听力障碍筛查量表用于老年人群听力筛查分析  

HHIE-S Scale for Hearing Screening in the Elderly Population

作　　者：胡娴亭 黄治物[1,2] 陈建勇[1,2] 梅玲[1,2] 李蕴[1,2] 任燕[1] 唐职健[1] 沈敏[1] 张勤[1] 吴皓[1] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092 [2]上海交通大学医学院耳科学研究所

出　　处：《听力学及言语疾病杂志》2014年第3期230-234,共5页Journal of Audiology and Speech Pathology

基　　金：十二五国家科技支撑计划项目(2012BAI12)

摘　　要：目的探讨中文版老年听力障碍筛查量表(the hearing handicap inventory for the elderly-screening version,HHIE-S)用于老年人群听力筛查的可行性及实用性。方法随机选取840例年龄大于60周岁的老年人,先自行填写HHIE-S量表,然后在工作人员指导下再次填写,对比指导前后HHIE-S量表的得分,计算指导后量表的信度Cronbach'sα值,判断量表的可行性;所有填表者均进行0.5、1.0、2.0、4.0kHz纯音听阈测试,计算平均纯音听阈(PTA)值,比较筛查目标听力损失分别设定为PTA>25dB HL、PTA>40dB HL、PTA>60dB HL时,HHIE-S得分>8分与>10分及指导前后所填量表的灵敏度、特异度、阳性预测值、假阳性率及假阴性率,并根据ROC曲线及曲线下面积值(AUC),判断三种目标听力损失时量表的实用性。结果 840例老年人指导前后HHIE-S量表平均得分分别为7.6±10.6和10.8±16.7分(P<0.01),指导后量表的Cronbach'sα值为0.85;以HHIE-S>8分作为听力障碍判断标准时较HHIE-S>10分灵敏度高,假阴性率低(P<0.05);指导后且以HHIE-S>8分时PTA>25dB HL、PTA>40dB HL及PTA>60dB HL三种听力损失条件下ROC曲线下面积值分别为0.70±0.03、0.84±0.01及0.88±0.02。结论适当指导后,HHIE-S量表用于老年人听力筛查得分>8分即可认为存在听力障碍,目标听力损失为PTA>40dB HL时,HHIE-S量表的实用性强,汉化版HHIE-S量表可作为老年人群听力障碍有效的筛查方式。Objective To investigate the reliability and practicality of Chinese version the hearing handicap in-ventory for the elderly -screening version（HHIE -S） scale for elderly hearing screening in China .Methods We compared the HHIE -S scores with results of pure -tone audiometry test .A total of 840 Chinese individuals older than 60 years filled in the scale all by themselves first ,then refilled it according to explanations of each question translated by researchers .All participants finished pure -tone audiometry test with frequencies of 0 .25 ,0 .5 ,1 .0 , 2 .0 ,and 4 .0 kHz .Sensitivity ,specificity ,positive predictive value （PPV ） ,false-negative rate and false -positive rate were compared with HHIE -S cut -off points of 〉8 or 〉10 and pure-tone averages （PTAs） greater than 25 ,40 and 60 dB HL .Analysis the area under the curve （AUC） values of receiver operating characteristic （ROC） curves for each three PTA levels .Results Cronbach＇s α of the scale was 0 .85 .HHIE -S scale pre -explanatory score was 7 .6 ± 10 .6 ,and post-explanatory score was 10 .8 ± 16 .7（P〈0 .01） .HHIE -S〉 8 points higher than H HIE-S〉 10 points in the sensitivity ,positive predictive value increase ,specificity ,false-positive rate ,false negative rate decreased ,paired samples t - test sensitivity and false -negative rate （P〈 0 .05） .After the guide meanwhile HHIE-S cut-off points of 〉 8 when grouping with PTA〉 25 dB HL ,PTA〉 40 dB HL and PTA〉60 dB HL ,conducted ROC curve analysis ,the AUC value was 0 .70 ± 0 .03 ,0 .84 ± 0 .01 and 0 .88 ± 0 .02 .Conclusion The score of HHIE-S scale〉8 points can be used when PTA〉 40 dB HL as goal for hearing loss of old people , it can be more accurate after explanations ,so HHIE-S scale can be used as a preliminary hearing screening method for Chinese elderly people .

关 键 词：老年性聋 老年听力障碍筛查量表 听力筛查 HEARING HANDICAP inventory for the elderly -screening version (HHIE-S) 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]