General Considerations about Screening and Their Relevance to Adult Hearing Screening

Abstract

Three-quarters of those who could benefit from hearing aids are never referred to be fitted. Referrals for fitting are delayed until patients are elderly and less likely to benefit from an aid. Adult hearing screening has been proposed as a solution to these two problems. Unsuspected factors such as general health and natural history of hearing loss can cause bias in screening studies. Screening can harm. Candidates for otological surgery identified at hearing screening may suffer complications. Labelling and stigma are important considerations. Acceptability of hearing aids is not the only criterion of success of screening. Not all who fail the hearing test ought to be fitted. Enabling people to opt out of rehabilitation may reduce waste of aids that are fitted and later rejected. In the UK, hearing screening could be integrated with screening for other health problems.

• hearing aids (Qualifiers SD, UT)
• adult hearing screening
• National Screening Committee
• informed choice
• bias
• pass-fail criterion

Notes

Case finding or opportunistic screening are terms used for a common form of screening where screening is conducted during the course of a consultation that was initiated by the patient for some reason other than the condition the screening is performed for. For example, people of a certain age range may have blood pressure screening, to reduce the risk of stroke, by having their blood pressure taken during a consultation for sinusitis or any other health problem. Because case finding is executed at the same site as the definitive diagnosis and therapy, the problem of linking those who are ‘screen positive’ to a source of care is obviated. In many regions the great majority of individuals visit a physician at least once a year, thus case-finding may result in good levels of coverage. 21. Sackett DL, Haynes RB, Guyatt GH, Tugwell P. Clinical Epidemiology: a basic science for clinical medicine. 2nd edn. Boston, Massachusetts: Little, Brown and Company; 1991.