CDC/NIOSH for Audiometric Support for 3 NIDCD-Sponsored, Population-Based Surveys

CDC/NIOSH 为 3 项 NIDCD 赞助的基于人群的调查提供听力测量支持

• 批准号: 9487755
• 金额: $ 19.98万
• 依托单位: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9487755
• 关键词: Acoustics; Address; Affect; Age; Agreement; Air; Area; Atherosclerosis; Attention; Audiometry; Bilateral; Blood Pressure; Calibration; Centers for Disease Control and Prevention (U.S.); Child; Classification; Collaborations; Competence; Computer software; Consultations; Country; Data; Data Analyses; Data Collection; Data Element; Data Files; Data Set; Databases; Dementia; Development; Diagnostic; Disease; Ear; Earache; Earwax; Education; Elements; Environment; Equipment; Evaluation; Experimental Designs; Frequencies; Funding; General Population; Genes; Genetic; Goals; Government; Health; Health Surveys; Hearing; Heart; Height; Hour; Household; Impaired cognition; Individual; Interview; Investigation; Ipsilateral; Learning; Longitudinal Studies; Maintenance; Manuals; Masks; Measurement; Measures; Methods; Minor; Monitor; National Health and Nutrition Examination Survey; National Institute on Deafness and Other Communication Disorders; Noise; Obesity; Osteoporosis; Otoscopy; Outcome; Periodicity; Physical Examination; Physicians; Population; Predisposition; Protocols documentation; Pure-Tone Audiometry; Questionnaires; Reporting; Research Institute; Risk Factors; Running; Sampling; Series; Specific qualifier value; Stroke; Surveys; System; Techniques; Test Result; Testing; Time; Training; Tube; Tympanometry; United States National Center for Health Statistics; Visual; Visual impairment; Weight; acoustic reflex; attenuation; disease phenotype; early childhood; hearing impairment; kindergarten; middle ear; molecular marker; operation; population based; quality assurance; sarcopenia; screening; sound; statistics; third grade

The purpose of this agreement is to provide funding for scientific and technical support as well as quality assurance of three large audiometric examination surveys funded by NIDCD. These health surveys are: (i) The National Health and Nutrition Examination Survey (NHANES), (ii) Age, Gene/Environment Susceptibility Study–Reykjavik Study (AGES–RS), and (iii) the Early Childhood Longitudinal Study – Kindergarten Class of 2010/2011 (ECLS–K:2010/2011). The Audiometry Components of all three health examination surveys were previously developed by NIDCD in collaboration with NIOSH and other consultants. NIOSH collaborated on the design of the experimental protocol and provided the equipment specifications, oversight of maintenance and calibration, technician training and oversight, operations manual development, and quality assurance for the NHANES. As well, NIOSH provided similar support to AGES and ECLS–K:2010/2011, including setting-up training sessions and observing/monitoring technical competence in obtaining audiometric measurements, technical assistance as needed, and limited quality assurance. The NHANES scientific goals are to establish a statistically accurate, demographically representative baseline on the general health (including Hearing Health) of the U.S. population. NHANES is now a continuous survey and while general health issues are always under investigation such as height, weight, and blood pressure, there are also elements that track individual health outcomes that move in and out of the NHANES as it cycles. NHANES consists of two major components: the household interview and the physical examination in the NHANES Mobile Examination Centers (MECs) that are set up in various areas around the country. The data from the NHANES elements are collected, weighted, and made available to the government and the public as a database on which analysis may be performed. Recently, the data have been released every two years with collaborating agencies receiving the data six months prior to the public release of the data sets. The AGES–RS scientific goals are: 1) to identify genetic and new risk factors for selected diseases including atherosclerosis, cognitive impairment, dementia, stroke, hearing loss, visual impairment, sarcopenia, osteoporosis, and obesity, 2) to characterize phenotypes for these diseases and conditions, and 3) to identify contributory molecular markers associated with these conditions. The proposed ECLS:K-2011 audiometry protocol for the third-grade data collection includes four components: pre-test questions, otoscopy, wideband reflectometry with tympanometry, and pure tone audiometry: (1) Pre-Test Questions: Children will be asked a series of short questions regarding conditions which could affect the test results (cold or earaches, noise exposure within past 24 hours, presence of pe tubes, and whether one ear is better than the other); (2) Otoscopy: Children will receive a brief visual examination of the ear, primarily to assure a clear sound path. In addition, the technicians will note the presence of excessive cerumen or any other gross abnormality which could affect interpretation of audiometric findings. The otoscopic exam will not be diagnostic; it will simply be observational; (3) Wideband Reflectometry, including Tympanometry: An automated wideband reflectometric/tympanometric evaluation of the middle ear will be conducted bilaterally. Analysis and interpretation of the results will be done remotely; (4) Pure Tone Audiometry: Pure tone air conduction thresholds will be obtained bilaterally at 1000, 2000, 3000, 4000, 6000, and 8000 Hz insofar as time and the child’s attention permits. A retest threshold will be obtained in both ears at 2000 Hz as a measure of test reliability. The thresholds will be obtained manually using a modified Hughson-Westlake technique. The first test ear will be alternated to avoid learning effect bias in the thresholds. Frequencies will be tested in a specified order to obtain the more important frequency data first in case time or the child’s attention runs out before all frequencies are completed. All three health surveys share similar hearing exam components, developed collaboratively by NIDCD, NIOSH, NCHS, WESTAT, the Icelandic Heart Association Research Institute, and the Department of Educations, National Center for Education Statistics. The hearing component consists of: 1) a set of questionnaires relating to hearing, noise exposure, and other factors relating to hearing, and 2) audiometric examinations consisting of otoscopy, acoustic immittance (bilateral tympanometry or wide-band reflectometry and screening for ipsilateral acoustic reflexes at 1000 and 2000 Hz), and pure-tone, air-conduction audiometry to determine the hearing thresholds in each ear at several frequencies, such as 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz. A repeat threshold test is obtained at 1000 Hz or 2000 Hz as a measure of test reliability. When significant inter-ear differences are found, then retests may be performed using insert earphones to maximize the inter-aural attenuation rather than using a noise masker of the non-test ear to obtain what is referred to as masked threshold in the in the test ear to avoid recording of a “shadow audiogram” from the better non-test ear.

