Effect of Telehealth Follow-upConsultation in Pediatric Acute Otitis Media — Shenzhen City, GuangdongProvince, China, 2023–2024

Yuzhang Huang^1,2*; Shige Qi³;Shaoshan Liu⁴; Zhongying Pan^1,2; Brian Siu²;Leiyu Shi^1*

1. Department of Health Policy Management,Johns Hopkins University Bloomberg School of Public Health, United States;

2. Shenzhen United Family Hospital,Shenzhen City, Guangdong Province, China;

3. National Center for Chronic and NoncommunicableDisease Control and Prevention, Chinese Center for Disease Control andPrevention, Beijing, China;

4. Shenzhen Institute of ArtificialIntelligence and Robotics for Society, Shenzhen City, Guangdong Province,China.

Corresponding authors:Yuzhang Huang, jason.jasonwong@hotmail.com; Leiyu Shi,lshi2@jhu.edu.

Between 50% and 85% of childrenexperience at least one episode of acute otitis media (AOM) by age three. Sincethe COVID-19 pandemic, numerous hospitals across China have integrated telehealthsolutions into their pediatric care services. Our research team introduced theTelehealth and Autonomous Mobile Clinic Framework, which was published in theBulletin of the World Health Organization in September 2022. The investigationemployed a retrospective cohort design. The study population comprised 200 pediatricpatients diagnosed with AOM who received either telehealth follow-upconsultation or traditional in-person clinic visits. Bivariate analysesexamined relationships between telehealth follow-up consultation and patientoutcome in ear pain, hearing loss, and patient satisfaction between telehealthand in-person AOM follow-up groups. Multivariate regression analysis evaluatedassociations between ear pain (a primary clinical outcome) and telehealthutilization, hearing loss, and patient satisfaction, with adjustments for ageand gender. Ear pain relief was reported by 84% of patients in the telehealthfollow-up group compared to 81% in the in-person follow-up group, showing nostatistically significant difference (P=0.57).Hearing loss was documented in 21 cases from the telehealth group and 23 casesfrom the in-person follow-up group (P=0.73).Patient satisfaction scores were comparable between groups, with mean scores of4.47 (range: 2.47–4.92) for telehealth and 4.49 (range: 2.72–4.94) forin-person follow-up (P=0.87). Multivariateregression revealed no significant difference in patient satisfaction betweentelehealth and in-person follow-up (P=0.21). This retrospective studyprovides compelling evidence for the effectiveness and feasibility oftelehealth follow-up consultations in pediatric otitis media management. Ourfindings demonstrate that telehealth consultations achieve comparable outcomesto in-person follow-up visits for AOM patients.

远程医疗对儿童急性中耳炎的影响 — 深圳市，广东省，中国, 2023-2024年

黄羽张^1,2,#；齐士格³；刘少山⁴；盘仲莹^1,2；萧毅晃²；石磊玉^1,#

1. 卫生政策学系，公共卫生学院，约翰斯霍普金斯大学，巴尔的摩，马里兰州，美国；

2. 深圳和睦家医院，深圳市，广东省，中国；

3. 慢性非传染病中心，中国疾病预防控制中心，北京，中国；

4. 深圳市人工智能与机器人研究院，深圳市，广东省，中国。

^# 通信作者:黄羽张，jason.jasonwong@hotmail.com；石磊玉，lshi2@jhu.edu。

有50% 至 85% 的儿童在三岁前至少经历过一次急性中耳炎（AOM）。自新冠疫情暴发以来，中国各大医院纷纷将远程医疗解决方案纳入儿科医疗服务体系。我们的研究团队提出了“远程医疗与自主移动诊疗框架”该框架已于 2022 年 9 月发表于《世界卫生组织公报》。本研究采用回顾性队列研究设计。研究对象为 200 名确诊为 急性中耳炎的儿科患者，他们分别接受了远程医疗随访或传统线下门诊随访。双变量分析用于探讨远程医疗随访与患者临床结局（耳痛、听力损失）及患者满意度之间的关系。多变量回归分析进一步评估耳痛（主要临床结局）与远程医疗应用、听力损失及患者满意度之间的关联，并对年龄和性别因素进行调整。在远程医疗随访组中，84% 的患者报告耳痛缓解，而在线下随访组中，该比例为 81%，两组间无统计学显著差异（P=0.57）。听力损失病例分别为远程医疗组 21 例，线下随访组 23 例（P=0.73）。患者满意度评分在两组间相近，远程医疗随访组的平均评分为 4.47（范围：2.47-4.92），线下随访组为 4.49（范围：2.72-4.94）（P=0.87）。多变量回归分析显，患者满意度在远程医疗随访组与线下随访组之间无显著差异（P=0.21）。本回顾性研究为远程医疗随访在儿童急性中耳炎管理中的有效性和可行性提供了有力证据。研究结果表明，远程医疗随访在急性中耳炎患者的临床结局方面与传统线下随访具有可比性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.047

