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\begin{document}

\title{Guidelines for diagnosis of noise-induced hearing loss and their
specificity}



\author[1]{Mark Lutman E}%
\author[2]{Jon De Carpentier}%
\author[3]{Kevin Green}%
\affil[1]{University of Southampton}%
\affil[2]{Lancashire Teaching Hospitals NHS Foundation Trust Microbiology Service}%
\affil[3]{Manchester Royal Infirmary}%


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  \date{June 13, 2024}


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\begin{abstract}
\textbf{Objectives:} A recent paper {[}Moore, B.C.J., Lowe, D.A., Cox,
G. (2022). Guidelines for diagnosing and quantifying noise-induced
hearing loss. Trends in Hearing, 26, 1-21{]} has proposed guidelines for
diagnosing noise-induced hearing loss (NIHL). It is referred to here as
the MLC guidelines. Our aim was to evaluate the specificity of those
guidelines (i.e., freedom from false positive outcomes).
\textbf{Design:} We applied the MLC guidelines to three data sets
composed of adults who do not have a history of material noise exposure
and therefore cannot have NIHL. \textbf{Setting:} National Health
Service (NHS) ENT clinic. \textbf{Participants:} 536 patients with
hearing difficulty and/or tinnitus who denied material noise exposure.
Two large archival population studies of hearing were also assessed,
which included 3250 participants without material noise exposure.
\textbf{Main outcome measure:} False positive outcome from guidelines.
\textbf{Results:} The MLC guidelines demonstrated high false positive
rates overall, the magnitude depending on the noise exposure scenario
and whether clinical or population samples were considered. For the
procedure applicable to steady broadband noise exposure, the false
positive rate averaged 56\% in the population samples, compared to 31\%
for previous guidelines. For exposure to intense impulse sounds, the MLC
guidelines take a different approach and the false positive rate was
70\% in the population samples and even higher in the clinic sample. For
exposure to intense tones, the MLC guidelines take yet another approach
and the false positive rate reached 80\%. \textbf{Conclusions:} The MLC
guidelines demonstrate poorer specificity than previous guidelines.
Medical experts should be aware of their poor specificity and
consequential likelihood of false positive diagnoses of NIHL.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Guidelines for diagnosis of noise-induced hearing loss and their specificity anonymised.docx`  available at \url{https://authorea.com/users/659410/articles/663346-guidelines-for-diagnosis-of-noise-induced-hearing-loss-and-their-specificity}

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