Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States.
Harvard Medical School, Boston, MA 02115, United States.
Biometrics. 2024 Jan 29;80(1). doi: 10.1093/biomtc/ujae013.
Age-related hearing loss has a complex etiology. Researchers have made efforts to classify relevant audiometric phenotypes, aiming to enhance medical interventions and improve hearing health. We leveraged existing pattern analyses of age-related hearing loss and implemented the phenotype classification via quadratic discriminant analysis (QDA). We herein propose a method for analyzing the exposure effects on the soft classification probabilities of the phenotypes via estimating equations. Under reasonable assumptions, the estimating equations are unbiased and lead to consistent estimators. The resulting estimator had good finite sample performances in simulation studies. As an illustrative example, we applied our proposed methods to assess the association between a dietary intake pattern, assessed as adherence scores for the dietary approaches to stop hypertension diet calculated using validated food-frequency questionnaires, and audiometric phenotypes (older-normal, metabolic, sensory, and metabolic plus sensory), determined based on data obtained in the Nurses' Health Study II Conservation of Hearing Study, the Audiology Assessment Arm. Our findings suggested that participants with a more healthful dietary pattern were less likely to develop the metabolic plus sensory phenotype of age-related hearing loss.
年龄相关性听力损失具有复杂的病因。研究人员努力对相关听力表型进行分类，旨在增强医学干预措施并改善听力健康。我们利用现有的年龄相关性听力损失模式分析，并通过二次判别分析（QDA）实现表型分类。我们在此提出了一种通过估计方程分析暴露对表型软分类概率影响的方法。在合理的假设下，估计方程是无偏的，并且得到一致的估计量。在模拟研究中，所得估计量具有良好的有限样本性能。作为说明性示例，我们应用我们提出的方法评估了饮食摄入模式与听力表型（老年正常、代谢、感觉和代谢加感觉）之间的关联，该模式通过使用经过验证的食物频率问卷计算的高血压饮食的饮食方法依从性评分来评估，基于在护士健康研究 II 听力保护研究的听力学评估臂中获得的数据确定。我们的研究结果表明，饮食模式更健康的参与者不太可能发展出年龄相关性听力损失的代谢加感觉表型。
