Objective Hearing Loss Research Articles

Hearing Loss, Incident Parkinson Disease, and Treatment With Hearing Aids

The risk of developing Parkinson disease (PD) after objective hearing loss is unknown. PD studies using self-reported hearing loss are insensitive, and objective data are lacking. To examine the association of hearing loss with incident PD in US veterans and its effect modification by well-established prodromal conditions and hearing aids. This cohort study analyzed electronic health record data from the US Department of Veterans Affairs for veterans who had an audiogram from January 1, 1999, to December 30, 2022. Individuals with data missing or a preexisting PD diagnosis were excluded. Audiogram-confirmed hearing loss. Cumulative incidence of PD was calculated with adjustment for competing risk of death. Among 7 296 051 veterans with an audiogram, 3 596 365 were included. They were mostly male (n = 3 452 898 [96%]) and had a mean (SD) age of 67 (10.3) years. A total of 750 010 individuals (20.8%) had normal hearing at the time of audiometry examination; among those with hearing loss, 1 080 651 (30.0%), 1 039 785 (28.9%), 568 296 (15.8%), and 157 623 (4.3%) individuals had mild (20-<35 dB), moderate (35-<50 dB), moderate to severe (50-<65 dB), and severe to profound (65-120 dB) hearing loss, respectively. Age, gender, and smoking history were balanced between all exposed and unexposed groups with further adjustment for race, ethnicity, and frailty. At 10 years after the baseline audiogram, the numbers of additional cases of PD were 6.1 (95% CI, 4.5-7.79, 15.8 (95% CI, 12.8-18.8), 16.2 (95% CI, 11.9-20.6), and 12.1 (95% CI, 4.5-19.6) among veterans with mild, moderate, moderate to severe, and severe to profound hearing loss, respectively, compared with those with normal hearing. When combined with established prodromal conditions, hearing loss was associated with 5.7 (95% CI, 2.2-9.2) additional cases of PD at 10 years compared with either condition alone. With prompt hearing aid dispensation, incident cases of PD decreased by 21.6 cases (95% CI, 19.5-23.6) at 10 years. Hearing loss appears to be an independent risk factor for later development of PD. Hearing aids attenuate this risk, and therefore widespread screening for hearing loss and appropriate use of hearing aids may reduce the incidence of PD. Additional studies are needed to examine the mechanisms underlying the association between hearing loss and PD.

Understanding pediatric inpatient conductive hearing loss: An analysis of patient demographics

ObjectiveHearing loss is a common sensory impairment in children that affects quality of life and development. Early intervention, such as hearing aids and communication therapies, can help children overcome these challenges and lessen the impact on their development. The objective of this study was to identify specific patient demographic factors correlated with the prevalence of pediatric conductive hearing loss. Study designThe study utilized the Kids' Inpatient Database (KID) by the Agency for Healthcare Research and Quality which collects inpatient information from hospitals for patients under 21 years old. We included all patients discharged in 2016 diagnosed with conductive hearing loss, and excluded neonatal patients discharged within 28 days of birth. MethodsStatistical analyses were performed using R Studio and IBM SPSS Statistics. Weighted odds ratios were calculated for conductive hearing loss in relation to race and income, and a multivariate regression analysis examined associations between demographic variables and race categories in conductive hearing loss. ResultsThe prevalence of conductive hearing loss (CHL) in pediatric patients in 2016 was 51.62 cases per 100,000 patients. Non-Hispanic White patients had the highest prevalence, while Black patients had the highest likelihood of CHL compared to the overall population. Lower income levels were associated with a decreased probability of CHL diagnosis. After adjusting for age, sex, hospital region, insurance, and income on multivariate analysis, White and Black patients were less likely to be diagnosed with CHL. Furthermore, patients in specific income quartiles also had lower CHL likelihood compared to the general population. ConclusionWhile Black patients had a higher likelihood of being diagnosed with CHL than the general population, socioeconomic factors such as income greatly influenced the likelihood of CHL diagnosis. Other significant factors included income, region of the country, sex, and age. Further research is needed to better understand and address healthcare disparities related to pediatric hearing loss.

