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KMID : 0390220200310010037
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2020 Volume.31 No. 1 p.37 ~ p.44
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Clinical Validity of the National Hearing Screening Method for Transitional Ages: A Proposal of Accurate Screening for Early Hearing Loss Detection
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Yi Hee-Jun
Kim Hyun-Jung
Suh Michelle J.
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Abstract
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Objectives: The purpose of this study was to investigate whether the current 1,000-Hz hearing screening test in transitional ages actually reflects the hearing status of Korean adults.
Materials and Methods: Retrospective cross?sectional analysis from the 2010-2012 Korean National Health and Nutrition Survey for adults aged 40 years or older. A questionnaire that could affect hearing and pure tone audiometry was conducted. Data were analyzed using complex samples general linear analyses and t-tests, and relative operating characteristic analysis. Hearing thresh?old averages by gender and age groups, and the appropriate screening frequency and cutoff values were calculated.
Results: The overall prevalence of referred cases was 7.7% [95% confidence interval (CI), 7.3-8.2%] according to the criterion standard. Hearing loss above 40 dB HL was observed in 10%, but mild hearing loss was observed in 18.3%. The 1,000-Hz screening test obtained a sensitivity of 67.5% (95% CI, 66.5-73.5%) and a specificity of 98.9% (95% CI, 98.7-99.1%). Among the cases screening as passing, 3.5% had hearing loss above 40 dB, 0.9% had low-frequency hearing loss, and 24.9% had high-frequency hearing loss. In particular, the discrepancy between the high-frequency hearing loss and the screening results was greater in men. The ROC analysis showed the largest AUC at 2,000 Hz in all subjects. The average threshold of 1,000 and 3,000 Hz showed the best screening perfor?mance.
Conclusions: The conventionally used 1,000-Hz hearing surveillance method is limited in reflecting the actual hearing status of Korean adults. Therefore, a modification from single frequency to two frequencies combi?nation of screening method to detect the early stages of hearing loss is needed
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KEYWORD
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Korean National Health and Nutrition Examination Surveys, Hearing impairment, Screening test, Sensitivity, Specificity, Receiver operating characteristic
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