Social Statistics, The University of Manchester School of Social Sciences, Manchester, UK
School of Social Sciences, The University of Manchester Cathie Marsh Institute for Social Research, Manchester, UK.
BMJ Open. 2020 Dec 8;10(12):e042571. doi: 10.1136/bmjopen-2020-042571.
Research using the UK Biobank data has shown ethnic inequalities in hearing health; however, the hearing test used may exhibit a disadvantage for non-native language speakers.
To validate the results of the UK Biobank hearing test (Digit Triplet Test, DTT) against self-reported measures of hearing in the dataset and create classifications of hearing health. To observe if language proficiency and migration age have the same effect on hearing health classification as on the DTT in isolation. Our hypothesis is that language proficiency acts differently on the DTT, demonstrating that the DTT is biased for non-native speakers of English.
Latent classes representing profiles of hearing health were identified from the available hearing measures. Factors associated with class membership were tested using multinomial logistic regression models. Ethnicity was defined as (1) White, native English-speaking, (2) ethnic minority, arrived in the UK aged <12 or (3) ethnic minority, arrived aged >12.
The UK Biobank participants with valid hearing test results and associated covariates (N=151 268).
DTT score, self-reported hearing difficulty, self-reported hearing difficulty in noise and hearing aid use.
Three classes of hearing health were found: 'normal', 'generally poor' and 'only subjectively poor'. In a model adjusting for known confounders of hearing loss, a poor or insufficient hearing test result was less likely for those with better language (OR 0.69, 95% CI 0.65 to 0.74) or numerical ability (OR 0.71, 95% CI 0.67 to 0.75) but more likely for those having migrated aged >12 (OR 3.85, 95% CI 3.64 to 4.07).
The DTT showed evidence of bias, having greater dependence on language ability and migration age than other hearing indicators. Designers of future surveys and hearing screening applications may wish to consider the limitations of speech-in-noise tests in evaluating hearing acuity for populations that include non-native speakers.
利用英国生物库的数据进行的研究表明，听力健康存在种族不平等现象；然而，使用的听力测试可能对非母语人士不利。
验证英国生物库听力测试（数字三联测试，DTT）与数据集内自我报告的听力测量结果的一致性，并创建听力健康分类。观察语言熟练程度和移民年龄对听力健康分类的影响是否与单独对 DTT 的影响相同。我们的假设是，语言熟练程度对 DTT 的影响不同，表明 DTT 对英语非母语者存在偏差。
从可用听力测量结果中确定代表听力健康状况的潜在类别。使用多项逻辑回归模型测试与类别成员资格相关的因素。种族定义为（1）白种人，母语为英语，（2）少数民族，12 岁以下抵达英国，或（3）少数民族，12 岁以上抵达英国。
具有有效听力测试结果和相关协变量的英国生物库参与者（N=151268）。
发现听力健康有三种类别：“正常”、“普遍较差”和“仅主观较差”。在调整已知听力损失混杂因素的模型中，语言（OR 0.69，95%CI 0.65 至 0.74）或数字能力（OR 0.71，95%CI 0.67 至 0.75）较好的人听力测试结果较差或不充分的可能性较低，但年龄>12 岁移民的人可能性较高（OR 3.85，95%CI 3.64 至 4.07）。
DTT 显示出存在偏差的证据，与其他听力指标相比，它对语言能力和移民年龄的依赖性更大。未来调查和听力筛查应用程序的设计者可能希望考虑包括非母语人士的人群中评估听力敏锐度时语音噪声测试的局限性。
