks that a 5% chance of a permanently louder T is something that is unacceptable, your lifestyle shouldn't include loud events. What is the problem with this logic?

All you know is that X% of people surveyed worsened.

This could mean that X% of people with T will worsen regardless of noise exposure.

No comparison to a control group

 

[Bill Bauer]

@Bill Bauer For now, all you have is "people who have tinnitus have a significant chance of worsening with time", which is NOT true either because your sample is highly biased (doesn't include people who don't attend loud events).

We are talking about different things. You have those testimonies (that we get more than once a week on this forum) of all of the people who learned the hard way to take protecting their ears seriously. I am talking about the poll
https://www.tinnitustalk.com/thread...the-onset-of-tinnitus-and-regretted-it.23061/
as well as the confidence interval implied by that poll (see my earlier messages in this thread).

What is wrong with the logic: "What we were talking about is the probability of worsening your T if your lifestyle includes loud events. The poll implies that we can be confident that this probability is above 5%. If you are one of the people who thinks that a 5% chance of a permanently louder T is something that is unacceptable, your lifestyle shouldn't include loud events."

 

[maltese]

We are talking about different things. You have those testimonies (that we get more than once a week on this forum) of all of the people who learned the hard way to take protecting their ears seriously. I am talking about the poll
https://www.tinnitustalk.com/thread...the-onset-of-tinnitus-and-regretted-it.23061/
as well as the confidence interval implied by that poll (see my earlier messages in this thread).

What is wrong with the logic: "What we were talking about is the probability of worsening your T if your lifestyle includes loud events. The poll implies that we can be confident that this probability is above 5%. If you are one of the people who thinks that a 5% chance of a permanently louder T is something that is unacceptable, your lifestyle shouldn't include loud events."

I'm going to repeat one last time: there is no reason to believe noise exposure caused those people to worsen. (Its your thesis, you can't assume it)

You have no control group and hence you didn't really investigate anything.

 

[Bill Bauer]

All you know is that X% of people surveyed worsened.

This could mean that X% of people with T will worsen regardless of noise exposure.

No comparison to a control group

That is a good critique. People self-select when answering polls, so even if the poll were to have questions like "I haven't gone and I got worse/I haven't gone and I didn't get worse", we would still not be able to use the actual numerical values from the poll.

What I was trying to find is evidence whether the probability of getting a permanent spike after attending those events is higher than 5%. I think I Had found such evidence.

Surely if someone reads the option "I attended a loud event and ended up with a permanent spike that has lasted longer than a month" they will not choose this option if they attended a loud event and then two months afterwards their T got louder. A person who had selected this option got a spike (that ended up being permanent) within hours of the event being over. So no, this poll does NOT imply that people with T get worse over time.

 

[Tinker Bell]

you also are not considering the type of protection these people had in the pole. were they using custom plugs? if not how well were they fitted? did they stand in front of a speaker at the event? did they keep their protection on the whole time? how soon after onset did they attend the club? how loud was the bass? if the person understands the difference between a spike and fleeting tinnitus? did they take any drugs? or even how well do they protect their ears on a daily basis? maybe something else triggered the spike.

Adding to that: what food did they eat? Did they drink anything? Were they taking any medications? Get enough sleep? Dealing with any stress, anxiety or depression? Had they been sick at all in months leading up to the spike? All of those factors can contribute to spikes.

Plus do you know who did not take the survey? All of the people living with tinnitus who encounter loud noises or go to loud events but do not frequent the TT forum. I happen to know quite a few people with tinnitus. If we added their experiences to the poll, it would change the statistics.

 

[Bill Bauer]

Adding to that: what food did they eat? Did they drink anything? Were they taking any medications? Get enough sleep? Dealing with any stress, anxiety or depression? Had they been sick at all in months leading up to the spike? All of those factors can contribute to spikes.

you also are not considering the type of protection these people had in the pole. were they using custom plugs? if not how well were they fitted? did they stand in front of a speaker at the event? did they keep their protection on the whole time? how soon after onset did they attend the club? how loud was the bass? if the person understands the difference between a spike and fleeting tinnitus? did they take any drugs?

