Discriminating and responsiveness abilities of two hearing handicap scales.
Several scales exist for screening handicap and assessing rehabilitation in elderly individuals with hearing loss. There are few comparative studies, however, to suggest which scales perform best. Using receiver-operating curves and responsiveness indices, we examined the relative discriminating ability and sensitivity to detect change of four scales: a long and short version of the Hearing Handicap Inventory in the Elderly (HHIE-L, HHIE-S), and a long and short version of the Revised Quantified Denver Scale of Communication Function (RQDS-L, RQDS-S). All scales were administered to 137 elderly veterans with hearing loss and 101 elderly veterans without hearing loss. Follow-up testing to determine relative ability to detect change was assessed in hearing impaired individuals only after they had used a hearing aid for 4 months. Discriminative accuracy for correctly identifying individuals with hearing loss were: HHIE-L 78%, HHIE-S 79%, RQDS-L 73%, and RQDS-S 74%. Overall differences between the HHIE-S and the RQDS-S were not statistically significant (p = 0.06). True positive results were greater with the HHIE-S compared to the RQDS-S (p = 0.03). Responsiveness indices were: HHIE-L 1.78, HHIE-S 1.86, RQDS-L 1.04, and RQDS-S 1.07. Differences between the HHIE-S and the RQDS-S were statistically significant (p less than 0.05). We conclude short versions of the HHIE and RQDS are as accurate and sensitive for detecting change as long versions, and the HHIE-S is a superior versatile instrument for screening and assessing rehabilitation in elderly individuals with hearing impairment.
Division of General Internal Medicine, Audie L. Murphy Memorial Veterans' Hospital, San Antonio, Texas.
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Mulrow
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Tuley
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D000368:Aged; D012048:Correction of Hearing Impairment; D004185:Disability Evaluation; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity