Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People's Republic of China.
Department of General Practice, Huamu Community Health Service Center, Shanghai, 201204, People's Republic of China.
Clin Interv Aging. 2023 Aug 10;18:1309-1320. doi: 10.2147/CIA.S423822. eCollection 2023.
There is a high incidence rate of age-related hearing loss. Severe hearing loss may increase the prevalence of mental illness, cognitive impairment, and even the risk of all-cause death.
Construction of the three-level and two-stage screening mode for age-related hearing loss of the community and to evaluate its effectiveness.
A total of 401 participants (aged 60 years or older) from five typical communities were enrolled in the study. The risk factors assessment of age-related hearing loss was completed by using a cross-sectional survey and receiver operating characteristic (ROC) curve. Multiple screening method was adopted and verified by serial and parallel tests, respectively. Based on research data, incorporate risk factors assessment, the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-s) and pure tone audiometry (PTA) were used to construct the screening mode.
Multiple screening series testing and multiple screening parallel testing, including risk factors assessment, HHIE-s, and PTA, were used for verification: the sensitivity, specificity, and Kappa index were 70.5% and 9.2%, 95.0% and 71.6%, 0.26 and 0.63, respectively. Finally, the three-level and two-stage screening mode for age-related hearing loss was established. "Three-level" was defined as the risk factors assessment/HHIE-s (high-risk population), PTA (suspect population), and comprehensive hearing loss assessment (confirmed population). "Two-stage" was defined as the population screening by general practitioner in the community and target screening by otolaryngologist of the tertiary hospitals.
The three-level and two-stage screening mode for age-related hearing loss consists of the following framework: from population screening to target screening, from suspicious diagnosis to accurate diagnosis, from primary health care to tertiary hospitals. The study objective is to structure a new secondary prevention and treatment mode for age-related hearing loss with primary health care as the core, so as to help the front-end management of healthy aging.
年龄相关性听力损失的发病率很高。严重的听力损失可能会增加精神疾病、认知障碍甚至全因死亡的风险。
构建社区年龄相关性听力损失的三层次两阶段筛查模式，并评估其效果。
本研究共纳入来自五个典型社区的 401 名（年龄 60 岁及以上）参与者。采用横断面调查和受试者工作特征（ROC）曲线完成年龄相关性听力损失的危险因素评估。采用串联和并联试验分别对多种筛查方法进行了验证。基于研究数据，结合危险因素评估、老年听力障碍简易筛查量表（HHIE-s）和纯音测听（PTA），构建了筛查模式。
串联和并联多筛查试验的验证结果为：危险因素评估/HHIE-s（高危人群）、PTA（疑似人群）和综合听力损失评估（确诊人群）的敏感性、特异性和 Kappa 指数分别为 70.5%和 9.2%、95.0%和 71.6%、0.26 和 0.63。最终建立了三层次两阶段的年龄相关性听力损失筛查模式。“三层次”定义为：危险因素评估/HHIE-s（高危人群）、PTA（疑似人群）和综合听力损失评估（确诊人群）。“两阶段”定义为：社区全科医生进行人群筛查和耳鼻喉科医生进行目标筛查。
年龄相关性听力损失的三层次两阶段筛查模式由人群筛查到目标筛查、从可疑诊断到准确诊断、从基层医疗到三级医院组成。该研究旨在构建以基层医疗为核心的年龄相关性听力损失二级预防和治疗新模式，以帮助实现健康老龄化的前端管理。