The same concerns could be raised about any statistical study! The point of stats is that we can learn meaningful information by looking at averages of large numbers of observations. (The confidence interval that I described was adjusted to reflect our population size - it got wider.) The idea is that things like that cancel each other out. The impact on a person who used poor protection will overestimate the average, the impact on a person who used above average protection will underestimate the average. When these are combined, we will arrive at the number that is close to the number corresponding to the impact on the average person.

 

[Tinker Bell]

The same concerns could be raised about any statistical study!

Only if the statistical study fails to use a representative sample. Do you truly think the members of TT are an accurate representation of the overall tinnitus population?

TT forum has significant sample bias because it is a site frequented by people who are (including myself) fairly anxious about tinnitus. Anxiety can cause spikes. Perhaps that is a key factor. Of the people I know with tinnitus who attend loud events yet have not had a spike, none have anxiety towards their tinnitus. Nor did they really ever beyond maybe the initial weeks.

 

[Bill Bauer]

Do you truly think the members of TT are an accurate representation of the overall tinnitus population?

We are a subset of T sufferers who are bothered by T enough to register for this forum. This means that whoever is reading the thread with that poll is part of the population the poll is trying to study. In other words, that confidence interval might not apply to a randomly selected T sufferer, but it applies to YOU.

 

[Bill Bauer]

Anxiety can cause spikes. Perhaps that is a key factor.

Surely if a person had attended a loud event and that same year his or her T got louder they would not choose the option "I attended a loud event and ended up with a permanent spike that has lasted longer than a month"

I would imagine they would choose this option if their T were to spike hours after the event and then to never get quieter.

 

[Sean]

Indeed, as I said @Bill Bauer means well and his heart is in the right place. However, he is still new to tinnitus and has hyperacusis. It can affect people in many different ways but in time will get better.

Michael

@Michael Leigh , I attended a loud event and I had such a crazy spike . It was one of the most difficult 3-4 months of my life .
Forget about permanent spike , that spike was so bad that even 3-4 months were difficult .
There are so many people who had this spike . I just don't see why any should take chance .
Again , it's a risk and if people want to take it then it's up to them .
I actually agree with Bill and I have paid price so I wouldn't suggest any goes but again , if some one still wants to then they should go ahead .

 

[Bill Bauer]

Yes and yes.

Is that because T makes you suicidal? Would your answer be the same if I were to ask you this question before you got T?

 

[Sean]

My goal was to determine whether the risk was above 0.1% (the risk that I personally find acceptable). I think that despite all of the uncertainty, it is clear that the risk is certainly above 1-5%.

I think it is clear that a "attending a loud event" refers to attending some place where loud music is playing (concert, pub, wedding, etc.), or where there are crowds of loud people. To interpret this poll, just try to predict what an average person would refer to as "loud".

By the way, using your logic, we should not have any polls on this forum. Every person had a different number of those hairs in the ear that got damaged (and they got damaged to a different degree). So what happened to other people is not relevant to your personal case.

@Bill Bauer, do you think if there are bunch of people gathered should be called a loud event? I think where music is playing loudly I would call loud event.

 

[Bill Bauer]

do you think if there are bunch of people gathered should be called a loud event? I think where music is playing loudly I would call loud event.

Yes, I think most people would just think of being at a place where loud music is playing as a loud event. I was thinking about sports events at a stadium with thousands of fans, when I was talking about loud people. I haven't actually ever been to a stadium like that, so I might be wrong about how loud those events can get. I wasn't talking about a bunch of friends getting together and raising their voices once in a while.

 

[Sean]

Indeed, as I said @Bill Bauer means well and his heart is in the right place. However, he is still new to tinnitus and has hyperacusis. It can affect people in many different ways but in time will get better.

Michael

@Michael Leigh, 3-4 hours of fun vs a spike that can last few months or even permanent spike. I personally wouldn't risk it. At least for me no event is that important.

 

[TuneOut]

Says the guy who bases his "our ears have been compromised" statement on one poll and some threads of a board representing a small portion of T sufferers

So you believe that people with tinnitus are no more susceptible to acoustic trauma than healthy people?