Validation of screening tools for identifying hearing-impaired elderly in primary care.
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.
Lichtenstein
M J
MJ
Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, TN 37232.
Bess
F H
FH
Logan
S A
SA
D000368:Aged; D005194:Family Practice; D006311:Hearing Disorders / Q000175:diagnosis*; D006320:Hearing Tests / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D012680:Sensitivity and Specificity