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不同純音聽力平均閾值計算方式對聽障鑑定結果之可能影響

Probable Effects of Hearing Handicap Authentication When Using Different Methods to Calculate the PTA Threshold

Abstracts


BACKGROUND: Hearing handicap authentication is one of the major responsibilities of otorhinolaryngologists, but the calculation method for the average hearing threshold is not the same across the different hospitals in Taiwan. We discuss the probable effect of handicap authentication on patients with hearing impairment when using different calculation methods for the average hearing threshold. These included the three-frequency average (500, 1,000, 2,000 Hz), the four-frequency average (500, 1,000, 2,000, 4,000 Hz), the 1,000 Hz weighted four-frequency average (500, 1,000, 1,000, 2,000 Hz), and the 1,000 & 2,000 Hz weighted six-frequency average (500, 1,000, 1,000, 2,000, 2,000, 4,000 Hz). MATERIALS AND METHODS: Between January 2004 and December 2007, audiometric data was retrospectively collected from 586 patients (366 males and 220 females) who had passed through the hearing handicap authentication process using the three-frequency pure-tone average method. We re-calculated the average hearing threshold using the various different calculation methods, re-authenticated the hearing handicap, and compared the results with the three-frequency pure-tone average method. RESULTS: There are statistically significant differences in hearing handicap authentication between the three-frequency pure-tone average method and the other calculation methods (p<0.05). After we re-authenticated using the four-frequency average method, the level of hearing handicap changed for 135 patients (23.04%) with 21.67% becoming more severe and 1.37% becoming milder. When the 1,000 Hz weighted four-frequency average method was used, the level of hearing handicap changed for 23 patients (3.92%) with 0.85% becoming more severe and 2.90% becoming milder. Furthermore, on using the 1,000 & 2,000 Hz weighted six-frequency average method, the level of hearing handicap changed for 125 patients (21.33%) with 20.31% becoming more severe and 1.02% becoming milder. When the change in level of hearing handicap was compared between methods, the four-frequency average method produced the greatest change towards a more severe handicap and the 1,000 Hz weighted four-frequency average method gave the greatest change towards milder handicap. CONCLUSION: The different calculation methods gave very different results for the hearing threshold average and this influences the level of hearing handicap authentication Otorhinolaryngologists need to make use of identical calculation methods when evaluating hearing threshold average and this will help to ensure that hearing handicap authentication is more equitable across Taiwan.

Parallel abstracts


BACKGROUND: Hearing handicap authentication is one of the major responsibilities of otorhinolaryngologists, but the calculation method for the average hearing threshold is not the same across the different hospitals in Taiwan. We discuss the probable effect of handicap authentication on patients with hearing impairment when using different calculation methods for the average hearing threshold. These included the three-frequency average (500, 1,000, 2,000 Hz), the four-frequency average (500, 1,000, 2,000, 4,000 Hz), the 1,000 Hz weighted four-frequency average (500, 1,000, 1,000, 2,000 Hz), and the 1,000 & 2,000 Hz weighted six-frequency average (500, 1,000, 1,000, 2,000, 2,000, 4,000 Hz). MATERIALS AND METHODS: Between January 2004 and December 2007, audiometric data was retrospectively collected from 586 patients (366 males and 220 females) who had passed through the hearing handicap authentication process using the three-frequency pure-tone average method. We re-calculated the average hearing threshold using the various different calculation methods, re-authenticated the hearing handicap, and compared the results with the three-frequency pure-tone average method. RESULTS: There are statistically significant differences in hearing handicap authentication between the three-frequency pure-tone average method and the other calculation methods (p<0.05). After we re-authenticated using the four-frequency average method, the level of hearing handicap changed for 135 patients (23.04%) with 21.67% becoming more severe and 1.37% becoming milder. When the 1,000 Hz weighted four-frequency average method was used, the level of hearing handicap changed for 23 patients (3.92%) with 0.85% becoming more severe and 2.90% becoming milder. Furthermore, on using the 1,000 & 2,000 Hz weighted six-frequency average method, the level of hearing handicap changed for 125 patients (21.33%) with 20.31% becoming more severe and 1.02% becoming milder. When the change in level of hearing handicap was compared between methods, the four-frequency average method produced the greatest change towards a more severe handicap and the 1,000 Hz weighted four-frequency average method gave the greatest change towards milder handicap. CONCLUSION: The different calculation methods gave very different results for the hearing threshold average and this influences the level of hearing handicap authentication Otorhinolaryngologists need to make use of identical calculation methods when evaluating hearing threshold average and this will help to ensure that hearing handicap authentication is more equitable across Taiwan.

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