scholarly journals A Large-Scale Examination of Veterans with Normal Pure-Tone Hearing Thresholds within the Department of Veterans Affairs

2018 ◽  
Vol 29 (10) ◽  
pp. 928-935 ◽  
Author(s):  
Curtis J. Billings ◽  
Lauren K. Dillard ◽  
Zachary B. Hoskins ◽  
Tina M. Penman ◽  
Kelly M. Reavis

AbstractDepartment of Veterans Affairs (VA) audiologists have anecdotally reported examining numerous Veterans with normal pure-tone thresholds; however, the prevalence of these patients within the VA is unknown. The VA audiological data repository provides an ideal dataset to examine this group of Veterans. Knowing the prevalence of normal-hearing Veterans within the VA system is the first step to understanding the underlying referral patterns and clinical complaints of Veterans. Data repositories which capture data from both normal and impaired populations provide an indispensable view into hearing health care which can help to improve diagnosis and treatment of Veterans’ hearing difficulties.Using the VA audiological data repository, this study aimed to (1) determine the prevalence of normal hearing thresholds among Veterans seeking hearing health care within the VA health care system and (2) determine the prevalence of abnormal clinical audiology test results among Veterans with normal hearing thresholds.This study was a large-scale retrospective, descriptive observational analysis of uploaded audiological records from the VA Denver Acquisition and Logistics Center audiological data repository encompassing visits that took place between April 1991 and June 2015.At the time of data extraction, there were 3,641,326 audiological records in the repository, with 2,322,771 unique individual records. The study sample was further restricted to include only individuals with normal hearing (n = 235,091), which was defined as pure-tone thresholds better than, or equal to, 25 dB HL at octave frequencies from 250 to 8000 Hz, bilaterally. Patients ranged from 19 to 90+ years of age.We describe the data using frequencies and percentages for categorical variables and means and standard deviations for continuous variables. In addition to hearing thresholds, the occurrence of abnormal results on other tests in the audiological test battery is also reported. We estimate the prevalence of normal hearing among all Veterans with records in the VA audiological data repository.Veterans with normal hearing were on average 37 yr old. The prevalence of Veterans with normal hearing thresholds visiting VA audiology clinics in the current hearing repository dataset was 10.12%. Overall, 41% of Veterans with normal pure-tone thresholds had other clinically abnormal audiological test results; for example, contralateral acoustic reflex thresholds (31.7%) and tympanometry (21.5%) had the highest rate of abnormal test results.Approximately one in ten Veterans seeking care within the VA healthcare system, and reported to the VA audiological data repository, has normal pure-tone hearing thresholds. This may be an underestimate of the true underlying prevalence of normal-hearing Veterans seeking audiology services at the VA because records with normal results were not consistently submitted to the repository. In addition, 41% of Veterans with normal pure-tone thresholds nonetheless presented with other audiological abnormalities. This study suggests that future work directed toward understanding referral patterns and clinical complaints of individuals who present to VA audiology clinics with normal hearing thresholds may be fruitful in the cause of improving diagnosis and treatment of Veterans’ hearing difficulties.

2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).


2009 ◽  
Vol 57 (10) ◽  
pp. 1908-1914 ◽  
Author(s):  
Carolyn W. Zhu ◽  
Joan D. Penrod ◽  
Joseph S. Ross ◽  
Cornelia Dellenbaugh ◽  
Mary Sano

2015 ◽  
Vol 25 (4) ◽  
pp. 377-381 ◽  
Author(s):  
Jodie G. Katon ◽  
Donna L. Washington ◽  
Kristina M. Cordasco ◽  
Gayle E. Reiber ◽  
Elizabeth M. Yano ◽  
...  

