title: Validation of hearing handicap inventory for the elderly questionnaire among elderly subjects in Sagamu, Nigeria.
abstract: BACKGROUND
  Use of hearing impairment (HI) questionnaires has been an alternative to formal audiometry.
  
  
  OBJECTIVE
  To validate hearing handicap inventory for the elderly (HHIE) questionnaire and verify its suitability or otherwise as a screening instrument in low-resource clinical settings.
  
  
  METHODS
  A cross-sectional analytical study deployed the HHIE questionnaire to detect emotional and situational hearing handicaps (HHs) and assigned scores. Total scores were categorised as no, mild to moderate or significant HH. Pure tone audiometries (PTAs) were performed and PT average (PTAv) was calculated. HHIE scores were compared with the PTAvs. Validity of HHIE scores compared with PTAvs was explored with sensitivity, specificity and predictive values, while correlation coefficients combined age, HHIE scores and PTAv. Level of statistical significance was taken as P < 0.05 for all analyses.
  
  
  RESULTS
  One hundred and three subjects with mean age ± standard deviation, 71.3 ± 7.2 years were studied. Over 70% (71.8%, 74/103) were married, 63.1% (65/103) attended secondary school, 35.0% (36/103) were professionals and 45.6% (47/103) were retired. HHIE questionnaire revealed 59.2% (61/103) had handicap and PTA confirmed 47.6% (49/103) had HI. Comparing HHIE scores with PTAv, overall sensitivity was 79.6%, specificity was 59.3%, positive predictive value was 63.9% and negative predictive value was 76.2%. HHIE scores correlated significantly with PTAv (r = 0.527, P < 0.001) and there was no correlation between age and PTAv (r = 0.145, P = 0.143) and between age and HHIE scores (r = 0.187, P = 0.059).
  
  
  CONCLUSIONS
  HHIE scores obtained from questionnaire can adequately quantify HI. HHIE questionnaire is a valid screening instrument to identify HH among elderly subjects.
authors.affiliation: From the ENT Unit, Department of Surgery, College of Health Sciences, Olabisi Onabanjo University, Sagamu, Nigeria.
authors.forename: Olusola Ayodele
authors.initials: OA
authors.lastname: Sogebi
authors.forename: Taofeeq Oluwaninsola
authors.initials: TO
authors.lastname: Mabifah