Association Between Limited English Proficiency and Hearing Healthcare Use in the United States.

To determine whether limited English proficiency (LEP) is associated with likelihood of prior audiogram and hearing aid use among US adults with hearing loss. This cross-sectional study of four merged National Health and Nutrition Examination Survey (NHANES) cycles included 12,636 adults with subjective (self-reported) or objective (audiometric) hearing loss. Subjects were classified as LEP if they completed the NHANES survey in a language other than English, or with the help of an interpreter. Likelihood of audiogram among participants with subjective and objective hearing loss, and likelihood of hearing aid use among participants with objective hearing loss were assessed using unadjusted and adjusted logistic regression. Individuals with LEP were less likely to have undergone audiogram among subjects with subjective (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.67-0.77), and objective (OR 0.70, 95% CI 0.65-0.74) hearing loss. The association persisted for those with subjective hearing loss (OR 0.79, 95% CI 0.72-0.86), and objective hearing loss (OR 0.81, 95% CI 0.73-0.89) after adjusting for relevant covariates. Individuals with LEP were less likely to use hearing aids (OR 0.88, 95% CI 0.84-0.93). This association disappeared (OR 0.99, 95% CI 0.95-1.04) after adjustment. LEP is associated with lower utilization of hearing healthcare services. This may be due to the complex interplay of socioeconomic and language disparities, which may act as barriers to hearing healthcare utilization. Individuals with LEP should be prioritized when designing interventions to improve accessibility to hearing healthcare. Level 3 Laryngoscope, 2024.

Immigrant Status Disparities in Hearing Health Care Use in the United States.

To determine whether immigrant status is associated with likelihood of audiogram and hearing aid use among US adults with hearing loss. Cross-sectional study. Nationally representative data from 2009 to 2010, 2011 to 2012, 2015 to 2016, and 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) cycles. This cross-sectional study of 4 merged cycles of NHANES included 12,455 adults with subjective (self-reported) or objective (audiometric) hearing loss. Sequentially adjusted logistic regressions were used to assess the association of immigration status with likelihood of having undergone audiogram among those with objective and self-reported hearing loss, and with likelihood of hearing aid use among candidates with objective hearing loss. Immigrants were less likely to have received an audiogram among subjects with subjective (odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.75-0.87), and objective (OR: 0.76, 95% CI: 0.72-0.81) hearing loss, compared to nonimmigrants. The association persisted for those with subjective (OR: 0.88, 95% CI: 0.81-0.96), and objective (OR: 0.87, 95% CI: 0.80-0.96) hearing loss after adjusting for sociodemographic factors, comorbidities, insurance, and hearing quality, but disappeared in both groups after adjusting for English proficiency. Immigrants were less likely to use hearing aids (OR: 0.90, 95% CI: 0.87-0.93). However, this association disappeared (OR: 0.98, 95% CI: 0.93-1.04) in the adjusted model. Immigrant status is a significant barrier to hearing health care and is associated with lower rates of audiometric testing and hearing aid use among individuals with hearing loss.

Impact of Migraine and Vestibular Migraine on Audiometric Profiles and Quality of Life in Patients With Tinnitus.

