Schlauch Robert S, Carney Edward
University of Minnesota, Minneapolis, MN, USA.
Am J Audiol. 2012 Jun;21(1):106-19. doi: 10.1044/1059-0889(2012/11-0012). Epub 2012 Jan 23.
This tutorial provides framework and context for understanding the complex interaction of hearing measurement methodology and cohort social factors, as well as their relation to approaches to data interpretation and identification of minimal hearing loss (HL) in audiometric surveys.
Pertinent archival studies were reviewed, and an original analysis on U.S. Centers for Disease Control and Prevention (CDC) audiometric survey data from children (ages 6-19) was performed.
The definition of an otologically normal individual, the pass-fail criterion representing the upper limit of the range of normal hearing, and the quality of the audiometry affect the percentage of persons who are falsely identified as having a minimal HL. An upper limit of normal hearing of 15 dB HL yields an unacceptably high false-positive rate, particularly when the more variable higher audiometric frequencies are examined. When air-conduction thresholds are assessed in isolation to estimate potential noise damage, the failure to exclude persons who have possible middle and external ear problems, including earwax, results in high false-positive rates. When these factors and other limitations are considered, audiograms from teens from a recent CDC survey do not show evidence consistent with widespread noise-induced HL. Suggestions are made to improve the effectiveness of pure-tone audiometry and the identification of minimal HL.
本教程提供了一个框架和背景，用于理解听力测量方法与队列社会因素之间的复杂相互作用，以及它们与听力计调查中数据解释方法和最小听力损失（HL）识别之间的关系。
回顾了相关的档案研究，并对美国疾病控制与预防中心（CDC）来自儿童（6至19岁）的听力计调查数据进行了原始分析。
耳科正常个体的定义、代表正常听力范围上限的通过/失败标准以及听力测定的质量，都会影响被错误识别为患有最小HL的人群比例。15 dB HL的正常听力上限会产生高得不可接受的假阳性率，尤其是在检查变化更大的较高听力计频率时。当单独评估气导阈值以估计潜在的噪声损伤时，未能排除可能存在中耳和外耳问题（包括耳垢）的人会导致高假阳性率。当考虑到这些因素和其他限制时，来自最近CDC调查的青少年听力图并未显示出与广泛的噪声性HL一致的证据。文中提出了提高纯音听力测定有效性和最小HL识别的建议。
