Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany
Department of Phoniatrics and Paediatric Audiology, University Hospital Münster, Muenster, Germany.
BMJ Open. 2023 May 18;13(5):e070259. doi: 10.1136/bmjopen-2022-070259.
Individuals with intellectual disabilities (ID) often suffer from hearing loss, in most cases undiagnosed or inappropriately treated. The implementation of a programme of systematic hearing screening, diagnostics, therapy initiation or allocation and long-term monitoring within the living environments of individuals with ID (nurseries, schools, workshops, homes), therefore, seems beneficial.
The study aims to assess the effectiveness and costs of a low-threshold screening programme for individuals with ID. Within this programme 1050 individuals with ID of all ages will undergo hearing screening and an immediate reference diagnosis in their living environment (outreach cohort). The recruitment of participants in the outreach group will take place within 158 institutions, for example, schools, kindergartens and places of living or work. If an individual fails the screening assessment, subsequent full audiometric diagnostics will follow and, if hearing loss is confirmed, initiation of therapy or referral to and monitoring of such therapy. A control cohort of 141 participants will receive an invitation from their health insurance provider via their family for the same procedure but within a clinic (clinical cohort). A second screening measurement will be performed with both cohorts 1 year later and the previous therapy outcome will be checked. It is hypothesised that this programme leads to a relevant reduction in the number of untreated or inadequately treated cases of hearing loss and strengthens the communication skills of the newly or better-treated individuals. Secondary outcomes include the age-dependent prevalence of hearing loss in individuals with ID, the costs associated with this programme, cost of illness before-and-after enrolment and modelling of the programme's cost-effectiveness compared with regular care.
The study has been approved by the Institutional Ethics Review Board of the Medical Association of Westphalia-Lippe and the University of Münster (No. 2020-843 f-S). Participants or guardians will provide written informed consent. Findings will be disseminated through presentations, peer-reviewed journals and conferences.
DRKS00024804.
智障人士（ID）通常患有听力损失，在大多数情况下未被诊断或治疗不当。因此，在智障人士的生活环境（托儿所、学校、工作坊、家庭）中实施系统的听力筛查、诊断、治疗启动或分配以及长期监测计划似乎是有益的。
本研究旨在评估智障人士低门槛筛查计划的有效性和成本。在该计划中，将对所有年龄段的 1050 名 ID 人士进行听力筛查，并在其生活环境中进行即时参考诊断（外展组）。外展组的参与者招募将在 158 个机构内进行，例如学校、幼儿园和居住或工作场所。如果个人未通过筛查评估，随后将进行全面听力诊断，如果确诊听力损失，将启动治疗或转介并监测治疗。141 名参与者将收到其健康保险公司通过其家庭发出的相同程序的邀请，但在诊所（临床组）进行。两个队列将在 1 年后进行第二次筛查测量，并检查以前的治疗结果。假设该计划可显著减少未经治疗或治疗不当的听力损失病例数量，并增强新治疗或治疗效果更好的个体的沟通能力。次要结果包括 ID 人士听力损失的年龄依赖性患病率、该计划相关费用、入组前后疾病相关费用以及与常规护理相比该计划的成本效益模型。
该研究已获得威斯特法伦-利珀医学协会和明斯特大学机构伦理审查委员会的批准（编号 2020-843 f-S）。参与者或监护人将提供书面知情同意书。研究结果将通过演讲、同行评议期刊和会议进行传播。
DRKS00024804。