To investigate the clinical manifestations and complete auditory function in primary tinnitus patients with and without migraine or vestibular migraine. Retrospective case-control study. A tertiary referral center. This study enrolled 298 patients from the Kaohsiung Veterans General Hospital. All patients were diagnosed with primary tinnitus by a neurotologist between April 2020 and August 2021. Patients were excluded if they had histories of chronic otitis media, idiopathic sudden sensorineural hearing loss, Ménière's disease, skull base neoplasm, or temporal bone trauma. Twenty-five-item Tinnitus Handicap Inventory (THI), speech audiometry including speech recognition threshold, most comfortable level, uncomfortable loudness levels, dynamic range, and pure-tone audiometry. Objective hearing loss is defined as a mean threshold greater than 25 dB. Extremely elevated THI is defined as a score greater than 1 standard deviation above the mean THI. Among the 298 patients with tinnitus, 149 were women and 149 were men, with a mean age of 57.06 (range, 19.22-94.58) years.A total of 125 patients completed the THI questionnaire during their initial visit. The median THI score was 32 (95% confidence interval: 13.98-56.00), and the mean score was 34.99 with a standard deviation of 21.01. The sole contributing factor significantly associated with higher total THI score was the diagnosis of migraine or vestibular migraine (p < 0.001, odds ratio = 19.41).Tinnitus patients with migraine or vestibular migraine exhibited significantly lower mean pure-tone auditory thresholds (right 22.2 versus 29.5, p = 0.002; left 22.5 versus 30.4, p < 0.001), speech recognition threshold (right 20.0 versus 25.2, p = 0.016; left 20.2 versus 25.5, p = 0.019), and most comfortable levels values (right 46.1 versus 51.4, p = 0.007; left 46.9 versus 51.4, p = 0.021) compared with the tinnitus patients without migraine. In this population-based study, patients with primary tinnitus experienced significantly higher THI scores and exhibited concurrent symptoms, including dizziness/vertigo, cervicalgia, and migraine or vestibular migraine. Among these parameters, the diagnosis of migraine or vestibular migraine was the sole contributor to significant higher THI score.

Subjective hearing loss is not associated with an increased risk of Alzheimer's disease dementia

Hearing loss is a risk-factor for dementia but the reasons for this are unclear. Subjective hearing loss is related to increased future dementia risk, however, this metric has not been previously examined with cognitive, neuroimaging and biochemical measures that are relevant to Alzheimer's disease. We assessed Cognitively Normal and Mild Cognitively Impaired participants from the Alzheimer's Disease Neuroimaging Initiative with subjective hearing loss to examine if they had faster decline in episodic memory scores, hippocampal volume and greater pTau positivity. The likelihood of a dementia diagnosis in hearing impaired participants over a 5-year period was also assessed. There were no statistically significant differences between the hearing subgroups over a 5-year period nor were there in conversions to a dementia diagnosis. Objective hearing loss metrics may provide a more reliable link between hearing loss and dementia risk.

POPULATION ATTRIBUTABLE FRACTIONS FOR THE CONTRIBUTION OF HEARING LOSS ON DEMENTIA RISK ACROSS COHORT STUDIES

Abstract Estimates range from 2-8% of dementia cases in the US are attributable to hearing loss. Here, we investigate measurement considerations in quantifying the population attributable fraction (PAF) of dementia from hearing loss to highlight how differences in methodology can underestimate the PAF. We use two cohort studies of older adults in the US: the National Health and Aging Trends Study (NHATS), a nationally-representative sample of older Medicare beneficiaries; and the Atherosclerosis Risk in Communities (ARIC) Study, a large, community-based cohort study with longitudinal follow-up. Each study collects reference-standard hearing measures on participants. We have two specific aims. First, we compare two valid, formula-based approaches to quantifying the PAF. The advantages of quantifying a PAF using a well-characterized, biracial, community-based sample with a longitudinal design are weighed against those of using a nationally-representative sample with a cross-sectional design (moderate or greater hearing loss: PAF in NHATS, 16.9% [95% CI: 4.1-28.7%]; PAF in ARIC, 13.2% [95% CI: 2.2-20.9%]), highlighting the need for longitudinal designs in studies of the PAF from hearing loss. Second, we describe the impact of subjective versus objective measures of hearing loss on the PAF. In ARIC, subjective hearing loss was not associated with incident dementia (hazard ratio &amp;lt;1.0). PAFs of dementia from objective hearing loss were 6- to 8-fold greater than PAFs previously quantified using self-reported hearing measures in population-based studies. Our findings have broad implications for the inclusion of hearing loss as a potentially modifiable risk factor in clinical and public health initiative for dementia prevention.

