[Comparative study on hearing screening tools for the elderly population in Beijing area]

Objective:To evaluate the hearing health status of the elderly in community settings in Beijing, and to compare the application effectiveness of the Hearing Handicap Inventory for the Elderly-Screening Version（HHIE-S） questionnaire, simple device screening, and audiometer screening. Methods:A total of 722 elderly individuals aged 60 years and above from 5 community health service centers in Beijing were enrolled between October and November 2024. Screening was conducted using the HHIE-S questionnaire, simple devices, and an audiometer. Data were analyzed with SPSS 25.0 software to determine the prevalence of hearing loss among the elderly. The Kappa test was used to assess the consistency between the results of HHIE-S questionnaire screening, simple device screening, and audiometer screening; the McNemar test was applied to analyze the presence of systematic bias. The intraclass correlation coefficient（ICC） and Bland-Altman plots were used to verify the consistency of hearing threshold measurements between simple device screening and audiometer screening. Results:Among the 722 subjects, 53.2% of the elderly had a 4-frequency pure-tone average（4fPTA）≥35 dB HL in the better ear. The McNemar test showed no statistically significant differences between the results of simple device screening（P=0.161） or HHIE-S questionnaire screening（P=0.195） and those of audiometer screening. The Kappa value for consistency between simple device screening and audiometer screening was 0.846（P<0.001）, with a sensitivity of 93.43% and a specificity of 92.00%. In the frequency range of 500-8 000 Hz, 89.7% of measurements showed a threshold difference of ≤10 dB between simple device screening and audiometer screening; the ICC for each frequency was>0.8, and only 3.59% of data points in the Bland-Altman plots fell outside the 95% limits of agreement. The Kappa value for consistency between HHIE-S questionnaire screening and audiometer screening was 0.420（P<0.001）, with a sensitivity of 77.54% and a specificity of 65.20%. Conclusion:The consistency between simple device screening and audiometer screening results is extremely strong, while the consistency between HHIE-S questionnaire screening and audiometer screening is moderate. Both methods can be used for large-scale hearing screening, and the appropriate screening tool can be selected based on the actual resource conditions of the community.