Associations between the probabilities of frequency-specific hearing loss and unaided APHAB scores

Abstract

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire reports subjective hearing impairments in four typical conditions. We investigated the association between the frequency-specific probability of hearing loss and scores from the unaided APHAB (APHABu) to determine whether the APHABu could be useful in primary diagnoses of hearing loss, in addition to pure tone and speech audiometry. This retrospective study included database records from 6558 patients (average age 69.0 years). We employed a multivariate generalised linear mixed model to analyse the probabilities of hearing losses (severity range 20–75 dB, evaluated in 5-dB steps), measured at different frequencies (0.5, 1.0, 2.0, 4.0, and 8.0 kHz), for nearly all combinations of APHABu subscale scores (subscale scores from 20 to 80%, evaluated in steps of 5%). We calculated the probability of hearing loss for 28,561 different combinations of APHABu subscale scores (results available online). In general, the probability of hearing loss was positively associated with the combined APHABu score (i.e. increasing probability with increasing scores). However, this association was negative at one frequency (8 kHz). The highest probabilities were for a hearing loss of 45 dB at test frequency 2.0 kHz, but with a wide spreading. We showed that the APHABu subscale scores were associated with the probability of hearing loss measured with audiometry. This information could enrich the expert’s evaluation of the subject’s hearing loss, and it might help resolve suspicious cases of aggravation. The 0.5 and 8.0 kHz frequencies influenced hearing loss less than the frequencies in-between, and 2.0 kHz was most influential on intermediate degree hearing loss (around 45 dB), which corresponded to the frequency-dependence of speech intelligibility measured with speech audiometry.Electronic supplementary materialThe online version of this article (doi:10.1007/s00405-016-4385-7) contains supplementary material, which is available to authorized users.

Sensitivity and specificity of the abbreviated profile of hearing aid benefit (APHAB)

“…In fact, including 8.0 kHz might be very strict and not used in MAT [19], and increases at least the number of healthy or sick ears. But our findings confirm previous results [7, 10]. In addition, such an influence of 8.0 kHz has been detected for the HHIE-S as well [20].…”

“…Using single subscales of APHAB u (EC, BN, and RV) leads to nearly similar cutoff values for EC u and RV u , and, by comparison, the cutoff score for BN u was even higher (Table 4). This may be explained by more widespread individual compensation abilities for hearing loss, as shown previously [9, 10]. In addition, the cutoff vaulue for the average model (Eq.…”

“…This finding is in concordance with those of previously published reports. The mean age of our group of participants was younger than studies that included subjects with are subsequently fitted with hearing aids [7, 9, 10]. According to previous results, the AV subscale is different for all others.…”

“…In contrast, they did not find any association between individual hearing loss typified to standard audiograms introduced by [8] and APHAB u scores in any subscale [9]. Moreover, they found that the majority of respondents answered most questions; those few questions (Question numbers 11, 18, and 21) that were answered less frequently may have been less relevant to everyday situations [10]. Finally, Löhler et al [11] investigated associations between APHAB u scores and hearing loss at all octave frequencies between 0.5 and 8 kHz.…”

“…Moreover, hearing problems in normal, low-noise conditions (EC) generally affect only individuals with severe hearing loss, with, again, fewer opportunities to learn how to compensate. The AV subscale score does appear to be negatively associated with hearing loss [7, 10]. The three subscales EC, BN, and RV assess understanding in different situations.…”