Zhongguo quanke yixue (Dec 2022)
Development of the General Practitioner Management of Age-related Hearing Loss System
Abstract
Background The prevalence of age-related hearing loss is increasing gradually as population aging advances in China. Untreated hearing loss is strongly associated with many adverse health events. Age-related hearing loss is difficult to be detected due to slow progression of symptoms, and its harmfulness is often underestimated or neglected. General practitioners (GPs) in primary care could play a vital role in early screening, timely referral and health education management regarding age-related hearing loss. Objective To formulate an GP management of age-related hearing loss system, promoting secondary prevention and management of this illness in primary health care. Methods By use of literature review and semi-structured reviews, we developed the first draft of General Practitioner Management of Age-related Hearing Loss System from April to June 2021. For reviewing the draft, we conducted a two-round e-mail-based consultation with a purposive sample of 15 experts (engaging in the field of otolaryngology, general practice, administrative management or public health management) from August to November 2021. Then we calculated the response coefficient, authority coefficient and Kendall's Wfor the two consultations, assessed the weights of indicators using analytic hierarchy process, checked the logical consistency of indicators, and determined the final draftof age-related hearing loss management system. Results The first draft of General Practitioner Management of Age-related Hearing Loss System consisted of 6 primary indicators and 15 secondary indicators. The response coefficient was 100.0% for both consultations. The expert authority coefficient was 0.877 for the first round of consultation, and 0.920 for the second round. Kendall's W coefficients were 0.428 (χ2=89.821, P<0.001) , and 0.307 (χ2=87.387, P<0.001) , respectively for the first and second rounds of consultations. The final system consists of 6 primary indicators (theoretical knowledge of age-related hearing loss, screening skills for age-related hearing loss, referral ability of age-related hearing loss, ability to diagnose and treat ear diseases, ability to manage adverse events of age-related hearing loss, doctor-patient communication ability) , and 20 secondary indicators. The mean value of importance for all indicators was above 8.000, the coefficient of variation of all indicators was above 0.250, and the full score ratio of all indicators was above 30.0%. The weights of the above-mentioned six primary indicatorswere 0.082, 0.082, 0.082, 0.077, 0.077, and 0.077, respectively. The consistency ratio of primary and secondary indicators was 0.063 5, 0.043 2, respectively (<0.100 0) . Conclusion The response and authority coefficients, and Kendall's W coefficients of the consultations were high, suggesting that the consultation results were scientific, credible and reliable. This system can be used as a guidance system for secondary prevention and management of this illness by GPs in primary care.
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