Davis A, Stephens D, Rayment A, Thomas K
MRC Institute of Hearing Research, University of Nottingham, UK.
Br J Audiol. 1992 Feb;26(1):1-14. doi: 10.3109/03005369209077866.
The major epidemiological investigations of hearing impairment, disability and handicap show that the elderly are the group most disabled by their hearing impairment. There is considerable debate concerning the most efficient way of reducing this inevitable burden of age-related hearing impairments in the next generation. Early fitting of 'targeted' individuals with hearing aids may help but there are a large number of methodological problems associated with conducting and evaluating such a programme of research (especially retrospectively). The logical prerequisite to early fitting as a means of reducing later disability is to ascertain the acceptability of and benefit given by intervention at this early stage. This study therefore set out to investigate the age/sex register provided by the primary physician (GP) as an appropriate base to identify candidates for early aid fitting among a sample of middle-aged patients (50-65 years) living in Roath, Cardiff. Of the 662 who replied to an initial contact letter (1050 were on the age/sex register), 21 already possessed hearing aids. After screening and examination 66 people were offered some form of management which was accepted by 43 during the course of the study. Aid use thereby increased from about 3% to over 9% in this middle-aged group. A 2 year follow-up indicated continued use of the aids, and benefit on a speech reception task was measured. The cost of detecting those who might benefit was calculated using a two-question 'paper and pencil' screen as the first step. A national programme for Wales would cost at least 188,000 pounds per annum at 1990 prices over an initial 5 year span if a criterion which aimed to find at least 45 dB HTL impairments over mid-frequencies was implemented. For a criterion of 35 dB the cost would be 378,000 pounds pa.
关于听力障碍、残疾和残障的主要流行病学调查表明，老年人是受听力障碍影响致残程度最高的群体。对于如何以最有效的方式减轻下一代不可避免的与年龄相关的听力障碍负担，存在相当多的争论。为“有针对性的”个体早期佩戴助听器可能会有所帮助，但开展和评估这样一个研究项目存在大量方法学问题（尤其是回顾性研究）。早期佩戴作为减少后期残疾的一种手段，其逻辑前提是确定在这个早期阶段干预措施的可接受性和益处。因此，本研究着手调查由初级医师（全科医生）提供的年龄/性别登记信息，以此作为在居住于加的夫罗斯的中年患者（50 - 65岁）样本中识别早期佩戴助听器候选人的合适依据。在回复初始联系信函的662人中（年龄/性别登记册上有1050人），21人已经佩戴了助听器。经过筛查和检查，66人接受了某种形式的治疗，其中43人在研究过程中接受了治疗。因此，这个中年群体中助听器的使用比例从约3%增加到了9%以上。为期2年的随访表明助听器持续得到使用，并对言语接受任务的益处进行了测量。第一步是使用两个问题的“纸笔”筛查来计算检测可能受益人群的成本。如果实施旨在发现至少45 dB HTL中频听力损失的标准，那么以1990年的价格计算，威尔士的一项全国性计划在最初的5年期间每年至少需要花费18.8万英镑。如果标准是35 dB，那么每年的成本将是37.8万英镑。