Reference Values of Non-CycloplegicSpherical Equivalent for Screening and Predicting Myopia Among Children andAdolescents — China, 2020-2024

Yang Liu^1,2,&; Qin Ran^1,2,3,&;Ying Xiong⁴; Fang Gu⁵; Wei Shi⁶; Jianmeng Liu^1,2,7;Xin Guo^3,8,#; Hongtian Li^1,2,7,#

1. Institute of Reproductive and ChildHealth/National Health Commission Key Laboratory of Reproductive Health, Schoolof Public Health, Peking University, Beijing, China;

2. Department of Epidemiology andBiostatistics, School of Public Health, Peking University Health ScienceCenter, Beijing, China;

3. School Health Department, Beijing Centerfor Disease Prevention and Control, Beijing, China;

4. Chongqing Center for Disease Preventionand Control, Chongqing, China;

5. Zhejiang Center for Disease Preventionand Control, Hangzhou City, Zhejiang Province, China;

6. Shaanxi Center for Disease Preventionand Control, Xi’an City, Shaanxi Province, China;

7. Center for Intelligent Public Health,Institute for Artificial Intelligence, Peking University, Beijing, China;

8. Chinese Center for Disease Control andPrevention, Beijing, China.

^&Joint first authors.

^#Corresponding authors: Hongtian Li,lihongtian@pku.edu.cn; Xin Guo, guoxin@chinacdc.cn.

Non-cycloplegic refraction is widelyutilized in vision screening programs. However, interpreting non-cycloplegicrefraction results remains a significant challenge in both clinical practiceand public health settings. This study aimed to establish grade- andsex-specific reference values for non-cycloplegic spherical equivalent (SE) toenhance myopia screening and risk prediction among Chinese students. Acomprehensive study was conducted between 2020 and 2024, involving 67,260students from kindergarten through high school across 10 provincial-leveladministrative divisions (PLADs) in China. The Lambda-Mu-Sigma method wasemployed to model non-cycloplegic SE. Reference values were established bycalculating SE centiles corresponding to myopia and high myopia prevalenceacross grades 0 through 12. Among boys, the estimated prevalence of myopia andhigh myopia increased from 1.2% and <0 1="" in="" grade="" 0="" senior="" kindergarten="" to="" 82="" 4="" and="" 11="" 6="" in="" grade="" 12="" third="" year="" of="" high="" school="" respectively="" fortwelfth-grade="" boys="" the="" 82="" 4th="" and="" 11="" 6th="" percentiles="" of="" se="" 0="" 99d="" and="" 6="" 16d="" were="" established="" as="" reference="" values="" for="" screening="" myopia="" and="" high="" myopia="" respectively="" the="" corresponding="" percentiles="" in="" lower="" grades="" served="" aspredictive="" reference="" values="" for="" grade="" 12="" outcomes="" for="" instance="" a="" grade-0="" boywith="" non-cycloplegic="" se="">0.70D (82.4th percentile) was predicted to remainfree of myopia before grade 12. Similarly, SE>–0.73D (11.6th percentile)indicated a low likelihood of developing high myopia before grade 12. Thisstudy established comprehensive non-cycloplegic SE reference values forscreening and predicting myopia among Chinese students. The methodologicalframework developed here may be applicable to other regions where studentmyopia prevalence patterns demonstrate relative stability.

