Independent Validation of an Existing Model Enables Prediction of Hearing Loss after Childhood Bacterial Meningitis

Objective: This study aimed external validation of a formerly developed prediction model identifying children at risk for hearing loss after bacterial meningitis (BM). Independent risk factors included in the model are: duration of symptoms prior to admission, petechiae, cerebral spinal fluid (CSF) glucose level, Streptococcus pneumoniae and ataxia. Validation helps to evaluate whether the model has potential in clinical practice. Study design: 116 Dutch school-age BM survivors were included in the validation cohort and screened for sensorineural hearing loss (>25 dB). Risk factors were obtained from medical records. The model was applied to the validation cohort and its performance was compared with the development cohort. Validation was performed by application of the model on the validation cohort and by assessment of discrimination and goodness of fit. Calibration was evaluated by testing deviations in intercept and slope. Multiple imputation techniques were used to deal with missing values. Results: Risk factors were distributed equally between both cohorts. Discriminative ability (Area Under the Curve, AUC) of the model was 0.84 in the development and 0.78 in the validation cohort. Hosmer-Lemeshow test for goodness of fit was not significant in the validation cohort, implying good fit concerning the similarity of expected and observed cases. There were no significant differences in calibration slope and intercept. Sensitivity and negative predicted value were high, while specificity and positive predicted value were low which is comparable with findings in the development cohort. Conclusions: Performance of the model remained good in the validation cohort. This prediction model might be used as a screening tool and can help to identify those children that need special attention and a long follow-up period or more frequent auditory testing

Adolescents risky MP3-player listening and its psychosocial correlates

Analogue to occupational noise-induced hearing loss, MP3-induced hearing loss may be evolving into a significant social and public health problem. To inform prevention strategies and interventions, this study investigated correlates of adolescents' risky MP3-player listening behavior primarily informed by protection motivation theory. We invited 1687 adolescents (12- to 19-year old) of Dutch secondary schools to complete questionnaires about their MP3-player listening, sociodemographic characteristics and presumed psychosocial determinants of MP3-player listening. Of all participants, 90% reported listening to music through earphones on MP3 players; 28.6% were categorized as listeners at risk for hearing loss due to estimated exposure of 89 dBA for =1 hour per day. Compared with listeners not at risk for hearing loss, listeners at risk were more likely not to live with both parents, to experience rewards of listening to high-volume levels, to report a high habit strength related to risky MP3 listening, and were less likely to be motivated to protect their hearing. Habit strength was the strongest correlate of risky listening behavior, suggesting that voluntary behavior change among adolescents might be difficult to achieve and that a multiple strategy approach may be needed to prevent MP3-induced hearing loss. © The Author 2010

Education qualification levels and school careers of unilateral versus bilateral hearing aid users.

Contains fulltext : 51872.pdf (publisher's version ) (Closed access)OBJECTIVE: Analyse the difference in school careers and secondary school qualification levels between unilateral hearing aid users and bilateral hearing aid users. STUDY DESIGN: Retrospective questionnaire study. SETTING: Postal-based questionnaire. PARTICIPANTS: Names of adults known to have been fitted with unilateral or bilateral hearing aids during childhood were retrieved. This resulted in 292 names. Participants were selected using the following criteria: availability of the medical record, presence of bilateral hearing loss, completed secondary school education, normal IQ and a minimum aided word-recognition score of 70% at 10 years of age. The questionnaire was sent to 50 potential participants of whom 40 responded, resulting in two groups comprising 19 unilateral and 21 bilateral hearing aid users. METHODS: A questionnaire was developed to obtain data on secondary school levels and aspects of the school careers, such as type of schools attended (mainstream versus special), repeating a school year and additional assistance (speech and language therapy, personal frequency modulation systems). MAIN OUTCOME MEASURES: Comparison of the benefit of bilateral hearing aid fitting versus unilateral hearing aid fitting on secondary school qualification level, type of school the children attended, class failure and additional assistance used. RESULTS: The group of bilaterally fitted hearing aid users eventually completed secondary school at a superior level than the unilaterally fitted users. 33% of binaural hearing aid users achieved qualifications giving access to a bachelors degree compared with 21% of unilateral users. There were no differences between those fitted with unilateral and bilateral hearing aids in the type of schools attended, repeating a school year and additional assistance. CONCLUSIONS: The bilateral hearing aid users obtained superior secondary school qualifications than the unilateral users but their school careers were comparable