Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics

Qixuan Wang; Minfei Qian; Lu Yang; Junbo Shi; Yingying Hong; Kun Han; Chen Li; James Lin; Zhiwu Huang; Hao Wu

doi:10.3389/fmed.2021.662045

Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics

Front Med (Lausanne). 2021 Mar 25:8:662045. doi: 10.3389/fmed.2021.662045. eCollection 2021.

Authors

Qixuan Wang^{1

2

3}, Minfei Qian^{1

2

3}, Lu Yang^{1

4}, Junbo Shi^{1

4}, Yingying Hong^{1

4}, Kun Han^{1

2

3}, Chen Li⁵, James Lin⁵, Zhiwu Huang^{1

2

3

4}, Hao Wu^{1

2

3}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
⁴ Hearing and Speech Center, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Network and Information Center, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Background: The definition of notched audiogram for noise-induced hearing loss (NIHL) is presently based on clinical experience, but audiometric phenotypes of NIHL are highly heterogeneous. The data-driven clustering of subtypes could provide refined characteristics of NIHL, and help identify individuals with typical NIHL at diagnosis. Methods: This cross-sectional study initially recruited 12,218 occupational noise-exposed employees aged 18-60 years from two factories of a shipyard in Eastern China. Of these, 10,307 subjects with no history of otological injurie or disease, family history of hearing loss, or history of ototoxic drug use were eventually enrolled. All these subjects completed health behavior questionnaires, cumulative noise exposure (CNE) measurement, and pure-tone audiometry. We did data-driven cluster analysis (k-means clustering) in subjects with hearing loss audiograms (n = 6,599) consist of two independent datasets (n = 4,461 and n = 2,138). Multinomial logistic regression was performed to analyze the relevant characteristics of subjects with different audiometric phenotypes compared to those subjects with normal hearing audiograms (n = 3,708). Results: A total of 10,307 subjects (9,165 males [88.9%], mean age 34.5 [8.8] years, mean CNE 91.2 [22.7] dB[A]) were included, 3,708 (36.0%) of them had completely normal hearing, the other 6,599 (64.0%) with hearing loss audiograms were clustered into four audiometric phenotypes, which were replicable in two distinct datasets. We named the four clusters as the 4-6 kHz sharp-notched, 4-6 kHz flat-notched, 3-8 kHz notched, and 1-8 kHz notched audiogram. Among them, except for the 4-6 kHz flat-notched audiogram which was not significantly related to NIHL, the other three phenotypes with different relevant characteristics were strongly associated with noise exposure. In particular, the 4-6 kHz sharp-notched audiogram might be a typical subtype of NIHL. Conclusions: By data-driven cluster analysis of the large-scale noise-exposed population, we identified three audiometric phenotypes associated with distinct NIHL subtypes. Data-driven sub-stratification of audiograms might eventually contribute to the precise diagnosis and treatment of NIHL.

Keywords: audiometric phenotype; data-driven cluster analysis; multivariate characteristics; noise-induced hearing loss; notched audiogram; unsupervised learning.