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      Clinical characteristics of the “Gap” between the prevalence and incidence of hearing loss using National Health Insurance Service data

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          Abstract

          Objectives

          Hearing loss is the inability to hear speech or sounds well, owing to a number of causes. This study aimed to simultaneously determine the prevalence, incidence, and the Gap between them in hearing loss in South Korean patients at the same point in time as well as to identify patients who have not recovered from hearing loss.

          Methods

          We examined the prevalence and incidence of patients diagnosed with hearing loss in the National Health Insurance Service database over an 11-year period from 2010 to 2020. The difference between the prevalence and the incidence was defined in this study as the term "Gap". Gap is the number of patients converted into the number of patients per 100,000 people by subtracting the incidence from the prevalence. Clinical characteristics such as sex and age per 100,000 individuals were examined.

          Results

          As of 2020, the domestic prevalence obtained in this study was 1.84%, increasing annually, and the prevalence increased with age to 4.10% among those over 60. The domestic incidence was 1.57%, increasing annually, and the incidence increased with age to 3.36% for those over 60s. The Gap was 0.27%, showing a steady increase from 2011 to 2020 with a corresponding increase in insurance benefit expenses.

          Conclusion

          To fully understand the burden of hearing loss and develop effective prevention and treatment strategies, it is important to measure the Gap between its prevalence and incidence. This Gap means a lot because hearing loss is an irreversible disease. Gap represents patients who have already been diagnosed with hearing loss and are being diagnosed every year, indicating that the number of patients who do not recover is increasing. In other words, the increase in Gap meant that there were many patients who constantly visited the hospital for diagnosis of hearing loss.

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          Most cited references22

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          Prevalence of Hearing Loss by Severity in the United States.

          To estimate the age- and severity-specific prevalence of hearing impairment in the United States.
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            Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999-2004.

            Hearing loss affects health and quality of life. The prevalence of hearing loss may be growing because of an aging population and increasing noise exposure. However, accurate national estimates of hearing loss prevalence based on recent objective criteria are lacking. We determined hearing loss prevalence among US adults and evaluated differences by demographic characteristics and known risk factors for hearing loss (smoking, noise exposure, and cardiovascular risks). A national cross-sectional survey with audiometric testing was performed. Participants were 5742 US adults aged 20 to 69 years who participated in the audiometric component of the National Health and Nutrition Examination Survey 1999-2004. The main outcome measure was 25-dB or higher hearing loss at speech frequencies (0.5, 1, 2, and 4 kHz) and at high frequencies (3, 4, and 6 kHz). In 2003-2004, 16.1% of US adults (29 million Americans) had speech-frequency hearing loss. In the youngest age group (20-29 years), 8.5% exhibited hearing loss, and the prevalence seems to be growing among this age group. Odds of hearing loss were 5.5-fold higher in men vs women and 70% lower in black subjects vs white subjects. Increases in hearing loss prevalence occurred earlier among participants with smoking, noise exposure, and cardiovascular risks. Hearing loss is more prevalent among US adults than previously reported. The prevalence of US hearing loss differs across racial/ethnic groups, and our data demonstrate associations with risk factors identified in prior smaller-cohort studies. Our findings also suggest that hearing loss prevention (through modifiable risk factor reduction) and screening should begin in young adulthood.
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              Prevalence of age-related hearing loss in Europe: a review

              Populations are becoming progressively older thus presenting symptoms of diminished organ function due to degenerative processes. These may be physiological or caused by additional factors damaging the organ. Presbyacusis refers to the physiological age-related changes of the peripheral and central auditory system leading to hearing impairment and difficulty understanding spoken language. In contrast to epidemiological data of other continents, the prevalence of age-related hearing loss (ARHL) in Europe is not well defined, due in part to the use of different classification systems. We performed a systematic literature review with the aim of gaining a picture of the prevalence of ARHL in Europe. The review included only population and epidemiological studies in English since 1970 with samples in European countries with subjects aged 60 years and above. Nineteen studies met our selection criteria and additional five studies reported self-reported hearing impairment. When these data were crudely averaged and interpolated, roughly 30% of men and 20% of women in Europe were found to have a hearing loss of 30 dB HL or more by age 70 years, and 55% of men and 45% of women by age 80 years. Apparent problems in comparing the available data were the heterogeneity of measures and cut-offs for grades of hearing impairment. Our systematic review of epidemiological data revealed more information gaps than information that would allow gaining a meaningful picture of prevalence of ARHL. The need for standardized procedures when collecting and reporting epidemiological data on hearing loss has become evident. Development of hearing loss over time in conjunction with the increase in life expectancy is a major factor determining strategies of detection and correction of ARHL. Thus, we recommend using the WHO classification of hearing loss strictly and including standard audiometric measures in population-based health surveys.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Project administrationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysis
                Role: MethodologyRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                8 March 2024
                2024
                : 19
                : 3
                : e0299478
                Affiliations
                [1 ] Research Institute of Hearing Enhancement, Yonsei University Wonju College of Medicine, Wonju, South Korea
                [2 ] Department of Medical Informatics and Biostatistics, Yonsei University Wonju College of Medicine, Wonju, South Korea
                [3 ] Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, South Korea
                Prince Sattam bin Abdulaziz University, SAUDI ARABIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-0162-1741
                https://orcid.org/0000-0002-2839-4676
                Article
                PONE-D-23-40189
                10.1371/journal.pone.0299478
                10923459
                38457395
                489795a2-ff6c-448c-8da5-a4b011e270b1
                © 2024 Lee et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 December 2023
                : 10 February 2024
                Page count
                Figures: 3, Tables: 4, Pages: 13
                Funding
                Funded by: the National Research Foundation of Korea
                Award ID: 2020R1A2C1009789
                Award Recipient :
                Funded by: the Korean Fund for Regenerative Medicine
                Award ID: 21C0721L1
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100023443, Commercializations Promotion Agency for R and D Outcomes;
                Award ID: 1711199152
                Award Recipient :
                The present study was grant-funded by three institutions supported by the Korean government. - The National Research Foundation of Korea (No. NRF-2020R1A2C1009789) - The Korean Fund for Regenerative Medicine (21C0721L1) - The Commercialization Promotion Agency for R&D Outcomes (2023, 1711199152) The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Otorhinolaryngology
                Otology
                Hearing Disorders
                Deafness
                Medicine and Health Sciences
                Epidemiology
                Social Sciences
                Economics
                Health Economics
                Health Insurance
                Medicine and Health Sciences
                Health Care
                Health Economics
                Health Insurance
                People and Places
                Population Groupings
                Ethnicities
                Asian People
                Korean People
                People and Places
                Population Groupings
                Age Groups
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Perception
                Sensory Perception
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Social Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Biology and Life Sciences
                Neuroscience
                Sensory Perception
                Medicine and Health Sciences
                Otorhinolaryngology
                Otology
                People and places
                Geographical locations
                Asia
                South Korea
                Custom metadata
                For reasons such as personal information protection, registration of health insurance data is restricted due to domestic laws in Korea, and we conducted the study by obtaining permission to use health insurance data. The data analyzed in this study was obtained from the Korean National Health Insurance Service (NHIS). The following licenses/restrictions apply: only Korean researchers can access these datasets. Requests to access these datasets should be directed to NHIS, https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do.

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