格陵兰岛学童听力障碍的测量：自我报告数据与临床检查之间的关联。
Measurement of hearing impairment among Greenlandic school-children: association between self-reported data and clinical examinations.
机构信息
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
出版信息
BMC Pediatr. 2022 Oct 26;22(1):618. doi: 10.1186/s12887-022-03673-9.
BACKGROUND
Multiple ear infections is causing hearing impairment among children all over the world and the health and social consequences track into early adolescence and later in life, if not treated. The monitoring of prevalence in a population is important to assess the need for interventions in a population.
METHODS
One hundred eighty five children from 5 to 10 grade from Sisimiut town and the nearby settlements participated in a clinical examination to have ear-examination and pure tone audiometry. Participants filled out a questionnaire at home with their parents before the clinical examination, and hearing impairment was collected as individual self-reports and as audiometric measurements.
RESULTS
A total of 185 children between 9 and 15 years of age (median: 11 years, IQR: 10-13) were included, 60% (n = 111) were girls. 247 (70%) of the 355 available otoscopies were clinically assessed as normal. Cohen's Kappa coefficient was 0.31. Eighteen children (10%) were found to have hearing impairment. None of the children had hearing aids. Test performance for self-reports were that sensitivity was 56% and specificity was 87%. The predictive value of a positive test was 31%, and the predictive value of a negative test was 95%. 32 children (17%) reported hearing impairment to the extent that they were not able to keep up in school, of which half reported that it had lasted for more than one year. 7 of the 32 children reporting hearing impairment (22%) reported that the extent of their hearing impairment was affecting their classroom experience so they were not able to follow.
CONCLUSION
Self-reported and clinically screening for hearing impairment are two different concepts. Even though the two concepts are statistically correlated, the correlation coefficients are low. The test performance indicated that self-reported data might be measuring hearing as an experience in a social environment and not directly comparable to pure tone audiometry which examines hearing in controlled testing conditions. Since both measure hearing impairment, they supplement each other in research on impaired hearing, and the choice of measure should relate to the purpose and method of the investigation.
背景
全球范围内，多发性耳部感染导致儿童听力受损，如果不加以治疗，其健康和社会后果会一直持续到青少年早期甚至以后。对人群中流行情况进行监测对于评估人群中干预措施的需求非常重要。
方法
来自西西缪特镇和附近定居点的 185 名 5 至 10 年级的儿童参加了临床检查，包括耳部检查和纯音测听。参与者在临床检查前在家中与父母一起填写问卷，听力障碍的信息通过个人自我报告和听力测量收集。
结果
共有 185 名 9 至 15 岁的儿童（中位数：11 岁，IQR：10-13）入组，其中 60%（n=111）为女孩。355 例可进行临床评估的耳镜检查中，247 例（70%）结果正常。Cohen's Kappa 系数为 0.31。18 名儿童（10%）被发现有听力障碍。没有儿童佩戴助听器。自我报告的测试表现为，敏感性为 56%，特异性为 87%。阳性测试的预测值为 31%，阴性测试的预测值为 95%。32 名儿童（17%）报告听力受损，以至于他们在学校跟不上进度，其中一半报告听力受损持续了一年以上。在报告听力受损的 32 名儿童中，有 7 名（22%）报告说他们的听力受损程度影响了他们的课堂体验，以至于他们无法跟上。
结论
自我报告和临床筛查听力障碍是两个不同的概念。尽管这两个概念在统计学上是相关的，但相关系数较低。测试表现表明，自我报告的数据可能是在社会环境中测量听力，而不能直接与在受控测试条件下检查听力的纯音测听相比较。由于两者都测量听力障碍，因此它们在听力受损的研究中相互补充，并且测量方法的选择应与调查的目的和方法相关。
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