Auditory Brainstem Response Data Preprocessing Method for the Automatic Classification of Hearing Loss Patients

Auditory brainstem response (ABR) is the response of the brain stem through the auditory nerve. The ABR test is a method of testing for loss of hearing through electrical signals. Basically, the test is conducted on patients such as the elderly, the disabled, and infants who have difficulty in communication. This test has the advantage of being able to determine the presence or absence of objective hearing loss by brain stem reactions only, without any communication. This paper proposes the image preprocessing process required to construct an efficient graph image data set for deep learning models using auditory brainstem response data. To improve the performance of the deep learning model, we standardized the ABR image data measured on various devices with different forms. In addition, we applied the VGG16 model, a CNN-based deep learning network model developed by a research team at the University of Oxford, using preprocessed ABR data to classify the presence or absence of hearing loss and analyzed the accuracy of the proposed method. This experimental test was performed using 10,000 preprocessed data, and the model was tested with various weights to verify classification learning. Based on the learning results, we believe it is possible to help set the criteria for preprocessing and the learning process in medical graph data, including ABR graph data.

The acute vestibular syndrome: prevalence of new hearing loss and its diagnostic value

ObjectivesTo assess the prevalence of new hearing losses in patients with acute vestibular syndrome (AVS) and to start to evaluate its diagnostic value for the differentiation between peripheral and central causes.DesignWe performed a cross-sectional prospective study in AVS patients presenting to our Emergency Department (ED) from February 2015 to November 2020. All patients received an MRI, Head-impulse test, Nystagmus test and Test of skew (‘HINTS’), caloric testing and a pure-tone audiometry.ResultsWe assessed 71 AVS patients, 17 of whom had a central and 54 a peripheral cause of dizziness. 12.7% had an objective hearing loss. ‘HINTS’ had an accuracy of 78.9% to diagnose stroke, whereas ‘HINTS’ plus audiometry 73.2%. ‘HINTS’ sensitivity was 82.4% and specificity 77.8% compared to ‘HINTS’ plus audiometry showing a sensitivity of 82.4% and specificity of 70.4%. The four patients with stroke and minor stroke had all central ‘HINTS’. 55% of the patients did not perceive their new unilateral hearing loss.ConclusionsWe found that almost one-eighth of the AVS patients had a new onset of hearing loss and only half had self-reported it. ‘HINTS’ plus audiometry proved to be less accurate to diagnose a central cause than ‘HINTS’ alone. Audiometry offered little diagnostic accuracy to detect strokes in the ED but might be useful to objectify a new hearing loss that was underestimated in the acute phase. Complete hearing loss should be considered a red flag, as three in four patients suffered from a central cause.

Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study.

Hearing loss has been pointed out as a potential predictor for cognitive decline. This study conducted a systematic review to evaluate the scientific evidence on the association between hearing loss in the elderly and cognitive decline, as well as whether race/color influences this relationship. The search for studies was performed in the following electronic databases: MedLine/PubMed Web of Science, Scopus and Virtual Health Library, and MedRkiv up to August 2022. Studies with epidemiological designs that assess the association between hearing loss and cognitive decline in the elderly were eligible for inclusion. Three independent reviewers performed the selection, data extraction and evaluation of the quality of the studies using the Newcastle-Ottawa Scale. A meta-analysis using a random effects model estimated the global association measurements (Beta coefficient: β) and their 95% confidence intervals (95%CI), and the Higgins and Thompson indicator (I2) was also estimated to assess statistical heterogeneity among the studies. 5,207 records were identified in the database surveys, of which only 18 were eligible studies, totaling 19,551 individuals. Hearing loss was associated with cognitive decline in the elderly, with statistical significance: β = -0.13; 95%CI = -0.23 to -0.04; I2 = 98.70%). For black individuals, the magnitude of the association increased: β = -0.64; 95%CI = -3.36 to 2.07; I2 = 95.65%, but it was not statistically significant. The findings of this systematic review showed the existence of a significant relationship between hearing loss and cognitive decline in the elderly, as well as signaling that among black individuals the magnitude of the association can be increased.

