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West JS, Stelmach RD, Francis HW, Zhu X, Wu CH, Stockton MA, Troutman Adams E, Madson G, Kraemer JD, Nyblade L. Preliminary Validation of Hearing Device-Related Stigma Measures in Four United States Populations. Ear Hear 2024; 45:53S-61S. [PMID: 39294881 DOI: 10.1097/aud.0000000000001539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2024]
Abstract
OBJECTIVES Although hearing devices such as cochlear implants and hearing aids often improve communication, many people who are d/Deaf or hard of hearing (d/DHH) choose not to use them. Hearing device-related stigma, or negative societal beliefs about people who use hearing devices, often drives this decision. Although much research has documented the negative effects of hearing device-related stigma, no widely accepted, validated measure to quantify such stigma across populations currently exists. In this article, we describe the preliminary validation of four distinct but related scales measuring hearing device-related stigma in different populations, including people who use hearing devices and those close to them. DESIGN We preliminarily validated four measures for quantifying hearing device-related stigma in different populations that were previously developed and refined through a literature review, Delphi interviews, cognitive interviews, and a pretest. We preliminarily validated these measures through self-administered online surveys in a convenience sample in the United States. Among participants who use a hearing device and who either (a) self-identified as being d/DHH before they developed language (lifelong; n = 78) or (b) those who self-identified as having acquired a d/DHH identity after they developed language (acquired n = 71), we validated an anticipated hearing device-related stigma scale (d/DHHS-LE-HDA). We validated three scales that measure perceived hearing device-related stigma observed by parents of children who are d/DHH and who use a hearing device (n = 79) (d/DHHS-P-HDPO), care partners of adults who are d/DHH and use a hearing device (n = 108) (d/DHHS-CP-HDPO), and health care providers (n = 203) (d/DHHS-HCP-HDSH). Exploratory factor analysis assessed the reliability of each measure. RESULTS Each of the four scales loaded onto one factor. Factor loadings for the eight-item scale measuring anticipated hearing device-related stigma among the two populations with lived experience ranged from 0.635 to 0.910, with an ordinal α of 0.93 in the lifelong d/DHH participants and 0.94 among the acquired d/DHH participants. The six-item scale of perceived stigma observed by parents had item loadings from 0.630 to 0.920 (α = 0.91). The nine-item scale of hearing device-related stigma observed by care partners had item loadings from 0.554 to 0.922 (α = 0.95). The eight-item scale of hearing device-related stigma reported by health care providers had item loadings from 0.647 to 0.941 (α = 0.89). CONCLUSIONS Preliminary validation results show that the four stigma measures perform well in their respective populations. The anticipated stigma scale performed similarly well for both lifelong d/DHH and acquired d/DHH, which suggests that it could perform well in different contexts. Future research should further validate the scales described here as well as measure hearing device-related stigma in different populations-including people who live in different geographic regions and people using different kinds of hearing devices-and evaluate the success of interventions developed to reduce hearing device-related stigma.
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Affiliation(s)
- Jessica S West
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, USA
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA
- Duke University Population Research Institute, Duke University, Durham, North Carolina, USA
- These authors are co-first authors
| | - Rachel D Stelmach
- These authors are co-first authors
- International Development Group, RTI International, Research Triangle Park, North Carolina, USA
| | - Howard W Francis
- Department of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, USA
- These authors are co-first authors
| | - Xianxin Zhu
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ching-Heng Wu
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Melissa A Stockton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Elizabeth Troutman Adams
- Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, North Carolina, USA
| | - Gabriel Madson
- International Development Group, RTI International, Research Triangle Park, North Carolina, USA
| | - John D Kraemer
- International Development Group, RTI International, Research Triangle Park, North Carolina, USA
- Department of Health Management and Policy, Georgetown University, Washington, DC, USA
| | - Laura Nyblade
- Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, North Carolina, USA
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Mamo SK, Krysko AN, Garrity K, Wallhagen MI. Single-Item Hearing Screening in a Group Care Health Clinic for Older Adults. J Am Med Dir Assoc 2024; 25:105223. [PMID: 39174008 DOI: 10.1016/j.jamda.2024.105223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 08/24/2024]
Affiliation(s)
- Sara K Mamo
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
| | - Alyssa N Krysko
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Katherine Garrity
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Margaret I Wallhagen
- Department of Physiological Nursing, University of California, San Francisco, CA, USA
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Ihler F, Brzoska T, Altindal R, Dziemba O, Völzke H, Busch CJ, Ittermann T. Prevalence and risk factors of self-reported hearing loss, tinnitus, and dizziness in a population-based sample from rural northeastern Germany. Sci Rep 2024; 14:17739. [PMID: 39085387 PMCID: PMC11291685 DOI: 10.1038/s41598-024-68577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/25/2024] [Indexed: 08/02/2024] Open
Abstract
A close anatomical and physiological relationship is known between the senses of hearing and balance, while an additional pathophysiological interaction is supposed. The mechanisms underlying this association are not yet fully understood, especially in individuals without a known specific otologic disorder. In particular, only scarce information on the combined occurrence of audiovestibular sensory impairment is available so far. Therefore, this study aims to provide further insight into the prevalence and co-prevalence of the audiovestibular symptoms hearing loss, tinnitus and dizziness. Additionally, the influence of potential risk factors from lifestyle habits as well as cardiovascular and metabolic conditions on the development of those symptoms is studied. Data was analyzed from 8134 individuals from the population-based Study of Health in Pomerania (SHIP). SHIP pursues a broad and comprehensive examination program in chronologically separated cohorts with longitudinal follow-up. Cohorts are sampled from Western Pomerania, a rural region of north-eastern Germany. The study population represents a cross-sectional analysis from the cohorts SHIP-START (recruited 1997-2001) and SHIP-TREND (recruited 2008-2012), sampled for baseline investigations (SHIP-START-0 and SHIP-TREND-0) at the age of 20-79 years. Audiovestibular symptoms as outcome variables were assessed by structured questionnaires. Additionally, individuals were comprehensively characterized regarding modifiable lifestyle factors as well as cardiovascular and metabolic disorders, allowing the assessment of their role as exposure variables. We calculated a weighted prevalence of 14.2% for hearing loss, 9.7% for tinnitus, and 13.5% for dizziness in the population. Prevalence increased with age and differed among the sexes. A considerable share of 28.0% of the investigated individuals reported more than one symptom at once. The prevalence of hearing loss as well as tinnitus increased between the two cohorts. A moderate positive correlation was found between the occurrence of hearing loss and tinnitus (phi-coefficient 0.318). In multivariable regression analyses, education was identified as a significant protective factor while only smoking was significantly associated with all three symptoms. Furthermore, several cardiovascular risk factors contributed to both hearing loss and dizziness. In conclusion, audiovestibular symptoms are highly prevalent in the investigated population. A considerable but complex influence of risk factors points towards a relation with neuronal as well as cardiovascular disease processes. To clarify the underlying mechanisms, the interaction between the senses of hearing and balance as well as the mode of action of the risk factors should be evaluated in more detail in the future.
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Affiliation(s)
- Friedrich Ihler
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany.
| | - Tina Brzoska
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Reyhan Altindal
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Oliver Dziemba
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Chia-Jung Busch
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
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Yajima S, Masuda H. The significance of G8 and other geriatric assessments in urologic cancer management: A comprehensive review. Int J Urol 2024; 31:607-615. [PMID: 38402450 DOI: 10.1111/iju.15432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
In urologic oncology, which often involves older patients, it is important to consider how to manage their care appropriately. Geriatric assessment (GA) is a method that can address the specific needs of older cancer patients. The GA encompasses various assessment domains, but these domains exhibit variations across the literature. Some of the common items include functional ability, nutrition, comorbidities, cognitive ability, psychosocial disorders, polypharmacy, social and financial support, falls/imbalance, and vision/hearing. Despite the diversity of domains, there is limited consensus on reliable measurement methods. This review discusses the role of GA in managing urologic cancer in unique scenarios, such as those necessitating temporary or permanent urinary catheters or stomas due to urinary diversion. A comprehensive GA is time and human-resource-intensive in real-world clinical practice. Hence, simpler tools such as the Geriatric-8 (G8), capable of identifying high-risk patients requiring a detailed GA, are also under investigation in various contexts. Therefore, we conducted a systematic literature review on the G8. Our findings indicate that patients with low G8 scores encounter difficulties with stoma self-care after urinary diversion and have higher risks of urinary tract infections and ileus after radical cystectomy. The utilization of G8 as a screening tool for urologic cancer patients may facilitate the delivery of appropriate and personalized treatment and care.
