Screening for handicapping hearing loss in the elderly.
OBJECTIVE
To compare 2 screening methods for unrecognized handicapping hearing loss in the elderly.


METHODS
Cross-sectional study.


METHODS
Five hundred forty-six older individuals who underwent audiometry at biennial examination 22 of the Framingham Heart Study and who took the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire.


METHODS
The 2 screening methods were the 10-item HHIE-S and 1 global question: "Do you have a hearing problem now?" The gold standard was an audiogram showing a pure tone threshold of 40 dB HL or higher at 1 and 2 kHz in one ear or at 1 or 2 kHz in both ears. Both screening methods were compared with the gold standard in terms of sensitivity, specificity, and predictive values. The 10-item screening version of the HHIE-S (cutoff score between 8 and 10) had a sensitivity of 35% and a specificity of 94% for detecting the criterion hearing loss. The global subjective measure had greater sensitivity (71%) but lower specificity (71%) than the HHIE-S. Combining the global question and the HHIE-S items failed to improve the specificity of the global question or the sensitivity of the HHIE-S.


CONCLUSIONS
The global measure of hearing loss was more effective than the detailed questionnaire in identifying older individuals with unrecognized handicapping hearing loss. Primary care physicians are encouraged to ask their patients whether they have a hearing problem and refer patients who do for formal hearing testing.
Gates
George A
GA
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA 98195-7923, USA. ggates@u.washington.edu
Murphy
Michael
M
Rees
Thomas S
TS
Fraher
Arlene
A
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D001301:Audiometry, Pure-Tone; D003430:Cross-Sectional Studies; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis*; D006320:Hearing Tests / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D019986:Persons with Hearing Disabilities / Q000523:psychology; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States