Self-Reported Hearing Loss and Pure Tone Audiometry for Screening in Primary Health Care Clinics

Abstract

Objective: To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. Design: Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. Results: Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. Conclusion: While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.

Assessing hearing loss in older adults with a single question and person characteristics; Comparison with pure tone audiometry in the Rotterdam Study

“…The ability of the question to identify hearing loss increases substantially when other factors are taken into account, with age being the most important one. Our results are in line with the increasing support in literature for using a single question as an estimator for hearing loss in absence of pure tone audiometry [14,15,[23][24][25][26][27][28]. There is a growing general interest in applying this concept to large population-based studies, for which time or other resources to perform audiometry are not available [29,30].…”

Comparison of Self-reported Measures of Hearing With an Objective Audiometric Measure in Adults in the English Longitudinal Study of Ageing

“…These findings have important public health implications and call for a revised assessment approach for HL in older adults; clinical research often relies on self-report measure of HL, but our findings indicate that this could not be regarded as a well-suited and accurate measure to identifying individuals with HL without the additional use of a screening measure for audiometric testing. 27 The underestimation of hearing difficulties poses a significant barrier to HL intervention, and the self-report measures should not be considered reliable measures of hearing acuity to influence the judgment for referral to secondary care.…”

Validation of a questionnaire to identify noise-induced hearing loss among drivers

“…However, when self-reported HL and audiometry screening were combined, it showed high test accuracy (81.0%) for HL and being most accurate (86.1%) at a high-frequency HL, when compared with clinical audiometry test. [11]…”