用于六个月及以下婴儿听力筛查的反射行为（“巴啊”）测试和风险因素问卷的准确性及应用
Accuracy and Use of the Reflexive Behavioral ("Baah") Test and Risk Factor Questionnaire for Hearing Screening in Infants Six Months Old and Below.
作者信息
Evangelista Gienah F, Labra Patrick John P, Chiong Charlotte M, Chiong Alessandra Nadine E, Grullo Precious Eunice R
机构信息
Philippine National Ear Institute, National Institutes of Health, University of the Philippines Manila.
Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila.
出版信息
Acta Med Philipp. 2023 Sep 28;57(9):21-27. doi: 10.47895/amp.v57i9.4378. eCollection 2023.
OBJECTIVE
To determine the accuracy, sensitivity, specificity, positive predictive values, and use of the Reflexive Behavioral "Baah" Test and NHSRC Level 1 and Level 2 Questionnaires in detecting hearing impairment in rural health communities.
METHODS
This was a prospective cross-sectional study conducted at the rural health unit of five municipalities. Infants less than six months old were screened for hearing impairments using the OAE device (standard), the Reflexive Behavioral "Baah" test, and the NHSRC Level 1 and Level 2 Questionnaires. The "Baah" test and the filling out of the NHSRC Level 1 and 2 Questionnaires were done by trained health workers while OAE was done by an audiologist.
RESULTS
A total of 103 babies, with a mean age of 41.9 days at the time of testing and a male to female ratio of 1.02:1 (52 males and 51 females) were tested. A hearing impairment prevalence of 4.9% (5 out of 103) was noted. The "Baah" test showed to have a sensitivity of 60%, specificity of 97.96% and an accuracy rate of 96.12%. The NHSRC Level 1 and Level 2 Questionnaires showed sensitivity, specificity, and accuracy rate of 40%, 67.35% and 66.02%, respectively for the former and 40%, 85.71% and 83.50%, respectively for the latter. Analysis of the complimentary use of the NHSRC Level 1 and Level 2 Questionnaires with the "Baah" test also showed no significant improvement to using the "Baah" test as a stand-alone screening tool with sensitivity, specificity, and accuracy of 60%, 67.35% and 66.99%, respectively for the "Baah" test and Level 1 Questionnaire, and 60%, 83.67% and 82.52%, respectively for the "Baah" test and Level 2 Questionnaire.
CONCLUSION
The Reflexive Behavioral "Baah" test is a potentially accurate, sensitive, specific, and acceptable stand-alone hearing screening test to identify infants with higher risk of hearing impairment in the rural health community setting. On the other hand, the use of the NHSRC Questionnaires as a stand-alone or complementary tool for "Baah" is unnecessary as it results to more false positive and false negative results.
目的
确定反射行为“哞”测试以及国家听力筛查与康复中心1级和2级问卷在农村卫生社区检测听力障碍方面的准确性、敏感性、特异性、阳性预测值及实用性。
方法
这是一项在五个市镇的农村卫生单位进行的前瞻性横断面研究。使用耳声发射设备（标准）、反射行为“哞”测试以及国家听力筛查与康复中心1级和2级问卷对6个月以下婴儿进行听力障碍筛查。“哞”测试以及填写国家听力筛查与康复中心1级和2级问卷由经过培训的卫生工作者完成，而耳声发射测试由听力学家进行。
结果
共测试了103名婴儿，测试时平均年龄为41.9天，男女比例为1.02:1（52名男性和51名女性）。发现听力障碍患病率为4.9%（103名中有5名）。“哞”测试的敏感性为60%，特异性为97.96%，准确率为96.12%。国家听力筛查与康复中心1级问卷的敏感性、特异性和准确率分别为40%、67.35%和66.02%，2级问卷的敏感性、特异性和准确率分别为40%、85.71%和83.50%。对国家听力筛查与康复中心1级和2级问卷与“哞”测试的互补使用情况进行分析，结果表明，将其与“哞”测试作为单独的筛查工具相比，并无显著改善。“哞”测试与1级问卷组合时的敏感性、特异性和准确率分别为60%、67.35%和66.99%，“哞”测试与2级问卷组合时的敏感性、特异性和准确率分别为60%、83.67%和82.52%。
结论
反射行为“哞”测试是一种潜在准确、敏感、特异且可接受的单独听力筛查测试，可用于识别农村卫生社区中听力障碍风险较高的婴儿。另一方面，将国家听力筛查与康复中心问卷作为“哞”测试的单独或补充工具并无必要，因为这会导致更多的假阳性和假阴性结果。
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