Clinical Validity of the National Hearing Screening Method for Transitional Ages: A Proposal of Accurate Screening for Early Hearing Loss Detection
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Objectives: The purpose of this study was to investigate whether the current 1,000-Hz hearing screening test in transitional ages actually reflects the hearing status of Korean adults. Materials and Methods: Retrospective crosssectional analysis from the 2010-2012 Korean National Health and Nutrition Survey for adults aged 40 years or older. A questionnaire that could affect hearing and pure tone audiometry was conducted. Data were analyzed using complex samples general linear analyses and t-tests, and relative operating characteristic analysis. Hearing threshold averages by gender and age groups, and the appropriate screening frequency and cutoff values were calculated. Results: The overall prevalence of referred cases was 7.7% [95% confidence interval (CI), 7.3-8.2%] according to the criterion standard. Hearing loss above 40 dB HL was observed in 10%, but mild hearing loss was observed in 18.3%. The 1,000-Hz screening test obtained a sensitivity of 67.5% (95% CI, 66.5-73.5%) and a specificity of 98.9% (95% CI, 98.7-99.1%). Among the cases screening as passing, 3.5% had hearing loss above 40 dB, 0.9% had low-frequency hearing loss, and 24.9% had high-frequency hearing loss. In particular, the discrepancy between the high-frequency hearing loss and the screening results was greater in men. The ROC analysis showed the largest AUC at 2,000 Hz in all subjects. The average threshold of 1,000 and 3,000 Hz showed the best screening performance. Conclusions: The conventionally used 1,000-Hz hearing surveillance method is limited in reflecting the actual hearing status of Korean adults. Therefore, a modification from single frequency to two frequencies combination of screening method to detect the early stages of hearing loss is needed
Abstract
Objectives: The purpose of this study was to investigate whether the current 1,000-Hz hearing screening test in transitional ages actually reflects the hearing status of Korean adults. Materials and Methods: Retrospective crosssectional analysis from the 2010-2012 Korean National Health and Nutrition Survey for adults aged 40 years or older. A questionnaire that could affect hearing and pure tone audiometry was conducted. Data were analyzed using complex samples general linear analyses and t-tests, and relative operating characteristic analysis. Hearing threshold averages by gender and age groups, and the appropriate screening frequency and cutoff values were calculated. Results: The overall prevalence of referred cases was 7.7% [95% confidence interval (CI), 7.3-8.2%] according to the criterion standard. Hearing loss above 40 dB HL was observed in 10%, but mild hearing loss was observed in 18.3%. The 1,000-Hz screening test obtained a sensitivity of 67.5% (95% CI, 66.5-73.5%) and a specificity of 98.9% (95% CI, 98.7-99.1%). Among the cases screening as passing, 3.5% had hearing loss above 40 dB, 0.9% had low-frequency hearing loss, and 24.9% had high-frequency hearing loss. In particular, the discrepancy between the high-frequency hearing loss and the screening results was greater in men. The ROC analysis showed the largest AUC at 2,000 Hz in all subjects. The average threshold of 1,000 and 3,000 Hz showed the best screening performance. Conclusions: The conventionally used 1,000-Hz hearing surveillance method is limited in reflecting the actual hearing status of Korean adults. Therefore, a modification from single frequency to two frequencies combination of screening method to detect the early stages of hearing loss is needed
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