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

Abstract

Jianli Ge,1,* Shasha Geng,1,* Yang Gao,2 Guangwei Ren,3 Xiaoming Sun,1,4 Hua Jiang1 1Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China; 2Department of General Practice, Huamu Community Health Service Center, Shanghai, 201204, People’s Republic of China; 3Science and Education Department, Sanlin Community Health Service Center, Shanghai, 200124, People’s Republic of China; 4Department of General Practice, Zhongshan Hospital, Fudan University Medical School, Shanghai, 200032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoming Sun, Fudan University Medical School, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China, Email [email protected] Hua Jiang, Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, People’s Republic of China, Email [email protected]: 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.Keywords: age-related hearing loss, three-level and two-stage mode, screening, general practitioners, self-management

Keywords

• age-related hearing loss
• three-level and two-stage mode
• screening
• general practitioners；self-management