Before Prognosis Becomes Policy in Industrial Hearing Health
Abstract
Screening yield, burden, follow-up capacity create distinct evidence obligations in occupational hearing-risk assessment. This literature-based conceptual analysis does not report a new experiment. The starting source uses sex-stratified cross-sectional modeling, longitudinal generalized estimating equations, and Cox-model nomograms using baseline high-frequency audiometry. Predictive improvement and decision improvement are not equivalent. Benefits depend on action thresholds, harms, resource constraints, and who can receive follow-up. Compare complete policies at realistic capacity, including existing practice and simple rules. Measure avoidable harm and review burden rather than optimizing a metric in isolation. The proposed comparison concerns screening yield, burden, follow-up capacity; it would test whether the specific failure scenario is detected without erasing legitimate uncertainty. Implications are restricted to the evidence roles relevant to occupational hearing-risk assessment, leaving broader efficacy and deployment claims unresolved.
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