Adera T, Gullickson G M, Helfer T, Wang L, Gardner J W
Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biometrics, Bethesda, Maryland, USA.
J Am Acad Audiol. 1995 Jul;6(4):302-10.
The value of audiometric database analysis (ADBA) procedures for evaluating the effectiveness of hearing conservation programs (HCPs) was studied in a population of 82,195 workers. We rated the HCP using four ADBA procedures. Results showed that the HCP ratings ran the gamut from "unacceptable" to "acceptable" from year to year and from procedure to procedure. A mere 7 percent of the total population was eligible for ADBA analysis. This drastically reduced sample size precludes subgroup analyses of even a large cohort and likely could not be applied to the HCPs of most small- and medium-sized businesses. The low levels of agreement observed (weighted kappa = 15%-25%) between the ADBA procedures reflect poor validity. Generalizability of these results would be inappropriate when so few nonrandomly selected individuals contribute to the evaluation. In view of these problems, acceptance of the ADBA method as a national standard may not be warranted.
在82195名工人群体中，研究了听力测定数据库分析（ADBA）程序对评估听力保护计划（HCP）有效性的价值。我们使用四种ADBA程序对HCP进行评级。结果显示，HCP的评级每年以及不同程序之间从“不可接受”到“可接受”不等。总人口中仅有7%符合ADBA分析的条件。这种大幅减少的样本量甚至排除了对大型队列进行亚组分析的可能性，而且很可能不适用于大多数中小企业的HCP。ADBA程序之间观察到的低一致性水平（加权kappa = 15%-25%）反映出有效性较差。当如此少的非随机选择个体参与评估时，这些结果的可推广性是不合适的。鉴于这些问题，将ADBA方法接受为国家标准可能是不合理的。
