Sensitivity and specificity of hearing tests for screening hearing loss in older adults

J Otol. 2023 Jan;18(1):1-6. doi: 10.1016/j.joto.2022.11.003. Epub 2022 Nov 24.

Abstract

Objectives: The study aimed to determine the most appropriate hearing screening test to identify disabling hearing loss for adults aged 65 years or older.

Methods: This study included 577 older adults. Four hearing screening tests were considered in the study, including the Hearing Handicap Inventory for Elderly Screening (HHIE-s), three single question tests, the whisper test, and the finger rub test. The sensitivity and specificity of these tests referenced to the hearing threshold of disabling hearing loss were estimated.

Results: Among all tests, only the single self-perception question (0.7064 for sensitivity; 0.7225 for specificity) and whisper test (0.7833 for sensitivity; 0.7708 for specificity) could obtain both sensitivity and specificity higher than 70% for adults aged ≥65 years.

Conclusion: Overall, we suggest using the whisper test to identify disabling hearing loss (>40 dB HL at the better ear) for adults aged 65 years or older. However, if the conditions do not permit, the single self-perception question is also acceptable. Moreover, HHIE-s might not be a good test to detect disabling hearing loss for adults aged 80 years or older.

Keywords: Finger rub test; Hearing screening; Questionnaire; Sensitivity and specificity; Whisper test.