دورية أكاديمية
Department of Defense Medical Examination Review Board Audiogram Screening Comparative Analysis.
| العنوان: | Department of Defense Medical Examination Review Board Audiogram Screening Comparative Analysis. |
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| المؤلفون: | Kilgore KM; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Beer EN; Department of Otolaryngology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA., Adams JK; Department of Otolaryngology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA., Scalo JF; Department of Defense, Hearing Center of Excellence, San Antonio, TX 78240, USA.; zCore Business Solutions, Inc., Round Rock, TX 78681, USA., Kilgore AJ; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Marinelli JP; Department of Otolaryngology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA., Erbele ID; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.; Department of Otolaryngology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA., Dowling GA; Department of Defense Medical Examination Review Board, USAFA, CO 80840-2200, USA., Esquivel CR; Department of Defense, Hearing Center of Excellence, San Antonio, TX 78240, USA., Spear SA; Department of Defense, Hearing Center of Excellence, San Antonio, TX 78240, USA. |
| المصدر: | Military medicine [Mil Med] 2024 May 18; Vol. 189 (5-6), pp. e1036-e1044. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 2984771R Publication Model: Print Cited Medium: Internet ISSN: 1930-613X (Electronic) Linking ISSN: 00264075 NLM ISO Abbreviation: Mil Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : Oxford : Oxford University Press Original Publication: Washington, D.C. : Association of Military Surgeons, United States, 1955- |
| مواضيع طبية MeSH: | Mass Screening*/methods , Mass Screening*/standards , Mass Screening*/statistics & numerical data , Military Personnel*/statistics & numerical data , United States Department of Defense*/statistics & numerical data , United States Department of Defense*/organization & administration , Audiometry*/methods , Audiometry*/standards , Audiometry*/statistics & numerical data, Humans ; United States ; Male ; Adult ; Female ; Quality Improvement |
| مستخلص: | Introduction: The Department of Defense Medical Examination Review Board (DoDMERB) plays a pivotal role in the assessment of medical fitness for aspiring military officers. A crucial component of this process is the screening audiogram, designed to evaluate hearing capabilities. However, recent observations of high disqualification rates following screening audiograms led to concerns about their accuracy. Materials and Methods: This quality improvement project, conducted between 2017 and 2019, aimed to assess the concordance between screening audiograms and reference-standard audiometry, as well as to investigate the relationship between disqualification status and hearing thresholds at different frequencies. A sample of 134 candidates, drawn from various locations across the United States, was analyzed. Results: Results revealed that the screening audiogram mean thresholds were twice that of the reference-standard audiogram, particularly in the lower frequencies. Additionally, we found that 84% of candidates were incorrectly disqualified by the screening exam when followed up by the reference-standard. Overall, Bland-Altman analysis revealed significant disagreement between these two tests. This discrepancy prompted a fundamental policy shift in 2020, where candidates who fail screening audiograms now automatically undergo reference-standard audiometry before any disqualification decision. This policy change reflects the commitment of DoDMERB to refining the medical screening process. It reduces the burden on candidates, provides a more comprehensive assessment, and ensures that qualified individuals are not erroneously disqualified.In addition to policy changes, this quality improvement project explored potential courses of action to enhance the screening audiogram process. Among these, improving contract specifications for testing facilities to minimize ambient noise emerged as the most practical and cost-effective approach. Conclusion: In conclusion, the project underscores the importance of refining medical screening processes to accurately assess candidates' qualifications while retaining the utility of screening audiograms. These efforts not only benefit aspiring military officers but also contribute to maintaining the high standards required for military service. (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.) |
| تواريخ الأحداث: | Date Created: 20231019 Date Completed: 20240522 Latest Revision: 20240523 |
| رمز التحديث: | 20240523 |
| DOI: | 10.1093/milmed/usad400 |
| PMID: | 37856686 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1930-613X |
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| DOI: | 10.1093/milmed/usad400 |