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Affiliation(s)
- Shugo Yajima
- Department of Urology, National Cancer Center Hospital East, Chiba, Japan
| | - Hitoshi Masuda
- Department of Urology, National Cancer Center Hospital East, Chiba, Japan
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Ge J, Yan Y, Zhu Y, Cheng X, Li H, Sun X, Jiang H. Development and validation of the screening tool for age-related hearing loss in the community based on the information platform. Eur Arch Otorhinolaryngol 2024; 281:2893-2903. [PMID: 38206390 PMCID: PMC11065916 DOI: 10.1007/s00405-023-08389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Currently, age-related hearing loss has become prevalent, awareness and screening rates remain dismally low. Duing to several barriers, as time, personnel training and equipment costs, available hearing screening tools do not adequately meet the need for large-scale hearing detection in community-dwelling older adults. Therefore, an accurate, convenient, and inexpensive hearing screening tool is needed to detect hearing loss, intervene early and reduce the negative consequences and burden of untreated hearing loss on individuals, families and society. OBJECTIVES The study harnessed "medical big data" and "intelligent medical management" to develop a multi-dimensional screening tool of age-related hearing loss based on WeChat platform. METHODS The assessment of risk factors was carried out by cross-sectional survey, logistic regression model and receiver operating characteristic (ROC) curve analysis. Combining risk factor assessment, Hearing handicap inventory for the elderly screening version and analog audiometry, the screening software was been developed by JavaScript language and been evaluated and verified. RESULTS A total of 401 older adults were included in the cross-sectional study. Logistic regression model (univariate, multivariate) and reference to literature mention rate of risk factors, 18 variables (male, overweight/obesity, living alone, widowed/divorced, history of noise, family history of deafness, non-light diet, no exercising habit, smoking, drinking, headset wearer habit, hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases, hyperuricemia, hypothyroidism, history of ototoxic drug use) were defined as risk factors. The area under the ROC curve (AUC) of the cumulative score of risk factors for early prediction of age-related hearing loss was 0.777 [95% CI (0.721, 0.833)]. The cumulative score threshold of risk factors was defined as 4, to classify the older adults into low-risk (< 4) and high-risk (≥ 4) hearing loss groups. The sensitivity, specificity, positive predictive value, and negative predictive value of the screen tool were 100%, 65.5%, 71.8%, and 100.0%, respectively. The Kappa index was 0.6. CONCLUSIONS The screening software enabled the closed loop management of real-time data transmission, early warning, management, whole process supervision of the hearing loss and improve self-health belief in it. The software has huge prospects for application as a screening approach for age-related hearing loss.
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Affiliation(s)
- Jianli Ge
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Yunyun Yan
- Department of General Practice, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yinqian Zhu
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Xin Cheng
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Huazhang Li
- Department of Science and Education, Shanghai Guangming Traditional Chinese Medicine Hospital, Shanghai, 201399, China
| | - Xiaoming Sun
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China.
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Hua Jiang
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China.
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Guo X, Sun R, Cui X, Liu Y, Yang Y, Lin R, Yang H, Wu J, Xu J, Peng Y, Zheng X, Qin G, Chen J. Age-Specific Association Between Visit-to-Visit Blood Pressure Variability and Hearing Loss: A Population-Based Cohort Study. Innov Aging 2024; 8:igae047. [PMID: 38854854 PMCID: PMC11154138 DOI: 10.1093/geroni/igae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Indexed: 06/11/2024] Open
Abstract
Background and Objectives Hearing loss is common and undertreated, and the impact of blood pressure variability (BPV) on the development of hearing loss remains unclear. We aimed to examine the age-specific association between visit-to-visit BPV and hearing loss. Research Design and Methods This nationally representative cohort study included 3,939 adults over 50 years from the Health and Retirement Study in the United States. Variabilities of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed by standard deviation (SD), coefficient of variation, and variability independent of the mean (VIM), using SBP and DBP from 3 visits. Hearing loss was assessed by self-rated questions. Cox proportional risk models were used to evaluate age-specific associations (50-64, 65-79, and ≥80 years) between BPV and hearing loss. The generalized additive Cox models were further used to visualize the combined effect of age and BPV. Results During the follow-up up to 7.0 years, 700 participants developed hearing loss. Among people aged under 65 years, we observed a 36% increased risk of hearing loss with per-SD increment in VIM of SBP (hazard ratio [HR] per SD 1.36, 95% confidence interval [CI] 1.13-1.63) and a slightly significant association between VIM of DBP (HR per SD 1.21, 95% CI 1.01-1.45) and hearing loss. We did not observe significant associations among groups aged over 65 years (p > .05). The generalized additive Cox models also showed younger participants had stronger associations between BPV and hearing loss. Discussion and Implications Higher visit-to-visit variabilities of SBP were associated with an increased risk of hearing loss in middle-aged adults (50-65 years). Intervention in early BPV may help decrease hearing loss in adults aged over 50 years.
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Affiliation(s)
- Xinyue Guo
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Renjian Sun
- Department of Health Management, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaorui Cui
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yahang Liu
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yating Yang
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Ruilang Lin
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Hui Yang
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Jingyi Wu
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Jiaqin Xu
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yuwei Peng
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Xueying Zheng
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Guoyou Qin
- Department of Biostatistics, National Health Commission Key Laboratory of Health Technology Assessment, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Jiaohua Chen
- Department of Health Management, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Tsai Do BS, Bush ML, Weinreich HM, Schwartz SR, Anne S, Adunka OF, Bender K, Bold KM, Brenner MJ, Hashmi AZ, Keenan TA, Kim AH, Moore DJ, Nieman CL, Palmer CV, Ross EJ, Steenerson KK, Zhan KY, Reyes J, Dhepyasuwan N. Clinical Practice Guideline: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170 Suppl 2:S1-S54. [PMID: 38687845 DOI: 10.1002/ohn.750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. PURPOSE The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
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Affiliation(s)
| | - Matthew L Bush
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | | | | | | | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | | | - Ana H Kim
- Columbia University Medical Center, New York, New York, USA
| | | | - Carrie L Nieman
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Joe Reyes
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Ferrán S, Manrique-Huarte R, Lima JP, Rodríguez-Zanetti C, Calavia D, Andrade CJ, Terrasa D, Huarte A, Manrique M. Early Detection of Hearing Loss among the Elderly. Life (Basel) 2024; 14:471. [PMID: 38672742 PMCID: PMC11051108 DOI: 10.3390/life14040471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Age-related hearing loss (ARHL) is a complex communication disorder that affects the cochlea and central auditory pathway. The goal of this study is to characterize this type of hearing loss and to identify non-invasive, inexpensive, and quick tests to detect ARHL among elderly adults, seeking to preserve quality of life and reduce the burden on healthcare systems. METHODS An observational, prospective study is conducted with >55-year-old subjects divided into the following groups: normal range (Group A), detected but not treated (Group B), and detected and treated (Group C). During follow-up, Speech Spatial Qualities (SSQ12), and Hearing Handicap Inventory in the Elderly Screening test (HHIE-S) questionnaires were assessed, along with hearing levels (hearing thresholds at 4 kHz were studied in more depth), and a series of tests and questionnaires to assess balance, cognitive level, level of dependence, and depression. RESULTS A total of 710 patients were included in this study. The duration of hearing loss (11.8 yr. in Group B and 21.0 yr. in Group C) and average time-to-treatment for Group C (14.1 yr.) are both protracted. Both of the used questionnaires show statistically significant differences among the groups, revealing greater handicaps for Group C. Audiometry performed at 4 kHz shows how hearing loss progresses with age, finding differences between men and women. There is a correlation between time-to-treatment in Group C and the cognitive test DSST (-0.26; p = 0.003). CONCLUSIONS HHIE-S, SSQ12, and 4 kHz audiometry are sensitive and feasible tests to implement in screening programs.
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Affiliation(s)
| | | | - Janaina P. Lima
- Clínica Universidad de Navarra, 31008 Pamplona, Spain; (S.F.); (R.M.-H.); (C.R.-Z.); (D.C.); (C.J.A.); (D.T.); (A.H.); (M.M.)