构建儿童青少年近视筛查与预测的非睫状肌麻痹等效球镜度数参考值 — 中国，2020–2024年

刘扬^1,2,&；秦冉^1,2,3,&；熊鹰⁴；顾昉⁵；史伟⁶；刘建蒙^1,2,7；郭欣^3,8,#；李宏田^1,2,7,#

1. 北京大学生育健康研究所，国家卫生健康委员会生育健康重点实验室，公共卫生学院，北京大学，北京，中国；

2.流行病与卫生统计学系，公共卫生学院，北京大学，北京，中国；

3.北京市疾病预防控制中心，北京，中国；

4.重庆市疾病预防控制中心，重庆，中国；

5.浙江省疾病预防控制中心，杭州市，浙江省，中国；

6.陕西省疾病预防控制中心，西安市，陕西省，中国；

7.人工智能研究院智慧公众健康研究中心，北京大学，北京，中国；

8.中国疾病预防控制中心，北京，中国。

^&共同第一作者。

^#通信作者：郭欣，guoxin@chinacdc.cn；李宏田，lihongtian@pku.edu.cn。

非睫状肌麻痹验光常用于视力筛查，但如何合理解释和应用非睫状肌麻痹验光结果对于临床和公共卫生实践仍是一个挑战。本研究旨在建立分年级和性别的非睫状肌麻痹等效球镜度数（spherical equivalent，SE）参考值，以筛查和预测中国学生的近视发生及进展，促进儿童青少年近视防控。2020年至2024年期间，抽取我国10省共67260名幼儿园至高中学生进行屈光度检查。使用Lambda-Mu-Sigma(LMS)方法对非睫状肌麻痹SE建模。通过计算各年级对应于0至12年级近视和高度近视患病率的SE百分位数，确立筛查和预测近视和高度近视的SE参考值。男生在0年级（幼儿园大班）时，近视和高度近视患病率分别估计为1.2%和<0 1="" 12="" 82="" 4="" 11="" 6="" 12="" se="" 82="" 4="" -0="" 99d="" 11="" 6="" -6="" 16d="" 12="" 0="" se="">0.70D（第82.4百分位数），则可预测其12年级前不太可能发生近视。同样地，若该男生的非睫状肌麻痹SE>–0.73D (第11.6百分位数)，则可预测其12年级前不太可能发展为高度近视。本研究建立了中国学生分年级和性别的非睫状肌麻痹SE参考值。此外，本研究采用的建立参考值的方法同样适用于其他儿童青少年近视患病率相对稳定的国家和地区。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.048

Development and Testing of PhysicalLiteracy Scales for Chinese Elementary School Students — China, 2022

Mengyu Li¹; Ziqing Zan¹;Lizu Liu¹; Hanxin Gu¹; Yu Zhang¹; Lili You^1,#

1. School of Health Policy and Management,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing, China.

^# Correspondingauthor: Lili You, yll@pumc.edu.cn.

This study aimed to develop and validatetest-based physical literacy scales (PLSs) for primary school students acrossdifferent grades. Data were collected through a field survey conducted fromJune 1 to July 31, 2022, involving 3,275 primary school students from fourprovinces in China. The questionnaires assessed four domains: physicalknowledge, physical competence, physical motivation, and physical behavior. TheRasch model was employed for psychometric analysis. The variance explained bymeasures for the PLSs was 53.1%, 50.3%, and 54.7%, all exceeding the 50%threshold, confirming unidimensionality and robust internal consistency. Thisenabled effective differentiation among students with varying proficiencylevels. The item-person map demonstrated optimal alignment between itemdifficulty and participant ability levels. Most items showed favorable fitstatistics, with Infit MNSQ and Outfit MNSQ values ranging between 0.5 and 1.5.The PLSs demonstrate validity and reliability in measuring physical literacyamong Chinese primary school students across four components: physicalknowledge, physical competence, physical motivation, and physical behavior. Thescales measure a unidimensional construct, supporting the use of summed totalscores for assessment.

国内小学生体育量表的开发与测试 — 中国，2022年

李梦宇¹；昝子晴¹；刘丽珠¹；顾晗昕¹；张玉¹；尤莉莉^1,#

1. 卫生健康管理政策学院，中国医学科学院北京协和医学院，北京，中国。

^#通信作者:尤莉莉，yll@pumc.edu.cn。

本研究的目的是开发和验证基于测试的不同年级小学生的体育素养量表。量表框架包括身体活动知识、身体活动能力、身体活动动机和身体活动行为。研究通过实地调查 (2022年6月1日至2022年7月31日)收集数据，其中选择了来自中国四个省份的3275名小学生作为参与者填写量表、收集数据并采用Rasch模型进行量表质量分析。采用Rasch模型进行测量解释的方差为53.1%、50.3%和54.7%，均超过50%阈值，说明单维性假设仍然有效，内部一致性是稳健的，有助于有效区分不同熟练程度的学生能力。怀特图显示量表条目难度可以很好地匹配被试者的能力水平。大多数条目的Infit MNSQ和Outfit MNSQ值平均在0.5到1.5之间，表明量表整体拟合性良好。体育素养量表包括四个组成部分：身体活动知识、身体活动能力、身体活动动机和身体活动行为，是衡量中国小学生身体活动素养水平的有效且可靠的工具。它们的测量具有单维性，因此使用总分进行评估具有可行性。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.049

Implementation of Universal NewbornHearing Screening and Analysis of School Enrollment Among Hearing-ImpairedStudents in China

Zhili Wang^1,&;Yunge Gao^2,&; Yuzhang Huang^3,&; Wenying Nie⁴;Yun Li^1,2; Haibin Sheng^1,2; Jie Chen^1,2; YuzhuGuo⁵; Kun Han^1,2; Zhiwu Huang^1,2; Fan Jiang⁶;Jun Zhang⁷; Hao Wu^1,2,#; Ying Chen^8,#

