Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
National Taiwan University Children's Hospital, Taipei, Taiwan.
Am J Trop Med Hyg. 2022 Oct 17;107(6):1351-1354. doi: 10.4269/ajtmh.22-0161. Print 2022 Dec 14.
The Brighton Collaboration has developed a case definition to assess sensorineural hearing loss (SNHL) as an adverse event of special interest for Lassa fever vaccines. We applied the level of diagnostic certainty (LOC) criteria to 300 SNHL patients aged 18 to 59 years at a tertiary hospital in Ghana from January 2017 through June 2020 and evaluated the applicability of this definition. Most SNHL cases were assessable (85.0%) and assigned level 1 LOC (84.3%); missing information on otoscopy (86.7%) was the main reason for being unable to classify cases. Consistency of LOC classification between assessors was 99.3%. Cases with electronic medical records (EMRs) were less assessable than those with paper records (30.9% versus 93.8%). These findings indicate that the SNHL definition would be applicable to retrospectively ascertain and classify cases in resource-limited settings. Developing an EMR template to document otoscopy results may improve the feasibility at this hospital to ascertain SNHL.
布莱顿协作组织制定了一个病例定义，以评估感觉神经性听力损失（SNHL）作为拉沙热疫苗的一个特别关注的不良事件。我们将诊断确定性（LOC）标准应用于 2017 年 1 月至 2020 年 6 月期间加纳一家三级医院的 300 名年龄在 18 至 59 岁的 SNHL 患者，并评估了这一定义的适用性。大多数 SNHL 病例是可评估的（85.0%），并被分配了 1 级 LOC（84.3%）；无法对病例进行分类的主要原因是耳镜检查的信息缺失（86.7%）。评估者之间 LOC 分类的一致性为 99.3%。有电子病历（EMR）的病例比有纸质病历的病例更难评估（30.9%比 93.8%）。这些发现表明，SNHL 定义将适用于在资源有限的环境中回顾性确定和分类病例。开发一个 EMR 模板来记录耳镜检查结果可能会提高该医院确定 SNHL 的可行性。
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