Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, The Netherlands.
Department of Epidemiology, Erasmus MC, The Netherlands.
PLoS One. 2020 Jan 27;15(1):e0228349. doi: 10.1371/journal.pone.0228349. eCollection 2020.
Hearing loss (HL) is a frequent problem among the elderly and has been studied in many cohort studies. However, pure tone audiometry-the gold standard-is rather time-consuming and costly for large population-based studies. We have investigated if self-reported hearing loss, using a multiple choice question, can be used to assess HL in absence of pure tone audiometry.
This study was performed within 4,906 participants of the Rotterdam Study. The question (in Dutch) that was investigated was: 'Do you have any difficulty with your hearing (without hearing aids)?'. The answer options were: 'never', 'sometimes', 'often' and 'daily'. Mild hearing loss or worse was defined as PTA0.5-4(Pure Tone Average 0.5, 1, 2 & 4 kHz) ≥20dBHL and moderate HL or worse as ≥35dBHL. A univariable linear regression model was fitted with the PTA0.5-4 and the answer to the question. Subsequently, sex, age and education were added in a multivariable linear regression model. The ability of the question to classify HL, accounting for sex, age and education, was explored through logistic regression models creating prediction estimates, which were plotted in ROC curves.
The variance explained (R2) by the univariable regression was 0.37, which increased substantially after adding age (R2 = 0.60). The addition of sex and educational level, however, did not alter the R2 (0.61). The ability of the question to classify hearing loss, reflected in the area under the curve (AUC), was 0.70 (95% CI 0.68, 0.71) for mild hearing loss or worse and 0.86 (95% CI 0.85, 0.87) for moderate hearing loss or worse. The AUC increased substantially when sex, education and age were taken into account (AUC mild HL: 0.73 (95%CI 0.71, 0.75); moderate HL 0.90 (95%CI 0.89, 0.91)).
Self-reported hearing loss using a single question has a good ability to detect hearing loss in older adults, especially when age is accounted for. A single question cannot substitute audiometry, but it can assess hearing loss on a population level with reasonable accuracy.
听力损失（HL）是老年人中常见的问题，许多队列研究都对此进行了研究。然而，对于基于人群的大型研究来说，纯音测听（金标准）既费时又昂贵。我们研究了使用多选题来自我报告听力损失是否可以在没有纯音测听的情况下评估 HL。
这项研究在 4906 名鹿特丹研究参与者中进行。研究的问题（荷兰语）是：“您的听力有困难吗（没有助听器）？”答案选项为：“从不”、“有时”、“经常”和“每天”。轻度听力损失或更差定义为 PTA0.5-4（纯音平均 0.5、1、2 和 4 kHz）≥20dBHL，中度听力损失或更差定义为≥35dBHL。使用单变量线性回归模型拟合 PTA0.5-4 与问题答案。随后，将性别、年龄和教育纳入多变量线性回归模型。通过创建预测估计值的逻辑回归模型来探索问题将 HL 分类的能力，考虑到性别、年龄和教育，这些预测估计值在 ROC 曲线中绘制。
单变量回归解释的方差（R2）为 0.37，加入年龄后大幅增加（R2=0.60）。然而，加入性别和教育水平并没有改变 R2（0.61）。问题分类听力损失的能力，反映在曲线下面积（AUC）中，轻度听力损失或更差为 0.70（95%CI 0.68,0.71），中度听力损失或更差为 0.86（95%CI 0.85,0.87）。当考虑性别、教育和年龄时，AUC 会大幅增加（轻度 HL 的 AUC：0.73（95%CI 0.71,0.75）；中度 HL 0.90（95%CI 0.89,0.91））。
使用单一问题自我报告听力损失具有很好的能力，可以检测老年人的听力损失，尤其是在考虑年龄的情况下。单一问题不能替代听力测试，但它可以以合理的准确性评估人群中的听力损失。