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9
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Pingali H, Ulin L, Stiles D, Martinchek M, Schwartz AW. Hearing matters: An audiology and geriatrics collaboration to improve hearing care service utilization among older veterans. J Am Geriatr Soc 2024; 72:1269-1271. [PMID: 38064298 DOI: 10.1111/jgs.18697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 04/16/2024]
Affiliation(s)
- Hema Pingali
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lindsey Ulin
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Danielle Stiles
- Department of Audiology, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Michelle Martinchek
- Department of Geriatrics and Extended Care, VA Boston Healthcare System, Boston, MA, USA
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Andrea Wershof Schwartz
- Department of Geriatrics and Extended Care, VA Boston Healthcare System, Boston, MA, USA
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
- Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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10
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Kim YR, Kim SR. Differences in Oral Health According to the Presence of Hearing Loss: Data from the 2021 Korea National Health and Nutrition Examination Survey. Noise Health 2024; 26:88-96. [PMID: 38904806 DOI: 10.4103/nah.nah_114_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/01/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND The prevalence of hearing loss is increasing annually and has a strong relationship with oral health. However, existing research on hearing loss is limited to children, making it necessary to expand the analysis to adults. Therefore, this study aims to identify differences in oral health-related factors according to hearing loss in adults over 40 years of age using the Korea National Health and Nutrition Examination Survey. METHODS This study analyzed survey data from 2021. The study participants were divided into 1738 individuals in the nonhearing loss group and 1384 in the hearing loss group. Complex sample chi-square and complex sample independent t-tests were performed to determine differences in the sociodemographic characteristics, systemic diseases, hearing loss-related factors, and oral health status between the two groups. RESULTS Compared to the nonhearing loss group, the hearing loss group was older and had lower income and education levels. In terms of oral health, the hearing loss group had fewer existing natural teeth, poorer prosthesis conditions, and a higher number of implants than the nonhearing loss group. The hearing loss group also experienced comparatively more problems with chewing and speaking (P < 0.05). CONCLUSIONS Individuals with hearing loss exhibited poorer oral health status than those without hearing loss. Therefore, dental professionals in clinical practice should develop their communication skills to interact effectively with patients with hearing loss and strive to improve their oral health.
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Affiliation(s)
- Yu Rin Kim
- Department of Dental Hygiene, Silla University, Busan, Republic of Korea
| | - Seon Rye Kim
- Department of Healthcare Management, Youngsan University, Yangsan, Republic of Korea
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Zeitler DM, Prentiss SM, Sydlowski SA, Dunn CC. American Cochlear Implant Alliance Task Force: Recommendations for Determining Cochlear Implant Candidacy in Adults. Laryngoscope 2024; 134 Suppl 3:S1-S14. [PMID: 37435829 PMCID: PMC10914083 DOI: 10.1002/lary.30879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
The indications for cochlear implantation have expanded over time due to evidence demonstrating identification and implantation of appropriate cochlear implant (CI) candidates lead to significant improvements in speech recognition and quality of life (QoL). However, clinical practice is variable, with some providers using outdated criteria and others exceeding current labeled indications. As a results, only a fraction of those persons who could benefit from CI technology receive it. This document summarizes the current evidence for determining appropriate referrals for adults with bilateral hearing loss into CI centers for formal evaluation by stressing the importance of treating each ear individually and a "revised 60/60 rule". By mirroring contemporary clinical practice and available evidence, these recommendations will also provide a standardized testing protocol for CI candidates using a team-based approach that prioritizes individualized patient care. This manuscript was developed by the Adult Cochlear Implantation Candidacy Task Force of the American Cochlear Implant Alliance using review of the existing literature and clinical consensus. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:S1-S14, 2024.
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Affiliation(s)
- Daniel M. Zeitler
- Listen for Life Center, Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, Seattle, WA
| | - Sandra M. Prentiss
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, FL
| | | | - Camille C. Dunn
- The University of Iowa Cochlear Implant Clinical Research Center, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA
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Smith SL, Francis HW, Witsell DL, Dubno JR, Dolor RJ, Bettger JP, Silberberg M, Pieper CF, Schulz KA, Majumder P, Walker AR, Eifert V, West JS, Singh A, Tucci DL. A Pragmatic Clinical Trial of Hearing Screening in Primary Care Clinics: Effect of Setting and Provider Encouragement. Ear Hear 2024; 45:23-34. [PMID: 37599396 PMCID: PMC10841210 DOI: 10.1097/aud.0000000000001418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
OBJECTIVES The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonetheless, evidence is insufficient to support the benefits of universal hearing screening in asymptomatic older adults. The primary goal of the present study was to compare three hearing screening protocols that differed in their level of support by the primary care (PC) clinic and provider. The protocols varied in setting (in-clinic versus at-home screening) and in primary care provider (PCP) encouragement for hearing screening (yes versus no). DESIGN We conducted a multisite, pragmatic clinical trial. A total of 660 adults aged 65 to 75 years; 64.1% female; 35.3% African American/Black completed the trial. Three hearing screening protocols were studied, with 220 patients enrolled in each protocol. All protocols included written educational materials about hearing loss and instructions on how to complete the self-administered telephone-based hearing screening but varied in the level of support provided in the clinic setting and by the provider. The protocols were as follows: (1) no provider encouragement to complete the hearing screening at home, (2) provider encouragement to complete the hearing screening at home, and (3) provider encouragement and clinical support to complete the hearing screening after the provider visit while in the clinic. Our primary outcome was the percentage of patients who completed the hearing screening within 60 days of a routine PC visit. Secondary outcomes following patient access of hearing healthcare were also considered and consisted of the percentage of patients who completed and failed the screening and who (1) scheduled, and (2) completed a diagnostic evaluation. For patients who completed the diagnostic evaluation, we also examined the percentage of those who received a hearing loss intervention plan by a hearing healthcare provider. RESULTS All patients who had provider encouragement and support to complete the screening in the clinic completed the screening (100%) versus 26.8% with encouragement to complete the screening at home. For patients who were offered hearing screening at home, completion rates were similar regardless of provider encouragement (26.8% with encouragement versus 22.7% without encouragement); adjusted odds ratio of 1.25 (95% confidence interval 0.80-1.94). Regarding the secondary outcomes, roughly half (38.9-57.1% depending on group) of all patients who failed the hearing screening scheduled and completed a formal diagnostic evaluation. The percentage of patients who completed a diagnostic evaluation and received a hearing loss intervention plan was 35.0% to 50.0% depending on the group. Rates of a hearing loss intervention plan by audiologists ranged from 28.6% to 47.5% and were higher compared with those by otolaryngology providers, which ranged from 15.0% to 20.8% among the groups. CONCLUSIONS The results of the pragmatic clinical trial showed that offering provider encouragement and screening facilities in the PC clinic led to a significantly higher rate of adherence with hearing screening associated with a single encounter. However, provider encouragement did not improve the significantly lower rate of adherence with home-based hearing screening.
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Affiliation(s)
- Sherri L. Smith
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
- Center for Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Howard W. Francis
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - David L. Witsell
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Judy R. Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Rowena J. Dolor
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Janet Prvu Bettger
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC
| | - Mina Silberberg
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC
| | - Carl F. Pieper
- Center for Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC
| | - Kristine A. Schulz
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | | | - Amy R. Walker
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Victoria Eifert
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Jessica S. West
- Center for Study of Aging and Human Development, Duke University School of Medicine, Durham, NC
| | | | - Debara L. Tucci
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD
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Yang TH, Chen YF, Cheng YF, Huang JN, Wu CS, Chu YC. Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S. BioData Min 2023; 16:35. [PMID: 38098102 PMCID: PMC10722728 DOI: 10.1186/s13040-023-00351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVES The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults. METHODS We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model-which had the greatest AUC of 0.83 (95% CI 0.81-0.85)-was then only used on the holdout testing data. RESULTS On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79-0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques-specifically, the LGBM classifier-with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects. CONCLUSIONS Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.
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Affiliation(s)
- Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan
- General Education Center, University of Taipei, Taipei, 10671, Taiwan
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Fu Chen
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
| | - Yen-Fu Cheng
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Jue-Ni Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Chuan-Song Wu
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan.
- College of Science and Engineering, Fu Jen University, Taipei, 243, Taiwan.
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Big Data Center, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan.
