title: The Sensitivity of Adolescent Hearing Screens Significantly Improves by Adding High Frequencies.
abstract: One in 6 US adolescents has high-frequency hearing loss, often related to hazardous noise. Yet, the American Academy of Pediatrics (AAP) hearing screen (500, 1,000, 2,000, 4,000 Hertz) primarily includes low frequencies (<3,000 Hertz). Study objectives were to determine (1) sensitivity and specificity of the AAP hearing screen for adolescent hearing loss and (2) if adding high frequencies increases sensitivity, while repeat screening of initial referrals reduces false positive results (maintaining acceptable specificity).
  
  
  
  Eleventh graders (n = 134) participated in hearing screening (2013-2014) including "gold-standard" sound-treated booth testing to calculate sensitivity and specificity.
  
  
  
  Of the 43 referrals, 27 (63%) had high-frequency hearing loss. AAP screen sensitivity and specificity were 58.1% (95% confidence interval 42.1%-73.0%) and 91.2% (95% confidence interval 83.4-96.1), respectively. Adding high frequencies (6,000, 8,000 Hertz) significantly increased sensitivity to 79.1% (64.0%-90.0%; p = .003). Specificity with repeat screening was 81.3% (71.8%-88.7%; p = .003).
  
  
  
  Adolescent hearing screen sensitivity improves with high frequencies. Repeat testing maintains acceptable specificity.
authors.affiliation: Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania. Electronic address: dsekhar@hmc.psu.edu.
authors.forename: Deepa L
authors.initials: DL
authors.lastname: Sekhar
authors.affiliation: Department of Audiology, Bloomsburg University, Bloomsburg, Pennsylvania.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Zalewski
authors.affiliation: Pediatric Clinical Research Office, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Beiler
authors.affiliation: Department of Audiology, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Beth
authors.initials: B
authors.lastname: Czarnecki
authors.affiliation: Department of Audiology, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Barr
authors.affiliation: Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Tonya S
authors.initials: TS
authors.lastname: King
authors.affiliation: Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Paul
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D005260:Female; D006316:Hearing Loss, High-Frequency / Q000175:diagnosis*; D006320:Hearing Tests / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012680:Sensitivity and Specificity
keywords: Adolescents; Hazardous noise; High-frequency hearing loss; Primary care; Screening