Reasons for the non-use of hearing aids: perspectives of non-users, past users, and family members

Objective Hearing loss in the older adult population is a significant global health issue. Hearing aids can provide an effective means to address hearing loss and improve quality of life. Despite this, the uptake and continued use of hearing aids is low, with non-use of hearing aids representing a significant problem for effective audiological rehabilitation. The aim of this study was to investigate the reasons for the non-use of hearing aids. Design and study sample A cross-sectional survey was used to investigate the reasons given for the non-use of hearing aids by people with hearing loss (n = 332) and family members (n = 313) of people with hearing loss in Australia, the UK, and USA. Results Survey results showed that hearing aid non-users generally cited external factors as reasons for non-use, whereas family members reported non-use due to attitudinal barriers. Past users of hearing aids and family members of past users both identified devices factors as barriers to use. Conclusions Differences in reasons for non-use may provide further insight for researchers and clinicians and help inform future clinical practice in addressing the low uptake and use of hearing aids by people with hearing loss and the role of family members in audiological rehabilitation.

Subjective and Objective Hearing Loss Among US Adult Cancer Survivors

Cancer survivors are at a higher risk of developing hearing loss (HL) due to older age, chemotherapy, and radiotherapy. However, the prevalence of HL among US cancer survivors remains unknown. Additionally, there is a lack of uniform HL screening guidelines for this enlarging population. To estimate the prevalence of subjective HL and objective HL by audiometry test among cancer survivors and compare them with the general population as well as to assess the performance of subjective HL questions in detecting true (ie, audiometry-confirmed) HL. In a cross-sectional design, adults between ages 20 and 80 years who had audiometry testing and responded to a hearing questionnaire from the National Health and Nutrition Examination Survey (2011-2012, 2015-2016, and 2017 to March 2020 prepandemic survey cycles) were selected. Data analysis was conducted from August 13, 2022, to July 26, 2023. The weighted prevalence of subjective HL (troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry were calculated. Analyses with χ2 testing and multiadjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, areas under the curve were estimated using age- and gender-adjusted logistic regression. Among the total 9337 participants (weighted n = 90 098 441; 51.2% women), 10.3% were cancer survivors. Compared with the general population, cancer survivors had a higher prevalence of troublesome hearing (adjusted odds ratio [AOR], 1.43; 95% CI, 1.11-1.84), tinnitus (AOR, 1.28; 95% CI, 0.94-1.74), speech-frequency HL (AOR, 1.43; 95% CI, 1.11-1.85), and high-frequency HL (AOR, 1.74; 95% CI, 1.29-2.34). When using the subjective HL tool and questioning regarding whether the participants were having troublesome hearing and/or tinnitus in screening for HL, the age- and gender-adjusted area under the curve was 0.88 in detecting speech-frequency HL and 0.90 in detecting high-frequency HL. The findings of this study suggest that cancer survivors have a significantly higher prevalence of HL than the general population. Two subjective HL questions could potentially accurately identify those who have true HL and provide a simple and efficient screening tool for health care professionals. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and health care professionals should facilitate raising awareness and provide early screening and timely referral when HL is identified.

Subclinical hearing loss and educational performance in children: a national study

ObjectiveHearing loss can cause speech and language delays, communication barriers, and learning problems. Such factors are associated with reduced academic achievement, social isolation, decreased quality of life, and poorer health outcomes. We use a national cohort of children to examine how subclinical hearing loss is associated with academic/educational performance. The goal of this study is to determine if different levels of subclinical hearing loss (pure tone average ≤ 25 dB HL) are associated with educational testing outcomes in children.DesignAnalysis of children 6–16 years old who participated in the National Health and Nutrition Examination Survey (NHANES-III, 1988–1994) was performed. Air-conduction thresholds were measured at 0.5, 1, 2, 4, 6, and 8 kHz. A four-frequency pure-tone average (PTA) was calculated from 0.5, 1, 2, and 4 kHz. Hearing thresholds were divided into categories ( ≤ 0, 1–10, and 11–25 dB) for analysis. The outcomes of interest were the Wide Range Achievement Test (WRAT-R) and Wechsler Intelligence Scale for Children (WISC-R). Analysis was conducted using ANOVA and logistic regression.ResultsWe analyzed 3,965 participants. In univariable analysis, the average scores in scaled math, reading, digit span (short-term memory), and block design (visual-motor skills) were significantly lower with worsening hearing categories (p &amp;lt; 0.01). In multivariable regression PTAs of 1–10 dB HL (OR 1.72, 95% CI 1.29–2.29, p &amp;lt; 0.01) and 11-25 dB HL (OR: 2.99, 95% CI 1.3–6.65, p &amp;lt; 0.01), compared to PTA of ≤0 dB HL, were associated with poor reading test performance (&amp;lt;25th percentile).ConclusionSubclinical hearing loss is associated with worse performance on educational attainment (as measured by reading test performance) in children between the ages of 6–16.