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Wang Q, Jiang C, Wen C, Xie H, Li Y, Zhang Y, Mady LJ, Bruno DS, Dutcher GMA, Chiec LS, Dowlati A, Hsu ML. Subjective and Objective Hearing Loss Among US Adult Cancer Survivors. JAMA Otolaryngol Head Neck Surg 2023; 149:1101-1110. [PMID: 37796484 PMCID: PMC10557032 DOI: 10.1001/jamaoto.2023.2941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/01/2023] [Indexed: 10/06/2023]
Abstract
Importance Cancer survivors are at a higher risk of developing hearing loss (HL) due to older age, chemotherapy, and radiotherapy. However, the prevalence of HL among US cancer survivors remains unknown. Additionally, there is a lack of uniform HL screening guidelines for this enlarging population. Objective To estimate the prevalence of subjective HL and objective HL by audiometry test among cancer survivors and compare them with the general population as well as to assess the performance of subjective HL questions in detecting true (ie, audiometry-confirmed) HL. Design, Setting, and Participants In a cross-sectional design, adults between ages 20 and 80 years who had audiometry testing and responded to a hearing questionnaire from the National Health and Nutrition Examination Survey (2011-2012, 2015-2016, and 2017 to March 2020 prepandemic survey cycles) were selected. Data analysis was conducted from August 13, 2022, to July 26, 2023. Main Outcomes and Measures The weighted prevalence of subjective HL (troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry were calculated. Analyses with χ2 testing and multiadjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, areas under the curve were estimated using age- and gender-adjusted logistic regression. Results Among the total 9337 participants (weighted n = 90 098 441; 51.2% women), 10.3% were cancer survivors. Compared with the general population, cancer survivors had a higher prevalence of troublesome hearing (adjusted odds ratio [AOR], 1.43; 95% CI, 1.11-1.84), tinnitus (AOR, 1.28; 95% CI, 0.94-1.74), speech-frequency HL (AOR, 1.43; 95% CI, 1.11-1.85), and high-frequency HL (AOR, 1.74; 95% CI, 1.29-2.34). When using the subjective HL tool and questioning regarding whether the participants were having troublesome hearing and/or tinnitus in screening for HL, the age- and gender-adjusted area under the curve was 0.88 in detecting speech-frequency HL and 0.90 in detecting high-frequency HL. Conclusion and Relevance The findings of this study suggest that cancer survivors have a significantly higher prevalence of HL than the general population. Two subjective HL questions could potentially accurately identify those who have true HL and provide a simple and efficient screening tool for health care professionals. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and health care professionals should facilitate raising awareness and provide early screening and timely referral when HL is identified.
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Affiliation(s)
- Qian Wang
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
- Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio
| | - Changchuan Jiang
- Division of Hematology & Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Chi Wen
- Quality Operations, Mount Sinai Health System, New York, New York
| | - Hui Xie
- University of Wisconsin-Milwaukee Joseph J Zilber School of Public Health, Milwaukee
| | - Yannan Li
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yaning Zhang
- Department of General Surgery, Ascension Providence Hospital, Southfield, Michigan
| | - Leila J. Mady
- Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Debora S. Bruno
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
- Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio
| | - Giselle M. A. Dutcher
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
- Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio
| | - Lauren S. Chiec
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
- Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio
| | - Afshin Dowlati
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
- Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio
| | - Melinda L. Hsu
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
- Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio
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Gathman TJ, Choi JS, Vasdev RMS, Schoephoerster JA, Adams ME. Machine Learning Prediction of Objective Hearing Loss With Demographics, Clinical Factors, and Subjective Hearing Status. Otolaryngol Head Neck Surg 2023; 169:504-513. [PMID: 36758959 DOI: 10.1002/ohn.288] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/17/2022] [Accepted: 01/16/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Hearing loss (HL) is highly prevalent, yet underrecognized and underdiagnosed. Lack of standardized screening, awareness, cost, and access to hearing testing present barriers to HL identification. To facilitate prescreening and selection of patients who warrant audiometric evaluation, we developed a machine learning (ML) model to predict speech-frequency pure-tone average (PTA). STUDY DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey (NHANES). METHODS The cohort included 8918 adults (≥20 years) who completed audiometric testing with NHANES (2012-2018). The primary outcome measure was the prediction of better hearing ear speech-frequency PTA. Relevant predictors included demographics, medical conditions, and subjective assessment of hearing. Supervised ML with a tree-based architecture was used. Regression performance was determined by the mean absolute error (MAE) with binary classification assessed with area under the receiver operating characteristic curve (AUC). RESULTS Using the full set of predictors, the test set MAE between the ML-predicted and actual PTA was 5.29 dB HL (95% confidence interval [CI]: 4.97-5.61). The 5 most influential predictors of higher PTA were increased age, worse subjective hearing, male gender, increased body mass index, and history of smoking. The 5-factor abbreviated model performed comparably to the extended feature set with MAE 5.36 (95% CI: 5.03-5.69) and AUC for PTA > 25 dB HL of 0.92 (95% CI: 0.90-0.94). CONCLUSION The ML model was able to predict PTA with patient demographics, clinical factors, and subjective hearing status. ML-based prediction may be used to identify individuals who could benefit most from audiometric evaluation.
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Affiliation(s)
- Tyler J Gathman
- School of Medicine, University of Minnesota, Minnesota, Minneapolis, USA
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Janet S Choi
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ranveer M S Vasdev
- School of Medicine, University of Minnesota, Minnesota, Minneapolis, USA
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Meredith E Adams
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
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Wiseman K, Slotkin J, Spratford M, Haggerty A, Heusinkvelt M, Weintraub S, Gershon R, McCreery R. Validation of a tablet-based assessment of auditory sensitivity for researchers. Behav Res Methods 2023; 55:2838-2852. [PMID: 35962308 PMCID: PMC10228289 DOI: 10.3758/s13428-022-01933-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 01/01/2023]
Abstract
Quantifying hearing acuity is increasingly important across a wide range of research areas in the behavioral and neurosciences. Scientists have relied on either self-reported hearing status or the availability of diagnostic hearing assessment in past studies. There remains a need for a valid and reliable assessment of auditory sensitivity that can provide estimates of the magnitude of hearing loss, if present, without requirements for professional audiologists, facilities, and equipment that are needed to conduct a diagnostic hearing assessment. The goal of this experiment was to validate the NIH Toolbox® Hearing Threshold Test (HTT), a tablet-based hearing assessment available via iPad application that uses consumer-grade headphones, on a clinical sample of children and adults with varying degrees of hearing acuity. Electroacoustic analysis of the hearing assessment application and headphones demonstrated acoustic outputs within established conformity standards for hearing assessment. Twenty-seven children and 63 adults participated in a standard diagnostic hearing assessment and the experimental tablet-based assessment. The results showed that thresholds from the tablet-based assessment were highly correlated with thresholds from the clinical hearing assessment (r = .83-.93) for children and adults for all frequencies and across a range of levels of hearing acuity. The HTT also met clinical test-retest reliability standards (Cronbach's α > .86). The tablet-based hearing assessment provides acceptable estimates of hearing levels for children and adults when diagnostic audiometric assessment capabilities are not available.
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Affiliation(s)
- Kathryn Wiseman
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | | | - Meredith Spratford
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | - Amberlee Haggerty
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | - Maggie Heusinkvelt
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Richard Gershon
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Ryan McCreery
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA.
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Ge J, Geng S, Gao Y, Ren G, Sun X, Jiang H. Construction and Effect of the Three-Level and Two-Stage Screening Mode for Age-Related Hearing Loss: A Study Based on the Community in Shanghai, China. Clin Interv Aging 2023; 18:1309-1320. [PMID: 37583570 PMCID: PMC10424679 DOI: 10.2147/cia.s423822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023] Open
Abstract
Background 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. Purpose Construction of the three-level and two-stage screening mode for age-related hearing loss of the community and to evaluate its effectiveness. Materials and Methods 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. Results 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. Conclusion 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.
