RESUMEN
OBJECTIVE: To evaluate the effectiveness of two screening methods (imitanciometry screening and questionnaire) to identify children at risk for conductive hearing loss, comparing this data with complete audiologic evaluation. METHODS: Of 507 children aged between three and six, 111 completed all procedures. The observational methods used were: imitanciometry screening, a questionnaire to identify risk factors for hearing loss and complete audiologic evaluation. Results obtained in the first two instruments were compared with results from complete audiologic evaluation (gold standard). From these comparisons, sensitivity and specificity, accuracy, positive and negative predictive values, and odds ratio were determined for the two screening methods and for the combination of both methods. RESULTS: The two methods applied in series (questionnaire and after imitanciometry screening) showed a greater odds ratio and better correlation between sensitivity and proportion of false-positives (ROC curve). CONCLUSION: Combining the two tests in series improved screening accuracy. This combination was the best tool for identifying children at risk for conductive hearing loss.
Asunto(s)
Técnicas de Diagnóstico Otológico , Pérdida Auditiva Conductiva/diagnóstico , Tamizaje Masivo/métodos , Edad de Inicio , Algoritmos , Niño , Preescolar , Análisis Costo-Beneficio , Técnicas de Diagnóstico Otológico/economía , Técnicas de Diagnóstico Otológico/instrumentación , Femenino , Pérdida Auditiva Conductiva/epidemiología , Humanos , Masculino , Tamizaje Masivo/economía , Prevalencia , Proyectos de Investigación , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Due to problems with long waiting times for assessment of vertiginous patients (more than 24 weeks), we changed practice and instituted a pre-ENT balance clinic assessment; we then audited the results. In particular, we looked at the subgroup with benign positional paroxysmal vertigo. METHODS: One hundred and fifteen patients were seen at the pre-ENT balance clinic from October 2003 to September 2004. Those diagnosed with benign positional paroxysmal vertigo received particle repositioning therapy at the same clinic and did not subsequently need ENT assessment. RESULTS: By the end of the audit period, waiting times were reduced to three weeks, and more than one-quarter of vertiginous patients (i.e. those diagnosed with benign positional paroxysmal vertigo) did not need to be reviewed at an ENT clinic. CONCLUSION: We believe this to be the first study to present prospective data showing that patients with benign positional paroxysmal vertigo may be safely diagnosed and effectively managed at a pre-ENT balance clinic.