本协议的目的是为NIDCD资助的三次大型听力学检查调查提供科学技术支持和质量保证。这些健康调查是：(i)全国健康和营养检查调查（NHANES）， （ii）年龄、基因/环境易感性研究-雷克雅未克研究（AGES-RS），以及（iii）幼儿纵向研究- 2010/2011年幼儿园班（ECLS-K:2010/2011）。所有三项健康检查调查的听力学部分以前都是由国家疾病预防控制中心与NIOSH和其他顾问合作制定的。NIOSH合作设计了实验方案，并为NHANES提供了设备规格、维护和校准监督、技术人员培训和监督、操作手册开发和质量保证。此外，NIOSH为AGES和ECLS-K:2010/2011提供了类似的支持，包括建立培训课程和观察/监测获得听力测量的技术能力，必要的技术援助和有限的质量保证。NHANES的科学目标是建立一个统计上准确的、人口统计学上具有代表性的美国人口总体健康（包括听力健康）基线。NHANES现在是一个连续的调查，虽然一般的健康问题总是在调查中，比如身高，体重和血压，但也有一些因素跟踪个人的健康结果，这些结果随着NHANES的循环而进入和退出。NHANES由两个主要部分组成：家庭访谈和在全国各地设立的NHANES移动检查中心（mec）进行的身体检查。来自NHANES要素的数据被收集、加权，并作为数据库提供给政府和公众，以进行分析。最近，数据每两年发布一次，合作机构在数据集公开发布前6个月收到数据。ags - rs的科学目标是：1)确定选定疾病的遗传和新的危险因素，包括动脉粥样硬化、认知障碍、痴呆、中风、听力损失、视力障碍、肌肉减少症、骨质疏松症和肥胖；2)表征这些疾病和病症的表型；3)确定与这些病症相关的分子标志物。拟议的ECLS:K-2011听力测试方案包括四部分：预测问题、耳镜检查、宽带反射与鼓室测量和纯音听力测量：(1)预测问题：儿童将被问及一系列可能影响测试结果的简短问题（寒冷或耳痛、过去24小时内的噪音暴露、是否存在pe管，以及一只耳朵是否比另一只耳朵好）；(2)耳镜检查：儿童将接受简短的耳部视觉检查，主要是为了确保清晰的声音通道。此外，技术人员将注意到是否存在过量的耵聍或任何其他可能影响听力学结果解释的严重异常。耳镜检查不能诊断；它只是观察性的；(3)宽带反射测量，包括鼓室测量：双方将对中耳进行自动宽带反射/鼓室测量评估。分析和解释结果将远程完成；(4)纯音听力学：在时间和儿童注意力允许的情况下，在1000、2000、3000、4000、6000和8000hz处获得双侧纯音空气传导阈值。在2000hz时，将获得双耳的重测阈值，作为测试可靠性的度量。阈值将使用改进的休森-韦斯特莱克技术手动获得。第一个测试耳将交替使用，以避免阈值中的学习效应偏差。频率将按照指定的顺序进行测试，以首先获得更重要的频率数据，以防时间或儿童的注意力在所有频率完成之前耗尽。所有三项健康调查都有类似的听力测试组成部分，由NIDCD、NIOSH、NCHS、WESTAT、冰岛心脏协会研究所和教育部、国家教育统计中心合作开发。听力部分包括：1)一套关于听力、噪声暴露和其他与听力有关的因素的问卷调查；2)听力学检查，包括耳镜检查、声阻抗（双侧鼓室测量或宽带反射测量，并筛查1000和2000赫兹的同侧声反射），以及纯音、空气传导听力学，以确定每只耳朵在500、1000、2000、3000、4000、6000和8000赫兹等几个频率下的听力阈值。在1000 Hz或2000 Hz下获得重复阈值测试，作为测试可靠性的度量。当发现明显的耳间差异时，可以使用插入式耳机进行重新测试，以最大化耳间衰减，而不是使用非测试耳的噪声掩蔽器来获得所谓的测试耳中的屏蔽阈值，以避免从较好的非测试耳中记录“阴影听力图”。