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Article
May 20, 1988

Validation of Screening Tools for Identifying Hearing-Impaired Elderly in Primary Care

Author Affiliations

From the Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn (Dr Lichtenstein); and Division of Hearing and Speech Sciences, Bill Wilkerson Hearing and Speech Center, Vanderbilt University School of Medicine (Dr Bess and Ms Logan). Dr Lichtenstein is a Milbank Memorial Fund Scholar in Clinical Epidemiology, 1983-1988.

From the Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, Tenn (Dr Lichtenstein); and Division of Hearing and Speech Sciences, Bill Wilkerson Hearing and Speech Center, Vanderbilt University School of Medicine (Dr Bess and Ms Logan). Dr Lichtenstein is a Milbank Memorial Fund Scholar in Clinical Epidemiology, 1983-1988.

JAMA. 1988;259(19):2875-2878. doi:10.1001/jama.1988.03720190043029
Abstract

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.

(JAMA 1988;259:2875-2878)

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