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Affiliation(s)
- Jianli Ge
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Shasha Geng
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
| | - Yang Gao
- Department of General Practice, Huamu Community Health Service Center, Shanghai, 201204, People’s Republic of China
| | - Guangwei Ren
- Science and Education Department, Sanlin Community Health Service Center, Shanghai, 200124, People’s Republic of China
| | - Xiaoming Sun
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
- Department of General Practice, Zhongshan Hospital, Fudan University Medical School, Shanghai, 200032, People’s Republic of China
| | - Hua Jiang
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China
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Jaradeh K, Tang A, Czechowicz JA, Jacobson L, Raphael E. Prevalence of otolaryngological disease in a refugee population compared to US-born patients. Laryngoscope Investig Otolaryngol 2023; 8:394-400. [PMID: 37090888 PMCID: PMC10116955 DOI: 10.1002/lio2.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Objective Limited data exists regarding otolaryngological (ENT) disease in refugees and we aim to characterize its prevalence. Methods This is a retrospective descriptive chart review of adult US-born, immigrant, and refugee patients receiving care at a primary care clinic between 2014 and 2017. We report the prevalence of ENT disease by immigration status. Bivariable and multivariable logistic regression models were conducted to assess differences in prevalence of ENT disease by immigration status. Results Of 995 patients included, 202 US-born, 450 immigrants, and 343 were refugees. Immigrants were older (46 years vs. 34 years among refugees, 35.5 years among US-born, p < .001) and more likely to be women (64% vs. 52% among refugees and 56% among US-born, p = .003). Among refugees, 27% were Central American, 22% Chinese, and 9.3% Middle Eastern. Hearing loss and allergic rhinitis were the top two diagnoses among the three groups of immigration status. More refugees had at least 1 ENT diagnosis compared to the other groups (16% vs 14% among immigrants and 6% US-born, p < .001). Refugees were more likely to have at least 1 ENT diagnosis compared to US-born individuals (age and gender adjusted [aOR] 3.40, 95% CI [1.80-6.95], p < .001) and immigrants (aOR 1.62, [1.05-2.51], p = .03). Conclusion ENT disease is prevalent among refugees, necessitating standardized evaluation during refugee health assessments and identifying barriers to referral and treatment. Level of evidence 2b.
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Affiliation(s)
- Katrin Jaradeh
- School of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Alice Tang
- School of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Josephine A. Czechowicz
- Department of Otolaryngology‐Head & Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lia Jacobson
- Department of Otolaryngology‐Head & Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Eva Raphael
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of Family and Community MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Lee J, Han JH, Lee HJ. Development of Novel Musical Stimuli to Investigate the Perception of Musical Emotions in Individuals With Hearing Loss. J Korean Med Sci 2023; 38:e82. [PMID: 36974396 PMCID: PMC10042730 DOI: 10.3346/jkms.2023.38.e82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/15/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Many studies have examined the perception of musical emotion using excerpts from familiar music that includes highly expressed emotions to classify emotional choices. However, using familiar music to study musical emotions in people with acquired hearing loss could produce ambiguous results as to whether the emotional perception is due to previous experiences or listening to the current musical stimuli. To overcome this limitation, we developed new musical stimuli to study emotional perception without the effects of episodic memory. METHODS A musician was instructed to compose five melodies with evenly distributed pitches around 1 kHz. The melodies were created to express the emotions of happy, sad, angry, tender, and neutral. To evaluate whether these melodies expressed the intended emotions, two methods were applied. First, we classified the expressed emotions of melodies with selected musical features from 60 features using genetic algorithm-based k-nearest neighbors. Second, forty-four people with normal hearing participated in an online survey regarding the emotional perception of music based on dimensional and discrete approaches to evaluate the musical stimuli set. RESULTS Twenty-four selected musical features produced classification for intended emotions with an accuracy of 76%. The results of the online survey in the normal hearing (NH) group showed that the intended emotions were selected significantly more often than the others. K-means clustering analysis revealed that melodies with arousal and valence ratings corresponded to representative quadrants of interest. Additionally, the applicability of the stimuli was tested in 4 individuals with high-frequency hearing loss. CONCLUSION By applying the individuals with NH, the musical stimuli were shown to classify emotions with high accuracy, as expressed. These results confirm that the set of musical stimuli can be used to study the perceived emotion in music, demonstrating the validity of the musical stimuli, independent of innate musical bias such as due to episodic memory. Furthermore, musical stimuli could be helpful for further studying perceived musical emotion in people with hearing loss because of the controlled pitch for each emotion.
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Affiliation(s)
- Jihyun Lee
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
| | - Ji-Hye Han
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
| | - Hyo-Jeong Lee
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea
- Ear and Interaction Center, Doheun Institute for Digital Innovation in Medicine (D.I.D.I.M.), Hallym University Medical Center, Anyang, Korea
- Department of Otorhinolaryngology, Hallym University College of Medicine, Chuncheon, Korea.
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20
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Ashikali EM, Ludwig C, Mastromauro L, Périvier S, Tholomier A, Ionita I, Graf C, Busnel C. Intrinsic Capacities, Functional Ability, Physiological Systems, and Caregiver Support: A Targeted Synthesis of Effective Interventions and International Recommendations for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4382. [PMID: 36901392 PMCID: PMC10002353 DOI: 10.3390/ijerph20054382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The ageing population calls for interventions that can assist older people to age healthily. This study aimed to provide a targeted synthesis of high-level research and current evidence-based recommendations on effective interventions for maintaining or preventing the decline in intrinsic capacity, functional ability, and physiological systems, or for caregiver support. Nestled within the healthy ageing framework by the World Health Organization, available evidence was selected in a targeted manner, with the purpose of providing a synthesis that would allow the application of this knowledge in real life. As such, the outcome variables were examined through an Evidence and Gap Map of interventions for functional ability and through guidelines from leading institutions. Systematic reviews, meta-analyses, and guidelines on community-dwelling older adults with or without minor health limitations were considered. Thirty-eight documents were included and over fifty interventions identified. Physical activity interventions were consistently effective across several domains. Recommendations point to screening, whilst highlighting the importance of behavioural factors in the endeavour to age healthily. There is a wide range of activities which are likely to foster healthy ageing. To encourage their uptake, it is important for communities to offer suitable promotion and support, and to make these accessible to the public.
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Affiliation(s)
| | - Catherine Ludwig
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Laura Mastromauro
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Samuel Périvier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Aude Tholomier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
| | - Irina Ionita
- PLATEFORME du Réseau Seniors Genève, 1227 Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Catherine Busnel
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
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21
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Borre ED, Dubno JR, Myers ER, Emmett SD, Pavon JM, Francis HW, Ogbuoji O, Sanders Schmidler GD. Model-Projected Cost-Effectiveness of Adult Hearing Screening in the USA. J Gen Intern Med 2023; 38:978-985. [PMID: 35931909 PMCID: PMC10039166 DOI: 10.1007/s11606-022-07735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/28/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND While 60% of older adults have hearing loss (HL), the majority have never had their hearing tested. OBJECTIVE We sought to estimate long-term clinical and economic effects of alternative adult hearing screening schedules in the USA. DESIGN Model-based cost-effectiveness analysis simulating Current Detection (CD) and linkage of persons with HL to hearing healthcare, compared to alternative screening schedules varying by age at first screen (45 to 75 years) and screening frequency (every 1 or 5 years). Simulated persons experience yearly age- and sex-specific probabilities of acquiring HL, and subsequent hearing aid uptake (0.5-8%/year) and discontinuation (13-4%). Quality-adjusted life-years (QALYs) were estimated according to hearing level and treatment status. Costs from a health system perspective include screening ($30-120; 2020 USD), HL diagnosis ($300), and hearing aid devices ($3690 year 1, $910/subsequent year). Data sources were published estimates from NHANES and clinical trials of adult hearing screening. PARTICIPANTS Forty-year-old persons in US primary care across their lifetime. INTERVENTION Alternative screening schedules that increase baseline probabilities of hearing aid uptake (base-case 1.62-fold; range 1.05-2.25-fold). MAIN MEASURES Lifetime undiscounted and discounted (3%/year) costs and QALYs and incremental cost-effectiveness ratios (ICERs). KEY RESULTS CD resulted in 1.20 average person-years of hearing aid use compared to 1.27-1.68 with the screening schedules. Lifetime total per-person undiscounted costs were $3300 for CD and ranged from $3630 for 5-yearly screening beginning at age 75 to $6490 for yearly screening beginning at age 45. In cost-effectiveness analysis, yearly screening beginning at ages 75, 65, and 55 years had ICERs of $39,100/QALY, $48,900/QALY, and $96,900/QALY, respectively. Results were most sensitive to variations in hearing aid utility benefit and screening effectiveness. LIMITATION Input uncertainty around screening effectiveness. CONCLUSIONS We project that yearly hearing screening beginning at age 55+ is cost-effective by US standards.
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Affiliation(s)
- Ethan D Borre
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Evan R Myers
- Division of Women's Community and Population Health, Department of Obstetrics & Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Susan D Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Juliessa M Pavon
- Department of Medicine, Division of Geriatrics, Duke University School of Medicine, Durham, NC, USA
| | - Howard W Francis
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Osondu Ogbuoji
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, USA
| | - Gillian D Sanders Schmidler
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA.
