SLPCohortInternational journal of audiology2020

Stroke risk in African Americans with subclinical auditory dysfuntion evidenced by Distortion Product Otoacoustic Emissions: the Jackson heart study.

Jonathan E Sorrel, Christopher Spankovich, Charles E Bishop and 3 others

PMID 32250182

WHAT IT FOUND

In African American adults with normal hearing, those with high stroke risk scores had slightly weaker cochlear function on distortion product otoacoustic emissions than low-risk peers.

The difference was small, 3 to 6 decibels, and the study did not show that hearing tests predict future stroke.

Key findings

01Higher stroke risk scores were associated with lower distortion product otoacoustic emission amplitudes in the full cohort and in the subgroup with normal hearing.

02Among participants with normal hearing, those in the high stroke risk group had significantly less robust cochlear responses than the low risk group, but the difference was only 3 to 6 decibels.

03The cross-sectional design cannot establish that these hearing test results predict future cardiovascular events or stroke.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study is cross-sectional, so it cannot determine if hearing changes precede or follow cardiovascular risk, nor can it prove causality. The sample was exclusively African American, limiting generalizability to other racial or ethnic groups. The stroke risk score includes age and sex, which prevented direct statistical adjustment for these variables, requiring stratified analyses instead. The difference in DPOAE amplitude between high and low risk groups in normal-hearing individuals was small (3-6 dB), raising questions about clinical utility. Multiple comparisons were made without adjustment for the number of tests, increasing the chance of false positive findings.

Declared interests

The research was supported by the National Institutes of Health (N.I.H., Extramural). No other specific conflicts of interest or industry funding were declared in the provided text.

The easy way to misread this

Do not use DPOAE results to screen for stroke risk. The study was cross-sectional and found only a small difference in hearing test scores between high and low risk groups, so it does not show that these tests can predict who will have a stroke.

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