Influence of demographic factors on the agreement between audiometric hearing loss and Revised Hearing Handicap Inventory self-reported hearing difficulty

Abstract

This study evaluated the agreement between audiometric hearing loss and Revised Hearing Handicap Inventory (RHHI) self-reported hearing difficulty, and modification by demographic factors (age, sex, race, socioeconomic status [SES]) in adults across the lifespan. Baseline data from the Medical University of South Carolina Longitudinal Cohort Study of Age-Related Hearing Loss (ARHL), a community-based cohort study of ARHL (1988-current) were used. Audiometric hearing loss was defined as pure-tone average (0.5–4.0 kHz) >25 dB HL in the better ear. RHHI hearing difficulty was defined as a score ≥6 on the full and screening (RHHI-S) versions. Sensitivity, specificity, and accuracy evaluated ability of the RHHI(-S) to detect audiometric hearing loss. The number of participants was 1558 (56.9% female; mean age 63.7 [range 18-89 + ] years). Prevalence of audiometric hearing loss, RHHI, and RHHI-S hearing difficulty was 38.2%, 48.8%, and 44.6%, respectively. Sensitivity, specificity, and accuracy were similar for RHHI and RHHI-S hearing difficulty (versus audiometric hearing loss). The RHHI(-S) was less sensitive in detecting audiometric hearing loss in older and non-White adults. Sensitivity was similar by sex and SES but specificity was lower in males and high/low (vs mid) SES. Agreement between audiometric hearing loss and RHHI(-S) hearing difficulty is modified by demographic factors.