Sekhar Deepa L, Zalewski Thomas R, Beiler Jessica S, Czarnecki Beth, Barr Ashley L, King Tonya S, Paul Ian M
Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania.
Department of Audiology, Bloomsburg University, Bloomsburg, Pennsylvania.
J Adolesc Health. 2016 Sep;59(3):362-364. doi: 10.1016/j.jadohealth.2016.02.002. Epub 2016 Mar 22.
One in 6 US adolescents has high-frequency hearing loss, often related to hazardous noise. Yet, the American Academy of Pediatrics (AAP) hearing screen (500, 1,000, 2,000, 4,000 Hertz) primarily includes low frequencies (<3,000 Hertz). Study objectives were to determine (1) sensitivity and specificity of the AAP hearing screen for adolescent hearing loss and (2) if adding high frequencies increases sensitivity, while repeat screening of initial referrals reduces false positive results (maintaining acceptable specificity).
Eleventh graders (n = 134) participated in hearing screening (2013-2014) including "gold-standard" sound-treated booth testing to calculate sensitivity and specificity.
Of the 43 referrals, 27 (63%) had high-frequency hearing loss. AAP screen sensitivity and specificity were 58.1% (95% confidence interval 42.1%-73.0%) and 91.2% (95% confidence interval 83.4-96.1), respectively. Adding high frequencies (6,000, 8,000 Hertz) significantly increased sensitivity to 79.1% (64.0%-90.0%; p = .003). Specificity with repeat screening was 81.3% (71.8%-88.7%; p = .003).
Adolescent hearing screen sensitivity improves with high frequencies. Repeat testing maintains acceptable specificity.
美国每6名青少年中就有1人患有高频听力损失，这通常与有害噪音有关。然而，美国儿科学会（AAP）的听力筛查（500、1000、2000、4000赫兹）主要涵盖低频（<3000赫兹）。研究目标是确定（1）AAP听力筛查对青少年听力损失的敏感性和特异性，以及（2）增加高频筛查是否能提高敏感性，同时对初次转诊者进行重复筛查是否能降低假阳性结果（保持可接受的特异性）。
11年级学生（n = 134）参与了听力筛查（2013 - 2014年），包括采用“金标准”的隔音室测试以计算敏感性和特异性。
在43名转诊者中，27名（63%）患有高频听力损失。AAP筛查的敏感性和特异性分别为58.1%（95%置信区间42.1% - 73.0%）和91.2%（95%置信区间83.4 - 96.1）。增加高频（6000、8000赫兹）后，敏感性显著提高至79.1%（64.0% - 90.0%；p = 0.003）。重复筛查后的特异性为81.3%（71.8% - 88.7%；p = 0.003）。
青少年听力筛查增加高频后敏感性提高。重复测试可保持可接受的特异性。