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
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22
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Kobewka D, Ruller S, Daly B, Mark Fraser AE, Bromwich M, Sveistrup H, Wilson K. Usability, acceptability and clinical utility of a mobile app to screen for hearing loss in older adults in a geriatric rehabilitation hospital. J Eval Clin Pract 2023; 29:392-396. [PMID: 36420708 DOI: 10.1111/jep.13795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Abstract
RATIONALE Hearing loss is a common problem for older adults entering rehabilitation hospitals. AIMS AND OBJECTIVES To pilot a hearing loss screening device to determine feasibility, usability, and impact on patient outcomes. METHODS We screened all patients newly admitted to a geriatric day hospital for hearing loss using the SHOEBOX® QuickTest (SHOEBOX Ltd.) app as part of a quality improvement programme. We measured the time it took for each patient to complete screening and recorded any issues they had using the app. We recorded the number of patients who screened positive who did not have a previous diagnosis and changes in physician behaviours after they received their patients' results. RESULTS Seventy-four patients with a mean age of 83.4 years used the hearing screener. All patients were able to complete the screening with a mean time to completion of 10 min and 48 s. Ninety-nine percent of patients screened positive for hearing loss. Of these positives 56% were in participants not already known to have hearing loss. Physicians often changed their behaviour after receiving results by using assistive devices during visits and referring to audiology for formal testing. CONCLUSIONS Screening for hearing loss is feasible in a geriatric day hospital. The SHOEBOX QuickTest app is acceptable, usable, resulting in the identification of undiagnosed hearing loss and in changes to physician behaviour.
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Affiliation(s)
- Daniel Kobewka
- Department of Medicine, Division of General Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Sydney Ruller
- Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Blake Daly
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | | | - Matt Bromwich
- SHOEBOX Ltd, Ottawa, Ontario, Canada.,Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,CHEO Research Institute, Ottawa, Ontario, Canada
| | - Heidi Sveistrup
- Bruyère Research Institute, Ottawa, Ontario, Canada.,Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kumanan Wilson
- Department of Medicine, Division of General Internal Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Bruyère Research Institute, Ottawa, Ontario, Canada
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23
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Ting HC, Huang YY. Sensitivity and specificity of hearing tests for screening hearing loss in older adults. J Otol 2023; 18:1-6. [PMID: 36820159 PMCID: PMC9937813 DOI: 10.1016/j.joto.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/08/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives The study aimed to determine the most appropriate hearing screening test to identify disabling hearing loss for adults aged 65 years or older. Methods This study included 577 older adults. Four hearing screening tests were considered in the study, including the Hearing Handicap Inventory for Elderly Screening (HHIE-s), three single question tests, the whisper test, and the finger rub test. The sensitivity and specificity of these tests referenced to the hearing threshold of disabling hearing loss were estimated. Results Among all tests, only the single self-perception question (0.7064 for sensitivity; 0.7225 for specificity) and whisper test (0.7833 for sensitivity; 0.7708 for specificity) could obtain both sensitivity and specificity higher than 70% for adults aged ≥65 years. Conclusion Overall, we suggest using the whisper test to identify disabling hearing loss (>40 dB HL at the better ear) for adults aged 65 years or older. However, if the conditions do not permit, the single self-perception question is also acceptable. Moreover, HHIE-s might not be a good test to detect disabling hearing loss for adults aged 80 years or older.
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Affiliation(s)
- Hsin-Chen Ting
- PSA Charitable Foundation, New Taipei City, Taiwan,Department of Audiology and Speech-Language Pathology, MacKay Medical College, New Taipei City, Taiwan,Corresponding author. Department of Audiology and Speech-Language Pathology, MacKay Medical College, No.46, Sec. 3, Zhongzheng Rd, Sanzhi Dist, New Taipei City, 252, Taiwan.
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24
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Powell DS, Reed NS, Wolff JL. Care for Hearing Loss and Best Principles of Dementia Care: The Time is Right for Inclusion. J Am Med Dir Assoc 2022; 23:e13-e14. [PMID: 36347277 DOI: 10.1016/j.jamda.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Danielle S Powell
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Roger C. Liptiz Center for Integrated Health Care, Johns Hopkins University, Hopkins Economics of Alzheimer's Disease and Services Center, Baltimore, MD
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Cochlear Center for Hearing and Public Health, Baltimore, MD
| | - Jennifer L Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Roger C. Liptiz Center for Integrated Health Care, Johns Hopkins University, Hopkins Economics of Alzheimer's Disease and Services Center, Baltimore, MD
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25
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Health-related quality of life in various health conditions: two consecutive surveys of older Japanese adults. Qual Life Res 2022; 32:1209-1219. [PMID: 36401756 DOI: 10.1007/s11136-022-03295-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Measuring health-related quality of life (HRQOL) in various health conditions in different countries is important given the regional differences. This study employed large-scale nationwide data targeting older adults in Japan to estimate the HRQOL in the key health conditions that are the major causes of disability. METHODS Our data were derived from two survey waves (2016 and 2019 surveys) of cross-sectional data from the Japan Gerontological Evaluation Study, an ongoing nationwide study targeting functionally independent older adults in Japan. A total of 28,345 individuals from 27 of the 47 Japanese provinces were analyzed. The EuroQoL 5-dimension 5-level instrument (EQ-5D-5L) was employed to assess the HRQOL utility scores. The targeted minimum loss-based estimator with sampling weighting methods was applied to estimate the utility score in eight major health conditions, including sensory organ disease, musculoskeletal disease, oral disorders, and depressive disorders. RESULTS The estimated HRQOL utility score for those with the poorest health conditions in self-rated health, hearing loss, vision loss, number of remaining teeth (e.g., no teeth with no denture use), oral dysfunction, depressive symptoms, chronic low back pain, and chronic knee pain was 0.576 (95% confidence interval (CI) 0.555-0.598), 0.768 (95% CI 0.737-0.800), 0.680 (95% CI 0.662-0.699), 0.809 (95% CI 0.796-0.821), 0.776 (95% CI 0.764-0.788), 0.723 (95% CI 0.710-0.737), 0.715 (95% CI 0.690-0.739), and 0.742 (95% CI 0.722-0.763), respectively. CONCLUSION We successfully provided a catalog for the HRQOL utility score in key health conditions that are the leading causes of disability among older adults.
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26
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McKee M, James TG, Helm KVT, Marzolf B, Chung DH, Williams J, Zazove P. Reframing Our Health Care System for Patients With Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3633-3645. [PMID: 35969852 PMCID: PMC9802570 DOI: 10.1044/2022_jslhr-22-00052] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 06/04/2023]
Abstract
PURPOSE Nearly 20% of U.S. Americans report a hearing loss, yet our current health care system is poorly designed and equipped to effectively care for these individuals. Individuals with hearing loss report communication breakdowns, inaccessible health information, reduced awareness and training by health care providers, and decreased satisfaction while struggling with inadequate health literacy. These all contribute to health inequities and increased health care expenditures and inefficiencies. It is time to reframe the health care system for these individuals using existing models of best practices and accessibility to mitigate inequities and improve quality of care. METHOD A review of system-, clinic-, provider-, and patient-level barriers, along with existing and suggested efforts to improve care for individuals with hearing loss, are presented. RESULTS These strategies include improving screening and identification of hearing loss, adopting universal design and inclusion principles, implementing effective communication approaches, leveraging assistive technologies and training, and diversifying a team to better care for patients with hearing loss. Patients should also be encouraged to seek social support and resources from hearing loss organizations while leveraging technologies to help facilitate communication. CONCLUSIONS The strategies described introduce actionable steps that can be made at the system, clinic, provider, and patient levels. With implementation of these steps, significant progress can be made to more proactively meet the needs of patients with hearing loss. Presentation Video: https://doi.org/10.23641/asha.21215843.
