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Ear, nose and throat/otolaryngology
Research
Discrepancies between self-reported hearing difficulty and hearing loss diagnosed by audiometry: prevalence and associated factors in a national survey
  1. Ji Eun Choi1,
  2. Il Joon Moon2,
  3. Sun-Young Baek3,
  4. Seon Woo Kim3,
  5. Yang-Sun Cho2
  1. 1 Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, Republic of Korea
  2. 2 Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Seoul, Republic of Korea
  3. 3 Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
  1. Correspondence to Professor Yang-Sun Cho; yscho{at}skku.edu

Abstract

Objective To evaluate discrepancies prevalent between self-reported hearing difficulty (SHD) and audiometrically measured hearing loss (AHL) and factors associated with such discrepancies.

Design Nationwide cross-sectional survey.

Setting Data from 2010 to 2012 Korea National Health and Nutrition Examination Survey conducted by the Korea Centers for Disease Control and Prevention.

Participants We included 14 345 participants aged ≥19 years who had normal tympanic membranes (mean age of 49 years).

Measures Self-reported hearing was assessed by asking participants whether they had difficulty in hearing. AHL was defined as >25 dB of mean hearing thresholds measured at 0.5, 1, 2 and 4 kHz in better ear. Underestimated hearing impairment (HI) was defined as having AHL without SHD. Likewise, overestimated HI was defined as having SHD without AHL. Prevalence of underestimated and overestimated HIs was determined. Univariable and multivariable analyses were performed to examine factors associated with such discrepancies compared with concordant HL.

Results Among 14 345 participants, 1876 (13.1%) had underestimated HI while 733 (5.1%) had overestimated HI. Multivariable models revealed that participants who had discrepancies between SHD and AHL were less likely to have older age (OR: 0.979, 95% CI: 0.967 to 0.991 for the underestimated HI, OR: 0.905, 95% CI: 0.890 to 0.921 for the overestimated HI) and tinnitus (OR: 0.425, 95% CI: 0.344 to 0.525 for the underestimated HI and OR 0.523, 95% CI: 0.391 to 0.699 for the overestimated HI) compared with those who had concordant HI. Exposure to occupational noise (OR: 0.566, 95% CI: 0.423 to 0.758) was associated with underestimated HI, and medical history of hypertension (OR: 1.501, 95% CI: 1.061 to 2.123) and depression (OR: 1.771, 95% CI: 1.041 to 3.016) was associated with overestimated HI.

Conclusion Age, tinnitus, occupational noise exposure, hypertension and depression should be incorporated into evaluation of hearing loss in clinical practice.

  • Self-reported hearing difficulty
  • prevalence
  • National Health and Nutrition Examination Survey
  • audiometry

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022440

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    Footnotes

    • JEC and IJM contributed equally.

    • Contributors JEC and IJM designed research and wrote the main paper. S-YB and SWK collected and analysed data. Y-SC provided critical revision and discussed the results and implications and commented on the manuscript at all stages.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval All participants provided written informed consent before completing the survey. KNHANES followed the tenets of the Declaration of Helsinki for biomedical research. It was approved by the Institutional Review Board of the Korean Centers for Disease Control and Prevention (IRB No. 2010-02CON-21-C, 2011-02CON-06-C and 2012-01EXP-01-2C). Approval for this research study was obtained from the Institutional Review Board of Samsung Medical Center (IRB No. 2016-06-142).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data are available from the Korea National Health and Nutrition Examination Survey (KNHANES) Data Access for researchers. Because annually, Korea Center for Disease Control and Prevention published the reports and microdata of KNHANES with survey manuals through the official website of KNHANES (http://knhanes.cdc.go.kr), all KNHANES data are de-identified and available to the public.

    • Patient consent for publication Obtained.