中文版老年听力障碍筛查量表临床应用评价

The Evaluation of the Practice of the HHIE-S Scale for Hearing Screening in the Elderly Population

目的研究中文版老年听力障碍筛查量表(Chinese version hearing handicap inventory for the elderly screening,CHHIE-S)在老年人听力筛查中的应用价值,评价其敏感性和特异性。方法对840例老年人进行纯音听阈测试筛查及CHHIE-S量表调查,根据量表得分,分析量表的信度指标,计算量表的内部一致性信度Cronbach'sα值,判断量表的整体可行性;计算0.5、1.0、2.0、4.0kHz平均纯音听阈(PTA)值,将筛查目标听力损失设定为PTA>25、PTA>40、PTA>60dB HL三种水平;参照美国言语听力协会听力筛查指南标准,将CHHIE-S量表得分大于8分定义为存在听力障碍,探讨CHHIE-S量表对不同目标听力损失老年人听力筛查的敏感性和特异性。结果 CHHIE-S量表的内部一致性信度好,Cronbach'sα值为0.85;CHHIE-S量表对目标听力损失为PTA>25、PTA>40及PTA>60dB HL老年人听力筛查的敏感性分别为45.8%、74.6%和96.7%,特异性分别为97.7%、83.0%和41.4%;CHHIE-S量表得分>8分与目标听力损失为PTA>25、PTA>40及PTA>60dB HL老年人听力损失程度的相关性具有统计学意义,相关系数分别为0.186、0.392和0.370(均为P<0.05)。结论 CHHIE-S量表具有较好的内部一致性信度;以CHHIE-S量表得分>8分作为PTA>40dB HL目标听力损失的听力筛查标准,具有良好的敏感性和特异性,可用于临床上老年人群听力筛查。

Objective To determine and evaluate the sensitivity and specificity of the Chinese version of the hearing handicap inventory for the elderly screening （CHHIE -S） in China .Methods A total of 840 subjects were assessed with the CHHIE -S scale .The internal consistency reliability of the CHHIE -S was evaluated according to the scale scores of each item .All participants finished pure -tone audiometry test with frequencies of 0 .5 ,1 .0 , 2 .0 ,and 4 .0 kHz .The CHHIE-S＇sensitivity ,specificity ,and co -relationship with different degrees of hearing loss were analyzed according to the American Speech -Language-Hearing Associations draft guidelines that sug‐gested a total HHIE -S cut-off points〉8 as indicating the presence of hearing handicap .Results ①The CHHIE-S showed a high internal consistency reliability （ Cronbach＇s α was 0 .85 ）;② For the detection of hearing loss PTA〉25 dB HL （i .e .,pure tone average at 0 .5~4 kHz frequencies 〉25 dB） ,the HHIE-S cut-off score of 〉8 had a sensitivity of 45 .8% and a specificity of 97 .7% ;PTA〉40 dB HL had a sensitivity of 74 .6% and a specificity of 83 .0% ;and PTA〉60 dB HL had a sensitivity of 96 .7% and a specificity of 41 .4% ;③The correlation between CHHIE -S score and hearing loss with PTA 〉25 dB HL ,PTA〉40 dB HL ,and PTA〉60 dB HL were 0 .186 , 0 .392 and 0 .370 ,respectively .Conclusion The CHHIE-S had good internal consistency reliability .Both sensitivity and specificity were better when PTA 〉 40 dB HL as goal to screen elder people for hearing loss .