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Affiliation(s)
- Michael McKee
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Tyler G. James
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Kaila V. T. Helm
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Brianna Marzolf
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Dana H. Chung
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - John Williams
- Department of Population Health Science, University of Mississippi Medical Center, Jackson
| | - Philip Zazove
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
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27
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Jaradeh K, Liao E, Dieterich C, Truong S, Anand P, Chan DK, Raphael E. Hearing Loss Screening, Diagnosis, and Treatment for Refugees and Asylees in an Urban Clinic, 2014-2017. OTO Open 2022; 6:2473974X221132509. [PMID: 36544570 PMCID: PMC9761227 DOI: 10.1177/2473974x221132509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives First, to determine whether using a single-question subjective hearing screen vs gold standard audiometric evaluation is effective for hearing loss screening in refugees and asylees. Second, to understand the clinical pathways for hearing loss diagnosis and treatment. Study Design This is a case series with chart review from January 2014 to December 2017. Setting A large urban safety net primary care clinic in San Francisco, California. Methods Patients were included who had a medical record and completed single-question subjective hearing screening and audiometric evaluation during refugee health examinations. An overall 349 patients met all inclusion criteria. Results Out of 349 patients, 48% were male; the median age was 29.3 years (SD, 15.1). The majority came from Central or South America (n = 148, 42%) and China (n = 79, 23%). Among all patients, 10 (3%) failed the subjective hearing screen, and 18 (5%) failed audiometric evaluation. Of those who failed the subjective hearing screen, 4 (40%) passed audiometric evaluation. Of those who failed the audiometric evaluation, 12 (66%) passed subjective screening, and only 5 (28%) received a diagnostic audiogram, with 4 diagnosed with hearing loss and 1 receiving hearing aids. The sensitivity of the subjective screening question was 33% and the specificity 99% as compared with audiometric evaluation. Conclusion Audiometric evaluation is relatively inexpensive and easily administered, while a single subjective question is a poor screening tool. Hearing loss is undertreated in this population. Ensuring appropriate hearing loss screening, diagnosis, and treatment in this population is paramount to improving quality of life.
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Affiliation(s)
- Katrin Jaradeh
- School of Medicine, University of
California, San Francisco, San Francisco, California, USA
| | - Elizabeth Liao
- School of Medicine, University of
California, San Francisco, San Francisco, California, USA
| | - Cristy Dieterich
- Newcomers Health Program, San Francisco
Refugee Health Assessment Program, Community Health Equity and Promotion Branch, San
Francisco Department of Public Health, San Francisco, California, USA
| | - Sammi Truong
- Newcomers Health Program, San Francisco
Refugee Health Assessment Program, Community Health Equity and Promotion Branch, San
Francisco Department of Public Health, San Francisco, California, USA
| | - Payal Anand
- Department of Otolaryngology–Head and
Neck Surgery, University of California, San Francisco, San Francisco, California,
USA
| | - Dylan K. Chan
- Department of Otolaryngology–Head and
Neck Surgery, University of California, San Francisco, San Francisco, California,
USA
| | - Eva Raphael
- Department of Epidemiology and
Biostatistics, University of California San Francisco, San Francisco, California,
USA
- Department of Family and Community
Medicine, University of California San Francisco, San Francisco, California,
USA
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28
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Brothers EB, Hay-McCutcheon MJ, Hughes PJ, Friend ML. Audiology, Medicine, and Pharmacy Interprofessional Preliminary Interviews and Discussions: Improving Hearing Health Care in Rural Alabama. Am J Audiol 2022; 31:656-668. [PMID: 35737896 PMCID: PMC9886163 DOI: 10.1044/2022_aja-21-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/07/2022] [Accepted: 04/11/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Access and affordability of hearing health care varies depending on residency and individual financial means. Those living in rural areas have limited health care resources and experience higher levels of poverty compared to those living in urban regions. The purpose of this study was to determine the feasibility of interprofessional collaboration among physicians and audiologists and pharmacists and audiologists to improve access and affordability of hearing health care in rural communities. METHOD Sixteen family physicians and medicine residents and 15 community pharmacists participated in the study. Physicians and residents completed an online survey to assess education regarding hearing health care and their understanding of hearing loss intervention. They also participated in small virtual focus group discussions. Pharmacists participated in virtual discussions based on guided questions. RESULTS The discussions with both physicians and pharmacists highlighted the need for more education, resources, and awareness of the negative impact of hearing loss on overall quality of life. Comments from these discussions were placed within the socio-ecological model of health behavior to increase understanding of hearing health behavior. CONCLUSIONS Increased collaboration among medical professionals has the potential to improve access to hearing health care for those living in audiologically underserved regions of the country. Further research will identify how to increase effective and sustainable hearing health care resources in rural communities.
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Affiliation(s)
- Emma B. Brothers
- Department of Communicative Disorders, The University of Alabama, Tuscaloosa
| | | | - Peter J. Hughes
- McWhorter School of Pharmacy, Samford University, Birmingham, AL
| | - M. Louanne Friend
- Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa
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29
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Lenatti M, Moreno-Sánchez PA, Polo EM, Mollura M, Barbieri R, Paglialonga A. Evaluation of Machine Learning Algorithms and Explainability Techniques to Detect Hearing Loss From a Speech-in-Noise Screening Test. Am J Audiol 2022; 31:961-979. [PMID: 35877954 DOI: 10.1044/2022_aja-21-00194] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The aim of this study was to analyze the performance of multivariate machine learning (ML) models applied to a speech-in-noise hearing screening test and investigate the contribution of the measured features toward hearing loss detection using explainability techniques. METHOD Seven different ML techniques, including transparent (i.e., decision tree and logistic regression) and opaque (e.g., random forest) models, were trained and evaluated on a data set including 215 tested ears (99 with hearing loss of mild degree or higher and 116 with no hearing loss). Post hoc explainability techniques were applied to highlight the role of each feature in predicting hearing loss. RESULTS Random forest (accuracy = .85, sensitivity = .86, specificity = .85, precision = .84) performed, on average, better than decision tree (accuracy = .82, sensitivity = .84, specificity = .80, precision = .79). Support vector machine, logistic regression, and gradient boosting had similar performance as random forest. According to post hoc explainability analysis on models generated using random forest, the features with the highest relevance in predicting hearing loss were age, number and percentage of correct responses, and average reaction time, whereas the total test time had the lowest relevance. CONCLUSIONS This study demonstrates that a multivariate approach can help detect hearing loss with satisfactory performance. Further research on a bigger sample and using more complex ML algorithms and explainability techniques is needed to fully investigate the role of input features (including additional features such as risk factors and individual responses to low-/high-frequency stimuli) in predicting hearing loss.
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Affiliation(s)
- Marta Lenatti
- Institute of Electronics, Information Engineering and Telecommunications, National Research Council of Italy, Milan
| | - Pedro A Moreno-Sánchez
- School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Finland.,Faculty of Medicine and Health Technology, Tampere University, Seinäjoki, Finland
| | - Edoardo M Polo
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Italy
| | - Maximiliano Mollura
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Riccardo Barbieri
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Alessia Paglialonga
- Institute of Electronics, Information Engineering and Telecommunications, National Research Council of Italy, Milan
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30
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Choi JS, Gathman TJ, Huang TC, Adams ME. Association of Hearing Test History With Awareness of Hearing Loss and Hearing Aid Use in Older Adults. JAMA Otolaryngol Head Neck Surg 2022; 148:886-888. [PMID: 35834237 DOI: 10.1001/jamaoto.2022.1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Janet S Choi
- Department of Otolaryngology-Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Tyler J Gathman
- University of Minnesota School of Medicine, Minneapolis, Minnesota
| | - Tina C Huang
- Department of Otolaryngology-Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Meredith E Adams
- Department of Otolaryngology-Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota
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31
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Dubno JR, Majumder P, Bettger JP, Dolor RJ, Eifert V, Francis HW, Pieper CF, Schulz KA, Silberberg M, Smith SL, Walker AR, Witsell DL, Tucci DL. A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2022; 20:26. [PMID: 35751122 PMCID: PMC9233354 DOI: 10.1186/s12962-022-00360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Hearing loss is a high prevalence condition among older adults, is associated with higher-than-average risk for poor health outcomes and quality of life, and is a public health concern to individuals, families, communities, professionals, governments, and policy makers. Although low-cost hearing screening (HS) is widely available, most older adults are not asked about hearing during health care visits. A promising approach to addressing unmet needs in hearing health care is HS in primary care (PC) clinics; most PC providers (PCPs) do not inquire about hearing loss. However, no cost assessment of HS in community PC settings has been conducted in the United States. Thus, this study conducted a cost-effectiveness analysis of HS using results from a pragmatic clinic trial that compared three HS protocols that differed in the level of support and encouragement provided by the PC office and the PCPs to older adults during their routine visits. Two protocols included HS at home (one with PCP encouragement and one without) and one protocol included HS in the PC office. METHODS Direct costs of the HS included costs of: (1) educational materials about hearing loss, (2) PCP educational and encouragement time, and (3) access to the HS system. Indirect costs for in-office HS included cost of space and minimal staff time. Costs were tracked and modeled for each phase of care during and following the HS, including completion of a diagnostic assessment and follow-up with the recommended treatment plan. RESULTS The cost-effectiveness analysis showed that the average cost per patient is highest in the patient group who completed the HS during their clinic visit, but the average cost per patient who failed the HS is by far the lowest in that group, due to the higher failure rate, that is, rate of identification of patients with suspected hearing loss. Estimated benefits of HS in terms of improvements in quality of life were also far greater when patients completed the HS during their clinic visit. CONCLUSIONS Providing HS to older adults during their PC visit is cost-effective and accrues greater estimated benefits in terms of improved quality of life. TRIAL REGISTRATION clinicaltrials.gov (Registration Identification Number: NCT02928107).
