防止听力损伤 Prevalence of permanent childhood hearing impairment
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
2.5 2 1.5 1 0.5 0 UNHS yield 1995 observed 1982-9 observed 1995 adjusted 1982-9 adjusted Prevalence/1000 live births
3. Late onset and/or progressive
Impact on children
• Communication skills • Educational attainment • Quality of life
Early intervention leads to improved outcomes1
Previous studies
Relatively small No assessment of under-ascertainment
1.63 (95% ci 1.59-1.67) 1.44 (95% ci 1.41-1.48)
Conclusion
The prevalence of permanent childhood hearing impairment continues to rise after birth over a wider age range than had previously been reported and reaches a higher plateau.
1. Acquired impairments
• Usually due to bacterial meningitis or trauma • Can occur at any age • Contributes 7% of overall prevalence
2. Delayed confirmation
Sample from source 1 (m) Sample from source 2 (n)
Population (N’)
In common (c)
Formulae (m+1)(n+1) 1 N= (c+1) (m+1)(n+1)(m-c)(n-c) Var(N) = (c+1) 2 (c+2)
Observed prevalence
(95% confidence intervals)
Birth cohorts Severity >40 dB HL 41-70 dB HL 71-95 dB HL >95 dB HL 1995 0.91 (0.85-0.98) 0.45 (0.40-0.50) 0.20 (0.17-0.24) 0.26 (0.22-0.29) 1982-89 1.65 (1.62-1.68) 0.89 (0.86-0.91) 0.35 (0.33-0.36) 0.39 (0.38-0.41)
Adjusted prevalence
(95% confidence intervals)
Birth cohorts Severity >40 dB HL 41-70 dB HL 71-95 dB HL >95 dB HL 1995 1.07 (1.03-1.12) 0.60 (0.54-0.66) 0.22 (0.21-0.24) 0.27 (0.26-0.29) 1982-89 2.05 (2.02-2.08) 1.21 (1.18-1.24) 0.41 (0.40-0.42) 0.44 (0.43-0.44)
Cohorts
age in years
Prevalence per 1000 live births
1.33 (95% ci 1.22-1.45)
Trent Ascertainment2 1985-1990 5-10
National Ascertainment3 1985-1990 8-13 1988-1993 5-10
Capture-recapture
• No change in population • Cases from different sources can be matched • Same chance of being included in each data source • Independent data sources
95% c.i. = ± 1.96 Var(N)
Sources are independent if: p 1 x p 2 = p 12
National Ascertainment Study
Data source
N of children
11577 12107 6524 17160
Health professionals Education professionals Both Either
Prevalence of permanent childhood hearing impairment
Heather Fortnum
B Med Sci, BM BS, DM
MRC Institute of Hearing Research, Nottingham, UK
Heather Fortnum …is an epidemiologist working in Health Services Research for UK Medical Research Council ...has always been interested in the impact of permanent hearing impairment on children ...is excited by the current findings and their implications for Universal Newborn Hearing Screening
Prevalence by age
Prevalence
(per 1000 live births) 2.5
2.0 1.5 1.0 0.5 0.0 0 2 4 6 8 10 12 14 16 18
>40dB
Age (years)
• Incre来自百度文库se with age? • Decrease with time?
3. Late onset and/or progressive
Impact on children
• Communication skills • Educational attainment • Quality of life
Early intervention leads to improved outcomes1
Previous studies
Relatively small No assessment of under-ascertainment
1.63 (95% ci 1.59-1.67) 1.44 (95% ci 1.41-1.48)
Conclusion
The prevalence of permanent childhood hearing impairment continues to rise after birth over a wider age range than had previously been reported and reaches a higher plateau.
1. Acquired impairments
• Usually due to bacterial meningitis or trauma • Can occur at any age • Contributes 7% of overall prevalence
2. Delayed confirmation
Sample from source 1 (m) Sample from source 2 (n)
Population (N’)
In common (c)
Formulae (m+1)(n+1) 1 N= (c+1) (m+1)(n+1)(m-c)(n-c) Var(N) = (c+1) 2 (c+2)
Observed prevalence
(95% confidence intervals)
Birth cohorts Severity >40 dB HL 41-70 dB HL 71-95 dB HL >95 dB HL 1995 0.91 (0.85-0.98) 0.45 (0.40-0.50) 0.20 (0.17-0.24) 0.26 (0.22-0.29) 1982-89 1.65 (1.62-1.68) 0.89 (0.86-0.91) 0.35 (0.33-0.36) 0.39 (0.38-0.41)
Adjusted prevalence
(95% confidence intervals)
Birth cohorts Severity >40 dB HL 41-70 dB HL 71-95 dB HL >95 dB HL 1995 1.07 (1.03-1.12) 0.60 (0.54-0.66) 0.22 (0.21-0.24) 0.27 (0.26-0.29) 1982-89 2.05 (2.02-2.08) 1.21 (1.18-1.24) 0.41 (0.40-0.42) 0.44 (0.43-0.44)
Cohorts
age in years
Prevalence per 1000 live births
1.33 (95% ci 1.22-1.45)
Trent Ascertainment2 1985-1990 5-10
National Ascertainment3 1985-1990 8-13 1988-1993 5-10
Capture-recapture
• No change in population • Cases from different sources can be matched • Same chance of being included in each data source • Independent data sources
95% c.i. = ± 1.96 Var(N)
Sources are independent if: p 1 x p 2 = p 12
National Ascertainment Study
Data source
N of children
11577 12107 6524 17160
Health professionals Education professionals Both Either
Prevalence of permanent childhood hearing impairment
Heather Fortnum
B Med Sci, BM BS, DM
MRC Institute of Hearing Research, Nottingham, UK
Heather Fortnum …is an epidemiologist working in Health Services Research for UK Medical Research Council ...has always been interested in the impact of permanent hearing impairment on children ...is excited by the current findings and their implications for Universal Newborn Hearing Screening
Prevalence by age
Prevalence
(per 1000 live births) 2.5
2.0 1.5 1.0 0.5 0.0 0 2 4 6 8 10 12 14 16 18
>40dB
Age (years)
• Incre来自百度文库se with age? • Decrease with time?