Zhongguo quanke yixue (Jan 2023)
Development and Validation of Hearing Loss Screening Software for the Elderly in the Community in the Context of Smart Medicine
Abstract
Background There is currently insufficient effective treatment for hearing loss in the elderly since it is a hidden disease whose damage is irreversible. It is crucial to establish early warnings, screenings and interventions. As of now, there are few studies carried out on the assessment of hearing loss in the elderly based on risk factors at home and abroad. There are no standardized measurement tools or perfect scales. Objective Utilizing smart medicine and the WeChat platform, investigate high-risk factors of hearing loss in the elderly, develop screening software for hearing loss in the elderly, and explore the screening and management modes of hearing loss in the elderly. Methods Based on cross-sectional survey, five community health service centers in Pudong New Area of Shanghai were obtained. The tudy was performed from April to December 2019 to investigate the distribution of risk factors for hearing loss in the elderly in the community, and conditional logic was applied, and receiver operation charateristic curve (ROC curve) were used for risk stratification. The screening software for hearing loss in the elderly has been developed using JavaScript language during the period January and June 2020. Verification and evaluation of the screening software were performed between July 2020 to March 2021. Results The study involved 401 elderly peoplein across-sectional design. Multivariate Logistic regression analysis revealed that aging〔OR=1.100, 95%CI (1.037, 1.166) 〕, noise history〔OR=3.886, 95%CI (1.077, 14.022) 〕, non-light diet〔OR=2.445, 95%CI (1.127, 5.305) 〕, hypertension〔OR=1.8393, 95%CI (1.015, 3.330) 〕, diabetes〔OR=4.310, 95%CI (1.817, 10.225) 〕and hyperuricemia〔OR=3.174, 95%CI (1.030, 9.779) 〕were independent risk factors (P<0.05) . A total of 18 factors (male, overweight/obesity, living alone, widowed/divorced, noise history, family history of deafness, non-light diet, no exercise habits, smoking, drinking, wearing headphones, hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases, hyperuricemia, hypothyroidism, ototoxic drug use history) were included in the analysis as a result of the difference analysis and literature review. According to the ROC curve, combined scores of risk factors can predict hearing loss in the elderly with an area under the curve (AUC) of 0.777〔95%CI (0.721, 0.833) 〕, and the cut off value is 3.5. According to this study, a cumulative risk factor score of 4 defined the threshold for predicting hearing loss in the elderly. The elderly were then stratified into those with low risk of hearing loss (<4) and those with high risk of hearing loss (≥4) . The software for screening elderly hearing loss is developed on the WeChat platform. There are four parts in total: risk factors stratification assessment, screening version of the Hearing Impairment Scale (HHIE-s) for the elderly, general conclusions, and health education. From July to December 2020, a total of 78 elderly people were recruited to evaluatethe hearing loss screening software, with a completion rate of 55.1% (43/78) .A mode ratecor relation exists between cumulative risk factor scores and HHIE-s scale score (rs=0.360, P=0.018) . From January to March, 2021, a suitability evaluation questionnaire with 8 single item questions was administered to 106 general practitioners to determine the suitability of hearing loss screening software for the elderly. According to the 5-level Likert scale, the proportion of respondents who answered "completely agree" to each question is 85.8% (91/106) , 81.1% (86/106) , 71.7% (76/106) , 68.9% (73/106) , 68.0% (72/106) , 59.4% (63/106) , 15.1% (16/106) and 14.2% (15/106) respectively. Conclusion There are 18 risk factors for hearing loss in the elderly. The screening software for hearing loss in the elderly based on WeChat platform has a good effect in early warning of hearing loss in the elderly, which provides a medical basis for screening for hearing loss in the elderly. Hearing loss screening software can support real-time data transmission, optimize, and integrate the hierarchical assessment system of risk factors, HHIE-s and WeChat platform for self-health management. The screening software of hearing loss for the elderly offers general practitioners a new way to manage and control hearing loss provides a new way of hearing loss management and control for general practitioners at the grassroots.It is appropriate and enforceable.
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