Adverse health consequences of undiagnosed hearing loss at middle age: A prospective cohort study with the UK Biobank.

Hearing impairment is common in the middle-aged population but remains largely undiagnosed and untreated. The knowledge about to what extent and how hearing impairment matters for health is currently lacking. Thus, we aimed to comprehensively examine the adverse health consequences as well as the comorbidity patterns of undiagnosed hearing loss. Based on the prospective cohort of the UK Biobank, we included 14,620 individuals (median age 61years) with audiometry-determined (i.e., speech-in-noise test) objective hearing loss and 38,479 individuals with subjective hearing loss (i.e., tested negative but with self-reported hearing problems; median age 58years) at recruitment (2006-2010), together with 29,240 and 38,479 matched unexposed individuals respectively. Cox regression was used to determine the associations of both hearing-loss exposures with the risk of 499 medical conditions and 14 cause-specific deaths, adjusting for ethnicity, annual household income, smoking and alcohol intake, exposure to working noise, and BMI. Comorbidity patterns following both exposures were visualized by comorbidity modules (i.e., sets of connected diseases) identified in the comorbidity network analyses. During a median follow-up of 9years, 28 medical conditions and mortality related to nervous system disease showed significant associations with prior objective hearing loss. Subsequently, the comorbidity network identified four comorbidity modules (i.e., neurodegenerative, respiratory, psychiatric, and cardiometabolic diseases), with the most pronounced association noted for the module related to neurodegenerative diseases (meta-hazard ratio [HR]=2.00, 95%confidence interval [CI] 1.67-2.39). For subjective hearing loss, we found 57 associated medical conditions, which were partitioned into four modules (i.e., diseases related to the digestive, psychiatric, inflammatory, and cardiometabolic systems), with meta-HRs varying from 1.17 to 1.25. Undiagnosed hearing loss captured by screening could identify individuals with at greater risk of multiple adverse health consequences, highlighting the importance of screening for speech-in-noise hearing impairment in the middle-aged population, for potential early diagnosis and intervention.

Subjective and objective hearing loss among US adult cancer survivors: A national cross-sectional study.

e24059 Background: Approximately 13% of adults had some degree of hearing loss (HL), and the prevalence is higher among adults aged 65 and over (30.9%). Approximately 50-80% of the childhood, adolescent and young adult cancer survivor population report HL following treatment with high-dose platinum-based chemotherapy, head or brain radiotherapy. We aimed to 1) estimate the prevalence of subjective and objective hearing loss (HL) among cancer survivors and compare to the general population; 2) assess the performance of subjective HL questions in detecting HL by audiometry among cancer survivors. Methods: Adults aged 20-80 years old were selected from the National Health and Nutrition Examination Survey. The weighted prevalence of subjective HL (having troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry test was calculated. Chi-square test and multi-adjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, area under the curve (AUC) were estimated using age-and gender- adjusted logistic regression. Results: Compared to the general population, cancer survivors had a statistically significantly higher prevalence of troublesome hearing (aOR = 1.43; 95%CI:1.22-1.68), tinnitus (aOR = 1.28; 95%CI:1.08-1.53), speech-frequency HL (SFHL) (aOR = 1.44; 95%CI:1.20-1.73) and high-frequency HL (HFHL) (aOR = 1.74; 95%CI:1.45-2.09). The sensitivity and specificity of the combined subjective questions “whether having troublesome hearing and/or tinnitus” in detecting HL was shown in Table. The age- and gender- adjusted AUC for detecting SFHL and HFHL using combined questions was 0.88 and 0.90. Conclusions: Cancer survivors have a significantly higher prevalence of both subjective and objective HL, but a lack of hearing examination. Two subjective HL questions could accurately identify those have true HL and provide a simple and efficient screening tool for providers. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and providers should facilitate raising awareness and provide early screening and timely referral when HL is identified.[Table: see text]

Antenatal Hospital Use among Deaf and Hard of Hearing Women.

