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hearing evaluation

Indications: - hearing loss - screening for hearing impairment - evidence insufficient to weigh benefits & risks of screening in asymptomatic adults >= 50 years of age [3,5,6] - simply asking older person about hearing impairment may be cost effective - 90% concurrence between self-reported hearing impairment & assessment by audiometry in adults >= 50 years of age [4] Procedure: - testing conducted to estimate a patient's hearing sensitivity, auditory system integrity, & auditory function - various tests are used, depending on the age of the patient & the need to define characteristics of any hearing loss. - audiometry is the gold standard - hand held audiometer is a reasonable screening tool [4] other screening tools include - bedside hearing tests: (sensitivity/specificity) a) finger rub 6 inches from ear (35%/97%) b) watch tick 6 inches from ear (60%/99%) c) whispered speech 2 feet from ear (46%/78%) d) Rinne test (-/100%) e) Weber test (74-83%) f) Do you think you have hearing difficulty? (27%/89%) - Hearing Handicap Inventory in the Elderly is the most reliable screening tool [2] Notes: - Medicare offers a one-time preventive hearing evaluation [2]

Related

audioscope hearing aid; digital hearing aid hearing loss (hearing impairment, hard of hearing, HOH) hearing; audition

Specific

audiometry electrocochleography Hearing Handicap Inventory in the Elderly-Screening Version (HHIE-S) Lombard test Rinne test Schwabach test sensorineural acuity level test staggered spondaic word test Stenger test synthetic sentence identification test Weber test whisper test

General

clinical procedure

References

  1. Boatman DF et al, How accurate are bedside hearing tests? Neurology 2007, 68:1311 PMID: 17438223
  2. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010 - Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  3. Moyer VA et al Screening for Hearing Loss in Older Adults: U.S. Preventive Services Task Force Recommendation Statement Ann Intern Med. 14 August 2012 PMID: 22893115 http://annals.org/article.aspx?articleid=1309706 (corresponding NGC guideline withdrawn Feb 2018)
  4. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  5. Chou R, Dana T, Bougatsos C, Fleming C, Beil T. Screening for Hearing Loss in Adults Ages 50 Years and Older: A Review of the Evidence for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Mar. PMID: 21542547 Free Books & Documents - Chou R, Dana T, Bougatsos C, Fleming C, Beil T. Screening adults aged 50 years or older for hearing loss: a review of the evidence for the U.S. preventive services task force. Ann Intern Med. 2011 Mar 1;154(5):347-55. Review. PMID: 21357912
  6. US Preventive Services Task Force Screening for Hearing Loss in Older Adults. US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(12):1196-1201 PMID: 33755083 https://jamanetwork.com/journals/jama/fullarticle/2777723 - Feltner C, Wallace IF, Kistler CE et al Screening for Hearing Loss in Older Adults. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(12):1202-1215 PMID: 33755082 https://jamanetwork.com/journals/jama/fullarticle/2777722 - Yueh B, Piccirillo JF Screening for Hearing Loss in Older Adults. Insufficient Evidence Does Not Mean Insufficient Benefit. JAMA. 2021;325(12):1162-1163 PMID: 33755056 https://jamanetwork.com/journals/jama/fullarticle/2777693 - Deal JA, Lin FR USPSTF Recommendations for Hearing Loss Screening in Asymptomatic Older Adults - A Case of Missing Evidence and Missing Treatment Options. JAMA Netw Open. 2021;4(3):e210274. PMID: 33755162 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777773m_campaign=article_alert-jama&utm_content=etoc&utm_term=032321 - Reed NS, Oh ES United States Preventive Services Task Force Recommendation for Hearing-Loss Screening Among Older Adults. An Opportunity in Insufficient Evidence JAMA Otolaryngol Head Neck Surg. Published online March 23, 2021 PMID: 33755045 https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2777788