A Simple Nomogram for Predicting Extended High-Frequency Hearing Loss in Pilots Despite Normal Audiometry: A...

Area of Science:

• Audiology
• Aerospace Medicine
• Preventive Medicine

Background:

• Extended high-frequency (EHF) hearing is sensitive to noise exposure and can indicate early noise-induced hearing loss (EHFHL).
• EHFHL may impact pilots' auditory perception, communication, and response capabilities during flight.
• Current pilot medical assessments in China do not include EHF screening, delaying early identification of potential hearing issues.

Purpose of the Study:

• To develop and validate a predictive nomogram for EHFHL in pilots with normal audiograms.
• To provide an early intervention tool for identifying pilots at risk of EHFHL.
• To enhance hearing health monitoring and flight safety protocols for aviators.

Main Methods:

• A cohort of 1091 pilots was divided into training (763) and validation (328) sets.
• Least absolute shrinkage and selection operator (LASSO) regression identified key predictors in the training set.
• Multivariable binary logistic regression was used to construct the nomogram, with performance assessed for calibration, discrimination, and clinical utility.

Main Results:

• The nomogram incorporated left/right ear high-frequency audiometry threshold averages (HFAs), flight time, and triglyceride levels.
• The model demonstrated good predictive performance with an area under the curve (AUC) of 0.819 in the training set and 0.771 in the validation set.
• The nomogram was well-calibrated and showed significant clinical utility for early detection of EHFHL.

Conclusions:

• The developed nomogram is the first validated tool for predicting EHFHL in Chinese pilots.
• The model's reliability and clinical utility support its use for early detection and personalized monitoring of pilot hearing.
• Findings can inform hearing protection strategies and improve overall flight safety.