International Journal of Epidemiology 2001;30:1371-1378
© International Epidemiological Association 2001
Theory and Methods |
Validation of self-reported hearing loss. The Blue Mountains Hearing Study
a Departments of Public Health & Community Medicine, and
b Ophthalmology, The University of Sydney (Westmead Hospital), Australia.
c National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
d Speech, Hearing and Language Research Centre, Macquarie University, Sydney, Australia.
e Australian Hearing, Sydney, Australia.
Assoc. Prof. Paul Mitchell, Department of Ophthalmology, The University of Sydney, Eye Clinic, Westmead Hospital, Hawkesbury Rd, Westmead, NSW, Australia, 2145. E-mail: paulmi{at}westgate.wh.usyd.edu.au
Abstract
Purpose Large-scale epidemiological studies have often used self-report to estimate prevalence of age-related hearing loss. However, few large population-based studies have validated self-report against measured hearing loss. Our study aimed to assess the performance of a single question and a brief hearing handicap questionnaire in identifying individuals with hearing loss, against the gold standard of pure-tone audiometry.
Methods We examined 2015 residents, aged 55–99 years, living in the west of Sydney, Australia, who participated in the Blue Mountains Hearing Study during 1997–1999. Audiologists administered a comprehensive questionnaire, including the question: ‘Do you feel you have a hearing loss?’ The Shortened Hearing Handicap Inventory for Elderly (HHIE-S) was also administered during the hearing examination, which included pure-tone audiometry. The single question and HHIE-S were compared with measured losses at levels >25, >40 and >60 decibels hearing level (dBHL) to indicate mild, moderate and marked hearing impairment, for pure-tone averages (PTA) of responses to 500, 1000, 2000 and 4000 Hz.
Results The single question yielded reasonable sensitivity and specificity for hearing impairment, and was minimally affected by age and gender. HHIE-S scores >8 had lower sensitivity but higher specificity and positive predictive value. The HHIE-S performed slightly better in younger than older subjects and performed better for moderate hearing impairment.
Conclusions In this older population with a high prevalence of hearing loss (39.4%), both a question about hearing and the HHIE-S appeared sufficiently sensitive and specific to provide reasonable estimates of hearing loss prevalence. Both could be recommended for use in epidemiological studies that aim to assess the magnitude of the burden caused by age-related sensory impairment but cannot measure hearing loss by audiometry.
Keywords Blue Mountains Hearing Study, hearing loss, hearing impairment, deafness, questionnaire, validation, sensitivity, specificity, positive predictive value, negative predictive value, accuracy, pure-tone average, Hearing Handicap Inventory for the Elderly, HHIE-S
Accepted 23 April 2001
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