Hearing loss is increasingly prevalent among younger adults, impacting health and health care use. Deaf and hard of hearing (DHH) women have a higher risk of chronic diseases, pregnancy complications, and adverse birth outcomes compared with hearing women. Health care utilization patterns during the perinatal period remain not well understood. The objective of this study was to examine differences in antenatal emergency department and inpatient utilization among DHH and non-DHH women. We conducted a retrospective cohort study design to analyze 2002 to 2013 Massachusetts Pregnancy to Early Life Longitudinal data to compare antenatal inpatient and emergency department use between DHH (N = 925) and hearing (N = 2,895) women with singleton deliveries. Matching was done based on delivery year, age at delivery, and birth parity in 1:3 case-control ratio. Demographic, socioeconomic, clinical, and hospital characteristics were first compared for DHH mothers and the matched control group using chi-squared tests and t-tests. Multivariable models were adjusted for sociodemographic and clinical characteristics. Among DHH women (N = 925), 49% had at least one emergency department visit, 19% had an observational stay, and 14% had a nondelivery hospital stay compared with 26, 14, and 6%, respectively, among hearing women (N = 28,95) during the antenatal period (all ps < 0.001). The risk of nondelivery emergency department visits (risk ratio [RR] 1.58; p < 0.001) and inpatient stays (RR = 1.89; p < 0.001) remained higher among DHH women compared with hearing women even after adjustment. Having four or more antenatal emergency department visits (7 vs. 2%) and two or more nondelivery hospital stays (4 vs. 0.4%) were more common among pregnant DHH women compared with their controls (all p-values < 0.001). The findings demonstrate that DHH women use emergency departments and inpatient services at a significantly higher rate than their hearing controls during the antenatal period. A systematic investigation of the mechanisms for these findings are needed. · Antenatal emergency department use is significantly higher among deaf and hard of hearing women.. · Antenatal hospitalizations are significantly higher among deaf and hard of hearing women.. · Hearing loss screening may identify those at risk for adverse pregnancy and birth outcomes..

Machine Learning Prediction of Objective Hearing Loss With Demographics, Clinical Factors, and Subjective Hearing Status.

Hearing loss (HL) is highly prevalent, yet underrecognized and underdiagnosed. Lack of standardized screening, awareness, cost, and access to hearing testing present barriers to HL identification. To facilitate prescreening and selection of patients who warrant audiometric evaluation, we developed a machine learning (ML) model to predict speech-frequency pure-tone average (PTA). Cross-sectional study. National Health and Nutrition Examination Survey (NHANES). The cohort included 8918 adults (≥20 years) who completed audiometric testing with NHANES (2012-2018). The primary outcome measure was the prediction of better hearing ear speech-frequency PTA. Relevant predictors included demographics, medical conditions, and subjective assessment of hearing. Supervised ML with a tree-based architecture was used. Regression performance was determined by the mean absolute error (MAE) with binary classification assessed with area under the receiver operating characteristic curve (AUC). Using the full set of predictors, the test set MAE between the ML-predicted and actual PTA was 5.29 dB HL (95% confidence interval [CI]: 4.97-5.61). The 5 most influential predictors of higher PTA were increased age, worse subjective hearing, male gender, increased body mass index, and history of smoking. The 5-factor abbreviated model performed comparably to the extended feature set with MAE 5.36 (95% CI: 5.03-5.69) and AUC for PTA > 25 dB HL of 0.92 (95% CI: 0.90-0.94). The ML model was able to predict PTA with patient demographics, clinical factors, and subjective hearing status. ML-based prediction may be used to identify individuals who could benefit most from audiometric evaluation.

