摘要
目的:探究基于互联网技术的噪声下数字识别阈(DIN)测试发现感音神经性聋的灵敏度和特异性,以期为临床提供一种快速有效的筛查工具。方法:本研究招募50例成人受试者,其中听力正常人34例、感音神经性聋患者16例。依次完成纯音听阈测试、声导抗测试以及噪声下DIN测试。采用皮尔逊相关系数分析纯音听阈与噪声下DIN阈值的相关性,采用受试者工作特征曲线(ROC曲线)及曲线下面积确定该测试材料的特征值、灵敏度和特异性。结果:(1)本组受试者噪声下DIN阈值与纯音平均听阈PTA_((500+1 000+2 000+4 000)Hz)之间呈高度相关(皮尔逊相关系数=0.85,P<0.01),2种测试方法的相关性优于荷兰语版本测试材料。(2)基于互联网技术的噪声下DIN测试材料的最佳诊断截点为-0.95dB,即噪声下DIN阈值大于该值时则怀疑存在听力损失,应转诊至听力中心进行诊断学检查。(3)以-0.95dB为最佳诊断截点时该测试材料发现感音神经性聋的灵敏度为0.938、特异性为0.941。结论:基于互联网技术的噪声下DIN测试具有操作简便、易于推广、敏感度和特异性高的特点,可为实施大群体成人听力筛查提供一种有效工具。
Objective：The aim of this study is to explore the sensitivity and specificity of the internet-based digital noise threshold（DIN）test for detecting noise-induced hearing loss,expecting to provide a rapid and effective screening tool for clinical application.Method：This study enrolled 50 adult subjects,of which 34 were normal hearing（NH）,16 patients with sensorineural hearing loss（SNHL）.Pure-tone audiometry,acoustic immittance and DIN test were tested respectively.Pearsons correlation coefficient was used to analyze the correlation between NH and SNHL.The eigenvalues,sensitivities and specificities of the tested materials were determined by receiver operating characteristic curve（ROC curve）and the area under the curve.Result：（1）The correlation between the speech recognition threshold（SRTn）and pure tone audiometry thresholds（average of 0.5,1,2 and 4 kHz）was0.85（P〈0.01）.（2）The optimal cut off point for DIN-based test materials under noise based on Internet technology was-9.5 dB,which means that hearing loss is highly suspect when DIN is above this value under noise and should be referred to a hearing center for diagnostic tests.（3）The sensitivity and specificity was 0.938 and 0.941 respectively with-0.95 dB as the best cutoff point.Conclusion：This DIN test based on Internet,which has an excellent performance as a hearing screening method with good sensitivity and specificity,could be an effective tool for large-scale adult hearing screening.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2018年第3期202-205,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
北京市科技新星项目(No:Z151110000315064)
北京市卫生系统高层次卫生技术人才培养计划(No:2015-3-019)
关键词
成人
听力筛查
互联网
adults
hearing screening
internet
