Validation of Screening Tools for Identifying Hearing-Impaired Elderly in Primary Care

Abstract

Two instruments for the detection of hearing impairment, the Welch-Allyn audioscope (Welch-Allyn Inc, Skaneateles Falls, NY) and the Hearing Handicap Inventory for the Elderly--Screening Version (HHIE-S), were validated against pure tone audiometry in 178 patients over 65 years old screened in primary care practice. The prevalence of hearing impairment in this sample was 30%. The audioscope yielded reproducible results in the physicians' offices and a hearing center. The sensitivity of the audioscope was 94% in both locations, while its specificity was 90% in the hearing center and 72% in the physicians' offices. The HHIE-S yielded reproducible results between the two test locations. An HHIE-S score from 0 to 8 resulted in a likelihood ratio of 0.36 (95% confidence interval, 0.19 to 0.68), and a score of 26 or more yielded a likelihood ratio of 12.00 (95% confidence interval, 2.62 to 55.00) for predicting the presence of hearing impairment. Used together, the two instruments had a test accuracy of 83%. The audioscope and HHIE-S are valid, reliable, inexpensive tools for detecting hearing impairment in the elderly.

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“…It is important to note that the frequency of 4,000 Hz is among the first to demonstrate an age-related decline, and is, therefore, fundamental in understanding speech, especially in noisy environments. 19,57,61 The classification adopted was made as shown in ►Table 1: 60 The accuracy of the HHIE-S questionnaire was determined by calculating the sensitivity and specificity, comparing the results that were true positive, false positive, true negative and false negative with the PTA. The confidence intervals (CIs) used to estimate the sensitivity, specificity, positive predictive value and negative predictive value were calculated using the exact method of Clopper-Pearson.…”

Prevalence, adverse health, and risk factors in association with sensory impairments: data from a prospective cohort study of older Japanese

“…Blood levels of the antioxidants, including alphaand gamma-tocopherols, retinol, beta-cryptoxanthin, alphaand beta-carotenes, lycopene, and lutein and zeaxanthin, were determined by high-performance liquid chromatography. Our structured questionnaire included socioeconomic and lifestyle-related factors, past/current history of illness, and some well-validated scales, such as the Geriatric Depression Scale (GDS) 5-item version [7] and the Hearing Handicap Inventory for the Elderly-Screening version (HHIE-S) [8].…”

Long-term cost effectiveness of screening strategies for hearing loss

“…The screening was positive if the participant did not hear a 40 dB tone at 2,000 Hz in either ear [13,[19][20]. Training required to use the device was negligible.…”

“…Together, they may assess complementary aspects of hearing loss [13,19]. The tone-emitting otoscope may identify those with mild hearing loss who may not have sufficient handicap to seek out and comply with treatment [19].…”

“…To alleviate the toll that hearing loss exacts on productivity, function, and quality of life, some authors have advocated routine hearing screening. Several screening tests can accurately detect hearing loss among elderly patients [12][13][14], and both the U.S. Preventive Service Task Force and the Canadian Task Force on Preventive Health Care have recommended routine screening of hearing loss in the elderly [15][16].…”