title: Interpretation of pure-tone thresholds in sensorineural hearing loss (SNHL): a review of measurement variability and age-specific references.
abstract: When assessing a patient with a sensorineural hearing impairment, the most simple and most widely available technical investigation is pure-tone audiometry. Although it is a subjective measure, the test is very reliable if the patient is cooperative. In this paper we review standards and test-retest reliability for pure-tone audiometry. A pure-tone threshold measurement at a single frequency has a chance of 90% to be repeated between -10 dB and +10 dB compared to the first measurement, assuming no real change in hearing thresholds has occurred. It is also of great importance to use correct gender- and age-specific reference values when interpreting pure-tone threshold measurements. Several large-scale epidemiological studies have been conducted during recent years, and have provided us with reliable gender- and age-specific references. A method to take into account the age-related deterioration is presented. In this method, Z-score audiograms represent traditional thresholds in an age- and gender-independent way. At each frequency, the Z-score value is the number of standard deviation units that the threshold differs from the median value for the otologically normal population (ISO 7029).
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Antwerp (UZA), Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Lemkens
authors.forename: K
authors.initials: K
authors.lastname: Vermeire
authors.forename: J P L
authors.initials: JP
authors.lastname: Brokx
authors.forename: E
authors.initials: E
authors.lastname: Fransen
authors.forename: G
authors.initials: G
authors.lastname: Van Camp
authors.forename: P H
authors.initials: PH
authors.lastname: Van De Heyning
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001301:Audiometry, Pure-Tone / Q000706:statistics & numerical data*; D001309:Auditory Threshold / Q000502:physiology*; D003627:Data Interpretation, Statistical; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012737:Sex Factors