Association Between Hearing Loss and Multiple Negative Emotional States in the USHispanic Population.

Hearing loss (HL) has been linked to commonly studied detrimental mood states, such as loneliness and depression. However, its relationship with other negative emotions remained largely unstudied. We explore the association between HL and anxiety, anger, hostility, poor self-esteem, and pessimism in a national cohort of USHispanic adults. Cross-sectional study. Multicentered USnational epidemiologic study (Hispanic Community Health Study). Subjects were ages 18 to 75 with completed audiometric and emotional survey data. Multivariable regressions controlling for age, gender, and education were conducted to analyze the association between HL, measured by 4-frequency pure-tone average (PTA), and emotional states. States included anxiety (Spielberger Trait Anxiety Scale-10), anger (Spielberger Trait Anger Scale), hostility (Cook Medley Cynicism Scale-13),poor self-esteem (Self-Esteem Scale-10), and pessimism (Revised Life Orientation Test). A total of 4120 to 4341 participants met inclusion criteria, depending on the specific survey; the average age was 46.7 years (standard deviation [SD] = 13.7), and the average PTA was 13.8 dB (SD = 10.1). Controlling for age, gender, and education, HL was associated with all outcomes. Specifically, for every 10 dB worsening in HL, the anxiety score worsened by 0.41 (0.23-0.60), the anger score worsened by 0.40 (0.22-0.58), the hostility score worsened by 0.16 (0.04-0.27), the self-esteem score worsened by 0.25 (0.12-0.38), and the pessimism score worsened by 0.17 (0.04-0.30) (all p < .01). HL is related to numerous negative mood states beyond loneliness and depression. This includes worse anxiety, anger, hostility, self-esteem, and pessimism. Future studies should investigate whether treating HL improves negative emotional states.

Job satisfaction and quality of life in adult users of bone conduction hearing devices pre-and post-implantation: a 1-year follow-up study

Objective Hearing loss is a growing public health issue that significantly impacts both health-related quality of life and working life. This study investigates how hearing rehabilitation with bone conduction hearing implants impacts health-related quality of life and working life in adults of working age with hearing impairment. Design This longitudinal study used data from Cochlear’s Implant Recipient Observational Study to assess hearing disabilities and job satisfaction in 18–65-year-old recipients of bone conduction hearing implants. Baseline data were collected pre-implantation and patients were followed-up at 12-months post-implantation. Study sample Patient demographics, Health Utilities Index Mark 3, the Speech Spatial and Qualities of Hearing Scale, and self-reported employment data are presented for a sample ranging from 30 to 43 patients, pre-implantation and at 12-months follow-up following implantation with a bone conduction hearing implant. Results Significant improvements in hearing and speech attribute, and overall health-related quality of life were observed between pre-and post-implantation. Overall hearing disability decreased post-implantation and job satisfaction improved. Conclusions Hearing rehabilitation using bone conduction hearing implants are shown to improve health-related quality of life, reduce hearing disability, and improve work performance and satisfaction. Results are representative of healthy and actively working users of bone conduction hearing implants.

Subclinical diagnosis of cisplatin-induced ototoxicity with biomarkers

A mouse model with cisplatin-induced ototoxicity was used in addition to human samples from the ITMAT Biobank at the University of Pennsylvania. Mouse auditory brainstem responses (ABR), inner ear histology, perilymph cisplatin sampling, and measurement of serum prestin via ELISA were performed. Human serum prestin level was measured via ELISA in patients with otological issues after cisplatin treatment and compared to matched controls. Serum prestin was significantly elevated before ABR threshold shifts in mice exposed to cisplatin compared to control mice. Prestin concentration also correlated with the severity of hearing threshold shifts in mice. After an extended rest post-cisplatin treatment, prestin returned to baseline levels in mice and humans. Prestin was significantly elevated in the serum before the onset of objective hearing loss and correlated with the severity of hearing damage indicating that prestin may function as an effective biomarker of cisplatin-induced ototoxicity. Human serum prestin levels responded similarly to mice > 3 weeks from ototoxic exposure with decreased levels of prestin in the serum.