Roger Chou, MD; Tracy Dana, MLS; Christina Bougatsos, BS; Craig Fleming, MD; Tracy Beil, MS
Hearing loss is common in older adults. Screening could identify untreated hearing loss and lead to interventions to improve hearing-related function and quality of life.
To update the 1996 U.S. Preventive Services Task Force evidence review on screening for hearing loss in primary care settings in adults aged 50 years or older.
MEDLINE (1950 and July 2010) and the Cochrane Library (through the second quarter of 2010).
Randomized trials, controlled observational studies, and studies on diagnostic accuracy were selected.
Investigators abstracted details about the patient population, study design, data analysis, follow-up, and results and assessed quality by using predefined criteria.
Evidence on benefits and harms of screening for and treatments of hearing loss was synthesized qualitatively. One large (2305 participants) randomized trial found that screening for hearing loss was associated with increased hearing aid use at 1 year, but screening was not associated with improvements in hearing-related function. Good-quality evidence suggests that common screening tests can help identify patients at higher risk for hearing loss. One good-quality randomized trial found that immediate hearing aids were effective compared with wait-list control in improving hearing-related quality of life in patients with mild or moderate hearing loss and severe hearing-related handicap. We did not find direct evidence on harms of screening or treatments with hearing aids.
Non–English-language studies were excluded, and studies of diagnostic accuracy in high-prevalence specialty settings were included.
Additional research is needed to understand the effects of screening for hearing loss compared with no screening on health outcomes and to confirm benefits of treatment under conditions likely to be encountered in most primary care settings.
Agency for Healthcare Research and Quality.
AE = adverse effect; KQ = key question.
* In primary care–applicable settings.
† Such as emotional and social function, communication, and cognitive function. Does not include outcomes related to hearing aid performance and efficacy, such as speech intelligibility and quality of the listening experience.
Appendix Table 1.
KQ = key question; RCT = randomized, controlled trial.
* Cochrane databases include the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews.
† Other sources include reference lists and suggestions by experts.
‡ Some articles are included for >1 KQ.
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March 10, 2011
Screening Adults Over 50 is Superfluous
Regarding your article on screening adults 50 years and older for hearing loss, in the March 1 issue of Annals, with all respects, it seems to me to be superfluous.
I am an 80 year-old retired physician, and I first became aware of a hearing loss in my late sixties. Were I a layman, had I not noticed this myself, I am sure that eventually my family would have called my attention to it. I eventually needed a hearing aid, but as I continue aging, even the hearing aid, which indeed helps me to a certain degree, proved less effective due, I presume, to the degeneration of my chochlear hair cells, a common factor of aging.
The point I am making is that it seems superfluous routinely to test patients at any age unless someone calls the attention to a physician of the problem. Once a person's hearing loss becomes a problem to the patient, appropriate referrals and diagnoses can be made.
Roger Chou, Tracy Dana, Christina Bougatsos, Craig Fleming, Tracy Beil. Screening Adults Aged 50 Years or Older for Hearing Loss: A Review of the Evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;154:347–355. doi: 10.7326/0003-4819-154-5-201103010-00009
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Published: Ann Intern Med. 2011;154(5):347-355.
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