ABSTRACT
BACKGROUND: Hearing impairment is one of the most common physical handicaps of the aged. This diseases has recently attracted such amount of social attention and understanding as never attracted several years ago, and high degree of achievement was made with regard to screening test method, diagnosis, treatment and rehabilitation. However, unfortunately, even now, not enough attention is being paid upon early discovery hearing handicap for patients frequently encountered in clinics. Therefore, as a screening test method of senile hypacusis, we were to apply "Hearing Handicap Inventory for the Elderly Screening Version" (HHIE S) inquiries in Korea and studied the usability, sensitivity, specificity, positive predictive value and negative predictive value and cutoff point of this method. METHODS: This study was performed for 120 persons over the age of 60, who visited general health screening centers of one university hospital located in Seoul, during the period of October 1997 through to March 1999. HHIE S questionnaires were used and pure tone audiometry was performed to generate gold standard. RESULTS: Only 110 out of 120 initial subjects were included in the study because of incomplete questionnaire answers by excluded 10 subjects. We defined gold standard of hearing handicap to be (1) lower than 40 dB of hearing capability of both ears to frequency between 1000 Hz and 2000 Hz or (2) lower than 40 dB of hearing capability of an ear to frequency between 1000 Hz and 2000 Hz, as determined by pure tone audiometry. Assuming cutoff point of HHIE S as 4 points, the sensitivity and specificity resulted to be 80% and 67% each. Assuming cutoff point of HHIE S as 6 points, the sensitivity and specificity were 76% and 78% each. At 8 points, the percentages were 64% and 80%. At 10 points, the percentages were 64% and 85%. As a result of this study, the appropriate cutoff point is 6 points. In order to specify the correlation between questionnaire result and pure tone audiometry, we performed 500 Hz, 1000 Hz and 2000 Hz audiometry which are within conversational range, calculated arithmetic mean from the results, and inspected correlation between the resultant mean of the better performing ear and questionnaire resultant points. The correlation coefficient was 0.612 and Chronbach's alpha, as a measurement of internal consistency of the questionnaire was 0.9044. CONCLUSION: HHIE S proved to be useful in screening hearing handicap in the Korean elderly.
Subject(s)
Aged , Humans , Audiometry , Diagnosis , Ear , Hearing Loss , Hearing , Korea , Mass Screening , Rehabilitation , Sensitivity and Specificity , Seoul , Surveys and QuestionnairesABSTRACT
Background : There is a substantial body of evidence that intraocular pressure increase with age among western population. However, Japanese study showed that intraocular pressure was inversely related with age. So we investigated whether intraocular pressure is related with age for Koreans. Methods : Between March, 1996 and February, 1997, 6201 subjects underwent comprehensive health examinationinthe Kyung Hee medical screening center in Seoul, Korea. The intraocular pressure was measured with pneumatonograpyh. At the same time blood pressure, body weight, height, serum osmolarity, fasting blood glucose, T3, T4, TSH(thyroid stimulating hormone), hematocrit measurements were performed. We selected 250 case randomly and investigated whether the distribution of C/D ration(cup/disk ratio), smoking status, alcohol drinking amount are uniform by aged group. So we measured C/D ratio by fundusphotograph and investigated smoking and drinking habits by questionnaires. Results : In the randomly sampled 250 cases, the amounts of smoking and alcohol consumption were lower in the elderly group. But, the C/D ration didn't show any difference between young and elderly group. In a multivariable analysis, both right and left intraocular pressure showed significantly inverse correlations with aged and visual acuity. Male had significantly higher intraocular pressure than female. Both right and left intraocular pressure showed significant positive correlations with body mass index, fasting blood glucose, hematocrit and systolic blood pressure. Diastolic blood pressure, serum osmolarity, T3 and T4 were not associated with intraocular pressure. TSH had significant positive correlation with right intraocular pressure, but no correlation with left intraocular pressure. Conclusion : Age was independently and inversely related with intraocular pressure for Koreans.