Biological Aging Measures and Hearing-Screening Equity
Abstract
A central question for occupational hearing-risk assessment is not simply whether an output is accurate, but whether it survives scrutiny of selection. The article develops a research agenda through critical comparison of published evidence. The starting source uses sex-stratified cross-sectional modeling, longitudinal generalized estimating equations, and Cox-model nomograms using baseline high-frequency audiometry. Selection shapes who appears in data and who remains observable. Conditioning on employment, participation, surgery, or follow-up can alter associations independently of the mechanism of interest. Map eligibility and observation pathways. Compare conclusions under plausible selection mechanisms and disclose which populations are excluded from the claim. The proposed comparison concerns survey weights, worker selection, age markers; it would test whether the specific failure scenario is detected without erasing legitimate uncertainty. An integrated account should preserve the distinction between noise-exposed workers and clinical follow-up and any stronger downstream decision.
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