Study of hearing screening for rural school children

Xiaolu Li; Xingkuan Bu; Carlie Driscoll

摘要：Objective: To develop an appropriate mass screening system to evaluate hearing loss for primary school children, especially in rural areas. Methods: In Jiangsu Province, at a rural primary school-Longdu Primary School, 317 of 479 rural students (from Grade 1 to Grade 6, over 50 students for each grade) were screened by, using the Chinese Hearing Questionnaire for School Children (CHQS). Two weeks later, they accepted transiently evoked otoacoustic emissions (TEOAEs) test. At the same time, all participants were given a 'gold standard' audiological assessment that comprised of otoscopy, pure tone, and tympanometry. After eight weeks, 103 out of the 317 students accepted the second TEOAEs and 'gold standard' test to confirm the results. Results: There was no statistical difference in the results of two 'gold standard' test (χ2 = 0.14, 0.5 ＜ P ＜ 0.75). Compared with the 'gold standard' results, the hit rate, sensitivity, specificity of the CHQS was 57% ± 2.78%, 61% ± 10.18%, 57%± 2.89% respectively(α = 0.43, β = 0.39). Youden Index J, LR+, LR-, PV+ and PV- was 0.18 ± 0.11, 1.42, 0.68, 0.10, 0.95(Az ＜ 0.54, EF = 0.75-0.95). While a higher system accuracy was obtained by TEOAEs [HR = 97 ± 0.71%, Sen = 69 ± 7.8%,Spe = 98 ± 0.52%(α = 0.02, β = 0.31), Youden Index J = 0.67 ± 0.08, LR+ = 34.5, LR- = 0.32, PV+ = 0.71, PV- = 0.99(Az = 0.85, EF = 0.97)]. Conclusion: TEOAEs got a high efficiency and specificity values with reasonable sensitivity. However,CHQS needs substantial modifications to improve its sensitivity in evaluating hearing loss.