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Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test
INTRODUCTION: Research using the UK Biobank data has shown ethnic inequalities in hearing health; however, the hearing test used may exhibit a disadvantage for non-native language speakers. OBJECTIVES: To validate the results of the UK Biobank hearing test (Digit Triplet Test, DTT) against self-repo...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725084/ https://www.ncbi.nlm.nih.gov/pubmed/33293400 http://dx.doi.org/10.1136/bmjopen-2020-042571 |
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author | Taylor, Harry Shryane, Nick Kapadia, Dharmi Dawes, Piers Norman, Paul |
author_facet | Taylor, Harry Shryane, Nick Kapadia, Dharmi Dawes, Piers Norman, Paul |
author_sort | Taylor, Harry |
collection | PubMed |
description | INTRODUCTION: Research using the UK Biobank data has shown ethnic inequalities in hearing health; however, the hearing test used may exhibit a disadvantage for non-native language speakers. OBJECTIVES: To validate the results of the UK Biobank hearing test (Digit Triplet Test, DTT) against self-reported measures of hearing in the dataset and create classifications of hearing health. To observe if language proficiency and migration age have the same effect on hearing health classification as on the DTT in isolation. Our hypothesis is that language proficiency acts differently on the DTT, demonstrating that the DTT is biased for non-native speakers of English. DESIGN: Latent classes representing profiles of hearing health were identified from the available hearing measures. Factors associated with class membership were tested using multinomial logistic regression models. Ethnicity was defined as (1) White, native English-speaking, (2) ethnic minority, arrived in the UK aged <12 or (3) ethnic minority, arrived aged >12. PARTICIPANTS: The UK Biobank participants with valid hearing test results and associated covariates (N=151 268). OUTCOME MEASURES: DTT score, self-reported hearing difficulty, self-reported hearing difficulty in noise and hearing aid use. RESULTS: Three classes of hearing health were found: ‘normal’, ‘generally poor’ and ‘only subjectively poor’. In a model adjusting for known confounders of hearing loss, a poor or insufficient hearing test result was less likely for those with better language (OR 0.69, 95% CI 0.65 to 0.74) or numerical ability (OR 0.71, 95% CI 0.67 to 0.75) but more likely for those having migrated aged >12 (OR 3.85, 95% CI 3.64 to 4.07). CONCLUSIONS: The DTT showed evidence of bias, having greater dependence on language ability and migration age than other hearing indicators. Designers of future surveys and hearing screening applications may wish to consider the limitations of speech-in-noise tests in evaluating hearing acuity for populations that include non-native speakers. |
format | Online Article Text |
id | pubmed-7725084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-77250842020-12-17 Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test Taylor, Harry Shryane, Nick Kapadia, Dharmi Dawes, Piers Norman, Paul BMJ Open Epidemiology INTRODUCTION: Research using the UK Biobank data has shown ethnic inequalities in hearing health; however, the hearing test used may exhibit a disadvantage for non-native language speakers. OBJECTIVES: To validate the results of the UK Biobank hearing test (Digit Triplet Test, DTT) against self-reported measures of hearing in the dataset and create classifications of hearing health. To observe if language proficiency and migration age have the same effect on hearing health classification as on the DTT in isolation. Our hypothesis is that language proficiency acts differently on the DTT, demonstrating that the DTT is biased for non-native speakers of English. DESIGN: Latent classes representing profiles of hearing health were identified from the available hearing measures. Factors associated with class membership were tested using multinomial logistic regression models. Ethnicity was defined as (1) White, native English-speaking, (2) ethnic minority, arrived in the UK aged <12 or (3) ethnic minority, arrived aged >12. PARTICIPANTS: The UK Biobank participants with valid hearing test results and associated covariates (N=151 268). OUTCOME MEASURES: DTT score, self-reported hearing difficulty, self-reported hearing difficulty in noise and hearing aid use. RESULTS: Three classes of hearing health were found: ‘normal’, ‘generally poor’ and ‘only subjectively poor’. In a model adjusting for known confounders of hearing loss, a poor or insufficient hearing test result was less likely for those with better language (OR 0.69, 95% CI 0.65 to 0.74) or numerical ability (OR 0.71, 95% CI 0.67 to 0.75) but more likely for those having migrated aged >12 (OR 3.85, 95% CI 3.64 to 4.07). CONCLUSIONS: The DTT showed evidence of bias, having greater dependence on language ability and migration age than other hearing indicators. Designers of future surveys and hearing screening applications may wish to consider the limitations of speech-in-noise tests in evaluating hearing acuity for populations that include non-native speakers. BMJ Publishing Group 2020-12-08 /pmc/articles/PMC7725084/ /pubmed/33293400 http://dx.doi.org/10.1136/bmjopen-2020-042571 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Epidemiology Taylor, Harry Shryane, Nick Kapadia, Dharmi Dawes, Piers Norman, Paul Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test |
title | Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test |
title_full | Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test |
title_fullStr | Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test |
title_full_unstemmed | Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test |
title_short | Understanding ethnic inequalities in hearing health in the UK: a cross-sectional study of the link between language proficiency and performance on the Digit Triplet Test |
title_sort | understanding ethnic inequalities in hearing health in the uk: a cross-sectional study of the link between language proficiency and performance on the digit triplet test |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725084/ https://www.ncbi.nlm.nih.gov/pubmed/33293400 http://dx.doi.org/10.1136/bmjopen-2020-042571 |
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