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Affiliation(s)
- Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | | | - Janet Prvu Bettger
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Rowena J Dolor
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Victoria Eifert
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Howard W Francis
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Carl F Pieper
- Center for Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Kristine A Schulz
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mina Silberberg
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
| | - Sherri L Smith
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Amy R Walker
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - David L Witsell
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Debara L Tucci
- National Institute On Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
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Lisan Q, Goldberg M, Lahlou G, Ozguler A, Lemonnier S, Jouven X, Zins M, Empana JP. Prevalence of Hearing Loss and Hearing Aid Use Among Adults in France in the CONSTANCES Study. JAMA Netw Open 2022; 5:e2217633. [PMID: 35713903 PMCID: PMC9206187 DOI: 10.1001/jamanetworkopen.2022.17633] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Although hearing loss is common in the population worldwide, the prevalence of hearing loss and hearing aid use is not known. OBJECTIVE To estimate the prevalence of hearing loss and hearing aid use in the adult French population. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the CONSTANCES cohort, a representative sample of the French population. Volunteers aged 18 to 75 years were recruited at 21 preventive health centers between January 1, 2012, and December 31, 2019. The present study included participants with audiometric data. MAIN OUTCOMES AND MEASURES The main outcomes were prevalence of hearing loss and disabling hearing loss overall and by sex and age group and prevalence of self-reported hearing aid use among those with disabling hearing loss. Hearing loss was defined as a pure-tone average (PTA) in the better ear of 20 dB or higher, and disabling hearing loss was defined as a PTA in the better ear of 35 dB or higher. RESULTS Of 200 870 participants in the CONSTANCES study, 186 460 had full audiometric data and were included in this study (mean [SD] age, 47.1 [13.5] years); 100 330 (53.8%) were female, and 86 130 (46.2%) were male. Of these participants, 24.8% (95% CI, 24.6%-25.0%) had hearing loss and 4.3% (95% CI, 4.2%-4.4%) had disabling hearing loss. The prevalence rates of hearing loss increased from 3.4% (95% CI, 2.8%-3.9%) at age 18 to 25 years to 73.3% (95% CI, 69.5%-77.2%) at age 71 to 75 years among men and from 4.4% (95% CI, 3.9%-5.0%) at age 18 to 25 years to 64.1% (95% CI, 59.7%-68.4%) at age 71 to 75 years among women. The prevalence of disabling hearing loss increased from 0.3% (95% CI, 0.2%-0.4%) among participants aged 18 to 25 years to 23.3% (95% CI, 20.7%-26.0%) among participants aged 71 to 75 years. Among the 8050 participants with disabling hearing loss, 36.8% (95% CI, 35.8%-37.9%) reported using hearing aids, including 56.7% (95% CI, 38.9%-74.4%) aged 18 to 25 years and 32.9% (95% CI, 26.8%-39.2%) aged 71 to 75 years. CONCLUSIONS AND RELEVANCE In this cohort study, hearing loss was prevalent in France, and the prevalence of hearing loss increased with age among both men and women. Hearing aids were underused, particularly among older individuals. These findings suggest that hearing loss prevention and screening in the French population are needed.
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Affiliation(s)
- Quentin Lisan
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Ghizlene Lahlou
- Assistance Publique–Hôpitaux de Paris Sorbonne Université, Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Département d’Oto-Rhino-Laryngologie, Unité Fonctionnelle Implants Auditifs, Paris, France
- Institut de l’Audition/Institut Pasteur, Équipe Technologies and Gene Therapy for Deafness, Paris, France
| | - Anna Ozguler
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Sylvie Lemonnier
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Xavier Jouven
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
- Department of Cardiology, European Hospital Georges Pompidou, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Marie Zins
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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Reed M, Freedman M, Mark Fraser AE, Bromwich M, Santiago AT, Gallucci CE, Frank A. Enhancing Clinical Visibility of Hearing Loss in Cognitive Decline. J Alzheimers Dis 2022; 86:413-424. [DOI: 10.3233/jad-215377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Hearing loss is the largest potentially modifiable risk factor for dementia and is highly prevalent among older adults, yet it goes largely unreported, unidentified, and untreated, at great cost to health and quality of life. Hearing screening is a proven cost-effective solution to overcome delays in its identification and management yet is not typically recommended by physicians for older adults. Objective: To demonstrate the feasibility and value of hearing screening for older adults at risk for dementia in order to enhance physicians’ awareness of hearing loss and improve access to timely hearing care. Methods: Patients referred to two academic medical clinics for memory disorders were offered hearing screening as part of clinic protocol. Patients with hearing loss were recruited to the study if they consented to a post-appointment telephone interview and chart review. Memory Clinic physicians were surveyed about the usefulness of the screening information and referral of patients with hearing loss to audiology. Results: Hearing loss was reliably detected in Memory Clinic patients with both in-office and online screening tools. Physicians reported that screening enhanced their awareness of hearing loss and increased the referral rate to audiology. Conclusion: Hearing screening in Memory Clinic patients is a useful component of clinic protocol that facilitates timely access to management and addresses an important risk factor for dementia.
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Affiliation(s)
- Marilyn Reed
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Morris Freedman
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Mt. Sinai Hospital, Toronto, ON, Canada
| | | | - Matthew Bromwich
- SHOEBOX Ltd., Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | | | | | - Andrew Frank
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
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Krist AH, Davidson KW, Mangione CM, Cabana M, Caughey AB, Davis EM, Donahue KE, Doubeni CA, Epling JW, Kubik M, Li L, Ogedegbe G, Pbert L, Silverstein M, Stevermer J, Tseng CW, Wong JB. Screening for Hearing Loss in Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA 2021; 325:1196-1201. [PMID: 33755083 DOI: 10.1001/jama.2021.2566] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Age-related sensorineural hearing loss is a common health problem among adults. Nearly 16% of US adults 18 years or older report difficulty hearing. The prevalence of perceived hearing loss increases with age. Hearing loss can adversely affect an individual's quality of life and ability to function independently and has been associated with increased risk of falls, hospitalizations, social isolation, and cognitive decline. OBJECTIVE To update its 2012 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on screening for hearing loss in adults 50 years or older. POPULATION Asymptomatic adults 50 years or older with age-related hearing loss. EVIDENCE ASSESSMENT Because of a lack of evidence, the USPSTF concludes that the benefits and harms of screening for hearing loss in asymptomatic older adults are uncertain and that the balance of benefits and harms cannot be determined. More research is needed. RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in older adults. (I statement).
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Affiliation(s)
| | - Alex H Krist
- Fairfax Family Practice Residency, Fairfax, Virginia
- Virginia Commonwealth University, Richmond
| | - Karina W Davidson
- Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York
| | | | | | | | - Esa M Davis
- University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | | | - Li Li
- University of Virginia, Charlottesville
| | | | - Lori Pbert
- University of Massachusetts Medical School, Worcester
| | | | | | - Chien-Wen Tseng
- University of Hawaii, Honolulu
- Pacific Health Research and Education Institute, Honolulu, Hawaii
| | - John B Wong
- Tufts University School of Medicine, Boston, Massachusetts
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Yueh B, Piccirillo JF. Screening for Hearing Loss in Older Adults: Insufficient Evidence Does Not Mean Insufficient Benefit. JAMA 2021; 325:1162-1163. [PMID: 33755056 DOI: 10.1001/jama.2021.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Bevan Yueh
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Deal JA, Lin FR. USPSTF Recommendations for Hearing Loss Screening in Asymptomatic Older Adults-A Case of Missing Evidence and Missing Treatment Options. JAMA Netw Open 2021; 4:e210274. [PMID: 33755162 DOI: 10.1001/jamanetworkopen.2021.0274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
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