"It just magically happened overnight!" - support for the digitalization of medical teaching provided by an interdisciplinary e-tutor team.

Background: The forced and time-critical changeover to digital teaching and learning formats in the summer semester 2020 brought about numerous new challenges for the teaching staff of the Faculty of Medicine at the University of Regensburg. Didactic and personnel support of clinical lecturers for the preparation, creation, and supervision of digital teaching materials became necessary. Project description: Since interdisciplinary teams seem to be superior in finding creative solutions, an interdisciplinary student e-tutor team was established at the Faculty of Medicine to support the digitalization of the range of courses. After their initial basic training the e-tutors had regular team meetings and internal mini-training sessions to ensure their continuous professional development. The e-tutors could be "requested" by clinical teaching staff and then accompanied the respective course preparation and implementation as required. Results and discussion: Both clinical teachers and students perceived the student e-tutors' support to be very positive. The e-tutors described the interdisciplinarity of the team as an important learning resource and their work as an exciting and instructive task. Conclusion and outlook: Due to the positive experiences with the e-tutors, the faculty is striving to establish sustainable digital teaching and learning services in the coming semesters.

Calculating annoyance: an option to proof efficacy in ENT treatment of snoring?

To develop and validate an objective method for calculating the annoyance caused by snoring sounds. 53 subjects assessed 50 different snoring and breath sounds on a visual analog scale for level of annoyance. A linear regression analysis was used to correlate these subjective assessments with objectively calculated psychoacoustic parameters (loudness, roughness, sharpness, and fluctuation strength, calculating the maximum, mean, and 5th percentile in each case). The quality of the resulting formula was checked, and additional validation was performed using subjective assessments of 60 new snoring and breath sounds by 52 new subjects. Receiver operating characteristic (ROC) analysis was used to scale the annoyance ranges obtained with the formula. A score consisting of the 5th percentile of loudness and the mean of roughness was developed. The formula displays high goodness of fit (R 2 = 0.91) and quality. In the validation phase, a highly significant correlation (r s = 0.95; p < 0.01) was obtained between the scores calculated with the formula and the subjective assessments. ROC analysis was able to define the annoyance ranges with a discriminatory power between 52 and 73 % (optimum sensitivity/specificity). The subjective assessments made by the participants were distinctly scaled and were reflected in a psychophysical algorithm. In the setting of polygraphy and polysomnography, this means that a reliable annoyance score that is not dependent on the bed partner can be obtained to establish the indication for anti-snoring treatments and to review their utility.

Are subjective assessments of snoring sounds reliable?

The aim of this study is to investigate whether snoring sounds can be reliably, i.e. reproducibly and comparably, assessed by the listener. This is an absolute prerequisite if an objective method is to provide a valid representation of subjective assessments of snoring sounds. Fifty-three subjects, both men and women, from different age categories assessed snoring sequences in terms of their annoyance level. This was done using a paired comparison model with ten sequences, once at original volume and once at adjusted peak level. In addition, assessments of 50 sequences were made using a visual analog scale (VAS). In the first paired comparison the assessments displayed very high consistency (K = 0.94) and high concordance (W = 0.83). The results showed very good agreement between the sexes (r s = 0.98), between different levels of snoring-related experience (r s = 0.99) and between different ages (r s = 0.98). At adjusted peak level there was also very high consistency (K = 0.91) although concordance was clearly lower (W = 0.50). The rankings in the two paired comparisons showed a high degree of correlation (r s = 0.81). The assessments on the VAS revealed good inter-rater reliability (α = 0.73) and a high degree of correlation with the result of the first paired comparison (r s = 0.93). Snoring sounds can be assessed in a reproducible and comparable manner in terms of their annoyance level. There are no gender-specific differences, and age-specific and experience-specific differences also appear to be negligible. While volume plays a dominant role, other characteristics of the sounds are also sufficient to permit an assessment.