Value of Hearing Handicap Elderly‐Screening in Predicting Hearing Impairment

Abstract

Objectives: Evaluate the usefulness of the Screening Version of the Hearing Handicap Inventory for the Elderly (HHIE-S) questionnaire in screening for hearing impairment in the general population. Methods: We recruited subjects at a health awareness event organized by the ENT Department of a tertiary hospital. Members of the public were invited to fill in the HHIE-S questionnaire and to undergo a four-frequency pure tone audiogram (PTA), of which 37 subjects aged 25 to 82 years completed both. Results: Conventionally, moderate or high scores on the HHIE-S questionnaire are considered strongly suspicious of a hearing impairment. If hearing impairment is defined as four-frequency average (0.5kHz, 1kHz, 2kHz & 4 kHz) PTA > 26dB in the better hearing ear, the sensitivity of the HHIE-S questionnaire in screening for hearing impairment is 80%, but its specificity is low at 18%. The positive predictive value is 40% and the negative predictive value 57%. However, if hearing impairment is defined as four-frequency average PTA > 41dB, the sensitivity of the HHIE-S questionnaire in screening for hearing impairment is increased to 100% though its specificity remains low at 20%. The positive predictive value of the screening questionnaire is greatly reduced to 6%, though the negative predictive value rises to 100%. Conclusions: For general population screening, the HHIE-S is too inaccurate to screen for slight and mild hearing loss, but it can be used to screen for moderate to severe hearing loss. However, all patients with moderate and high scores need a formal audiogram to confirm the hearing levels.