诊断噪音引起的听力损失的指导方针及其特异性
Mark E Lutman1, John de Carpentier2, Kevin Green3
1Emeritus Professor of Audiology, University of Southampton, Southampton, UK.
概括
诊断噪声引起的听力损失 (NIHL) 的新指南显示特异性较差,导致频繁的假阳性结果. 这些发现表明,医疗专家在使用MLC指南进行NIHL诊断时应谨慎使用.
科学领域:
- 听力学 听力学是指听力学.
- 职业健康 职业健康 职业健康
- 公共卫生 公共卫生
背景情况:
- 噪音引起的听力损失 (NIHL) 是一个重大的公共卫生问题.
- 准确的NIHL诊断对于适当的管理和预防至关重要.
- 摩尔,洛威和考克斯 (MLC) 最近的指导方针旨在标准化NIHL诊断.
研究的目的:
- 评估MLC指南诊断NIHL的特异性.
- 将MLC指南的特异性与先前存在的诊断标准进行比较.
主要方法:
- 应用了MLC指导方针和以前的指导方针对三个数据集.
- 数据集包括来自NHS ENT诊所的成年患者和两个大型人口研究.
- 参与者 (n=3786) 拒绝显著的噪音暴露,作为对照组.
主要成果:
- 在MLC指南中,在不同噪音暴露场景中,虚假阳性率中等至高.
- 对于稳定的宽带噪声,MLC指南在人口样本中具有56%的假阳性率,而前面的指南为31%.
- 对于MLC指南,错误阳性率在人口样本中约为70%的冲动声音和80%的强烈音色.
结论:
- 与现有方法相比,MLC指南的特异性明显较差.
- 根据目前的MLC指南,存在错误阳性NIHL诊断的很高可能性.
- 在使用MLC指南时,医疗专业人员应该意识到具体性的限制.
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