1. Department ofOtolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine, Shanghai, China;

2. Ear Institute, ShanghaiJiao Tong University School of Medicine; Shanghai Key Laboratory ofTranslational Medicine on Ear and Nose Diseases, Shanghai, China;

3. Department of HealthPolicy Management, Bloomberg School of Public Health, Johns Hopkins University,Baltimore, MD, USA;

4. Jinan Maternal and ChildCare Hospital Affiliated to Shandong First Medical University, Jinan City,Shandong Province, China;

5. School of Public Health,Shanghai Jiao Tong University, Shanghai, China;

6. Department ofDevelopmental and Behavioral Pediatrics, National Children's Medical Center,Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao TongUniversity, Shanghai, China;

7. Ministry ofEducation-Shanghai Key Laboratory of Children's Environmental Health, XinhuaHospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

8. Department of Audiology& Speech-Language Rehabilitation, College of Health Science and Technology,Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^&Joint first authors.

^# Corresponding author: Ying Chen, drevonne@shsmu.edu.cn; Hao Wu, wuhao@shsmu.edu.cn.

Universal newborn hearingscreening (UNHS) is recognized as the most effective strategy for earlydetection of congenital hearing loss; however, screening coverage remainsinadequate in many countries. In China, newborn hearing screening has beenimplemented for over two decades. To evaluate our policies and practices duringthis period and assess resource equity, health impacts, and future challenges,we conducted a nationwide survey focusing on newborn hearing screeningcoverage, the number of special schools for deaf-mutes, and the proportion ofhearing-impaired students in mainstream education. From 2001 to 2020, China'sUNHS program coverage increased from 10.9% to 94.3%, while the proportion ofhearing-impaired students in mainstream education rose from 24.8% to 57.5%.Concurrently, the number of hearing-impaired students in special schoolsdecreased from 76,554 to 34,945, and the number of special schools for deaf-mutesdeclined from 639 to 389. Through the implementation of the UNHS program, Chinahas made substantial progress in improving newborn hearing health, yieldinglong-term benefits for those with congenital hearing loss. However, targetedresource allocation and the establishment of a national platform remainpriorities for future development. Our experience may provide valuable insightsfor similar settings.

中国普遍新生儿听力筛查的实施与听障学生入学情况分析

王智立^1,&；高云鸽^2,&；黄羽张^3,&；聂文英⁴；李蕴^1,2；盛海斌^1,2；陈杰^1,2；郭玉珠⁵；韩琨^1,2；黄治物^1,2；江帆⁶；张军⁷；吴皓^1,2,#；陈颖^8,#

1. 耳鼻喉头颈外科，附属第九人民医院，上海交通大学医学院, 上海，中国；

2. 耳科学研究所，上海交通大学医学院；上海市耳鼻疾病转化医学重点实验室，上海，中国；

3. 卫生政策管理系，彭博公共卫生学院，约翰·霍普金斯大学，巴尔的摩市，马里兰州，美国；

4. 山东第一医科大学附属济南妇幼保健院，济南市，山东省，中国；

5. 公共卫生学院，上海交通大学，上海，中国；

6. 发育行为儿科，国家儿童医学中心，医学院附属上海儿童医学中心，上海交通大学，上海，中国；

7. 环境与儿童健康教育部和上海市重点实验室，医学院附属新华医院，上海交通大学，上海，中国；

8. 医学技术学院听力语言与康复系，医学院，上海交通大学，上海，中国。

^&共同第一作者。

^#通信作者：陈颖, drevonne@shsmu.edu.cn; 吴皓, wuhao@shsmu.edu.cn。

普遍性新生儿听力筛查是早期发现先天性耳聋的最有效方法, 然而，许多国家新生儿听力筛查的覆盖率仍然较低。在中国，新生儿听力筛查项目已经实施了20多年。为呈现这一时期的政策与实践，并阐明资源公平性、健康影响及未来的挑战，本研究对中国新生儿听力筛查覆盖率、聋哑学校数量和普通中小学教育（主流教育）中听力障碍学生的比例进行了调查。2001年至2020年，中国新生儿普遍听力筛查覆盖率从10.9%提高到94.3%，听障学生接受主流教育的比例从24.8%提高到57.5%。与此同时，特殊学校的听障学生人数从76,554人减少到34,945人，聋哑学校的数量从639所减少到389所。通过实施普遍性新生儿听力筛查, 中国在改善儿童听力健康方面取得了瞩目进展，这对先天性聋患者有重要意义。同时，在未来需要进行针对性的资源分配，并建立全国性平台。我们的经验可为类似环境提供有价值的借鉴。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.050