2018 ◽  
Vol 23 (2) ◽  
pp. 122-125 ◽  
Author(s):  
Elif Tugba Sarac ◽  
Bilgehan Boke ◽  
Semsettin Okuyucu

Introduction: Sickle cell anemia is a disease characterized by a wide vaso-occlusive incident from micro-vascular incident to muscularactivity. The cochlear function can also get affected by this vaso-occlusion. Objective: It is aimed at determining what kind of effects sickle cell anemia has on hearing and balance system. Methods: This study has been conducted on 46 patients with sickle cell anemia and 45 healthy individuals. For all participants, their pure tone hearing thresholds and videonystagmography (VNG) findings have been determined in 17 frequencies between 125–16.000 Hz. Results: All hearing thresholds between 125 and 16,000 Hz, pure tone averages of patients with sickle cell anemia have been found statistically significant to be higher than the corresponding values in the control group(p < 0.05). The normal hearing rate of patients with sickle cell anemia has been determined to be 71.1% conductive hearing loss (CHL) to be 4.4%, sensorineural hearing loss (SNHL) to be 22.2%, and mixed type hearing loss to be 2.2% in right ear; the normal hearing rate has been determined to be 71.1%, CHL to be 2.2%, SNHL to be 22.2%, and mixed type hearing loss to be 4.4% in left ear. Statistically significant difference has not been found between head shake, spontaneous nystagmus, optokinetic, tracking test batteries, static and dynamic positional tests used in VNG, saccade accuracy and saccade peak velocity, which are saccadic test findings of 2 groups. However, saccadic latency, which is a saccadic test finding, has been determined to be longer in patients with sickle cell anemia in comparison to the control group. Conclusion: While sickle cell anemia causes hearing deficits, it does not have any effect on the central or peripheral vestibular system.


1990 ◽  
Vol 80 (5) ◽  
pp. 238-239
Author(s):  
SB Hoffman ◽  
M Kaplan

The authors discuss the Interdisciplinary Team Training in Geriatrics program developed by the Department of Veterans Affairs. At the James A. Haley Veterans Hospital, this program provides funding to podiatric residents, enabling them to work with practitioners from other health care disciplines as a team that addresses all of the varied health needs of the elderly patient.


2011 ◽  
Vol 22 (08) ◽  
pp. 550-559 ◽  
Author(s):  
Samuli Hannula ◽  
Risto Bloigu ◽  
Kari Majamaa ◽  
Martti Sorri ◽  
Elina Mäki-Torkko

Background: There are not many population-based epidemiological studies on the association between self-reported hearing problems and measured hearing thresholds in older adults. Previous studies have shown that the relationship between self-reported hearing difficulties and measured hearing thresholds is unclear and, according to our knowledge, there are no previous population-based studies reporting hearing thresholds among subjects with hyperacusis. Purpose: The aim was to investigate the prevalence of self-reported hearing problems, that is, hearing difficulties, difficulties in following a conversation in noise, tinnitus, and hyperacusis, and to compare the results with measured hearing thresholds in older adults. Research Design: Cross-sectional, population-based, and unscreened. Study Sample: Random sample of subjects (n = 850) aged 54-66 yr living in the city of Oulu (Finland) and the surrounding areas. Data Collection and Analysis: Otological examination, pure tone audiometry, questionnaire survey Results: The prevalence of self-reported hearing problems was 37.1% for hearing difficulties, 43.3% for difficulties in following a conversation in noise, 29.2% for tinnitus, and 17.2% for hyperacusis. More than half of the subjects had no hearing impairment, or HI (BEHL[better ear hearing level]0.5–4 kHz < 20 dB HL) even though they reported hearing problems. Subjects with self-reported hearing problems, including tinnitus and hyperacusis, had significantly poorer hearing thresholds than those who did not report hearing problems. Self-reported hearing difficulties predicted hearing impairment in the pure-tone average at 4, 6, and 8 kHz, and at the single frequency of 4 kHz. Conclusions: The results indicate that self-reported hearing difficulties are more frequent than hearing impairment defined by audiometric measurement. Furthermore, self-reported hearing difficulties seem to predict hearing impairment at high frequencies (4–8 kHz) rather than at the frequencies of 0.5–4 kHz, which are commonly used to define the degree of hearing impairment in medical and legal issues.


Diabetes Care ◽  
2004 ◽  
Vol 27 (Supplement 2) ◽  
pp. B3-B9 ◽  
Author(s):  
G. E. Reiber ◽  
T. D. Koepsell ◽  
C. Maynard ◽  
L. B. Haas ◽  
E. J. Boyko

2003 ◽  
Vol 91 (6) ◽  
pp. 539-545 ◽  
Author(s):  
C. Raymond Zeiss ◽  
Ahmed Gomaa ◽  
Frances M. Murphy ◽  
David N. Weissman ◽  
Michael Hodgson ◽  
...  

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