研究主題 Researches

2024 以風險管理和台灣臨床資料庫為基礎的耳鳴篩檢工具初步研究

耳鳴是一種在無外部刺激下產生的主觀聽覺現象,全球盛行率約15%,且隨年齡增長而增加,超過四分之一老年族群曾經歷耳鳴。耳鳴的成因和相關因素複雜多樣,並因種族、地域等特徵有所差異,包括聽力損失、壓力、精神疾病、結構異常及腫瘤等。耳鳴的影響範圍差異顯著,從偶爾出現的短暫音段到嚴重干擾日常生活,甚至可能導致精神健康問題。研究顯示,全球嚴重影響生活的耳鳴患者約佔3%,且其所帶來的精神失能及醫療負擔在歐洲及美國平均每人每年超過 5,500美元。然而,目前尚無有效的客觀方法來評估耳鳴嚴重程度及風險,此大幅限制耳鳴篩檢、治療及療效評估之研究,而囿縮可延伸應用的空間。本研究利用台灣臨床病歷數據,分析本土耳鳴患者特徵並探尋潛在風險因素。基於文獻和臨床研究結果並結合規範模式模型,本研究開發了一種專為台灣人群設計的耳鳴風險篩檢工具。分析結果將耳鳴患者按風險程度進行分層,並與臨床評估結果進行比較。初步研究顯示,此篩檢工具在識別高風險耳鳴患者方面的準確度達到88.2%。該篩檢工具不僅能為台灣耳鳴族群及其失能照護者提供客觀參考依據,幫助潛在風險者及時就醫,避免錯失黃金治療期。此外,亦可減輕耳鳴患者對耳鳴情形及就醫的焦慮,進而減輕耳鳴帶來的精神、經濟、醫療及社會負擔。
 
 
Tinnitus, characterized by the perception of sound without an external source, is a widespread condition affecting approximately 15% of the global population, with a notably higher prevalence reaching up to 25% among older adults. The etiology of tinnitus is complex and multifactorial, encompassing factors such as hearing loss, stress, psychiatric disorders, structural abnormalities, and even tumors. The impact of tinnitus can range from mild, transient episodes to severe disruptions in daily life, potentially leading to psychiatric comorbidities. Studies suggest that severely debilitating tinnitus affects about 3% of individuals, with associated disability costs exceeding 5,500 USD annually per person. The absence of objective methods for assessing tinnitus risk complicates research and clinical practice. This study utilized clinical data from Taiwan to characterize tinnitus features and identify potential risk factors within the local population. Building on existing literature and clinical experience, a normative model-based tinnitus screening tool was developed specifically for Taiwanese individuals. The analysis stratified tinnitus patients according to risk levels and compared these results with clinical assessments. Preliminary findings demonstrate an accuracy of 88.2% in identifying high-risk tinnitus cases. This screening tool shows promise as an objective reference for Taiwanese individuals, their caregivers, and healthcare providers to evaluate tinnitus status and facilitate timely intervention for those at elevated risk. Additionally, it has the potential to mitigate anxiety related to tinnitus status and healthcare decisions, thereby reducing the psychological, economic, medical, and societal burdens associated with the condition.

郭俊麟