以捻指音及鍾錶音為聽篩工具之初步報告

背景：聽力損失是一常見的失能，目前篩檢工具有問卷、音叉測試等，但測試環境之噪音影響並不清楚。本研究採用鐘錶音測試法、弱捻指音測試法、強捻指音測試法在聽力檢查室與安靜開放空間中測試環境下做檢測，並比較此三種測試法其敏感度及特異度。方法：於耳鼻喉科門診主訴耳鳴或聽力不佳者，共39名受試者（男性25名，女性14名），78支耳朵，年齡從21歲到86歲（中位數54歲）。於聽力檢查室接受純音聽力檢查，受試者平均39.6 dB HL。利用鐘錶滴答音及捻指音作測試工具，訂定3種測試法：鐘錶音測試法、弱捻指音測試法、強捻指音測試法，分別於聽力檢查室及安靜開放空間採上述測試法施測，並以不同聽力閾值作為標準，計算敏感度及特異度，及接受者操作特徵曲線（Receiver Operating Characteristic curve, ROC曲線）及曲線下的面積（Area Under Curve, AUC），由此比較這些測試法對於聽損之區分能力。結果：在聽力檢查室中，強捻指音測試法、弱捻指音測試法、鐘錶音測試法其AUC分別為0.94、0.89、0.87；在安靜開放空間中，AUC分別為0.91、0.88、0.87。強捻指音測試法對於聽損劣於30 dBHL者敏感度達88%－90%，特異度達83%－89%，強捻指音測試法在三者AUC最高表示對聽損區分能力最大。結論：在一般安靜環境下之強捻指音測試法與聽力檢查室中相比其敏感度、特異度差異不大，建議可作為聽損篩檢工具。

關鍵字

聽力損失；床邊測試；聽力篩檢；捻指音測試法；鐘錶音測試法

並列摘要

BACKGROUND: Hearing loss is common in general population. The effects of environmental noises to the screening tools such as the questionnaire test and tuning forks test remain unclear. The study is to compare the sensitivities and specificities of three different screening tools in the auditory test room and in the open quiet room.METHODS: Thirty-nine subjects (25 men and 14 women, total 78 ears), aged from 21years to 86 years (median 54 years), with the presentations of tinnitus and/or hearing loss were enrolled. The mean hearing threshold level of all subjects was 39.6 dB HL. Three hearing screening tools, including watch-tick test, strong finger-rub test, and faint finger-rub test, were arranged in an random order. The tests were performed in the auditory test room and then in the open quiet room. The sensitivities and specificities of each tool were calculated according to the criteria of hearing loss using the hearing threshold levels of 15 to 80 dB HL. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were obtained from the acquired sensitivities and specificities.RESULTS: In the auditory test room, the AUC of strong finger-rub test, faint finger-rub test, and watch-tick test is 0.94, 0.89, and 0.87, respectively. In the open quiet room, the AUC is 0.91, 0.88, and 0.87, respectively. The sensitivities to detect the subjects with a hearing threshold level of worse than 30 dB HL using strong finger-rub test were 88% to 90% and the specificities were 83% to 89%. Among the three tests, the AUC was the greatest for strong finger-rub test, which implied the discriminatory ability is the best of the three tools.CONCLUSIONS: The sensitivity and specificity of strong finger-rub test in the auditory test room was similar as those in the open quiet room. We recommended strong finger-rub test as a hearing screening tool to detect a hearing loss worse than 30 dB HL.

並列關鍵字

hearing loss ； bedside test ； hearing screen ； finger-rub test ； watch-tick test

國際替代計量

以捻指音及鍾錶音為聽篩工具之初步報告

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