Validation of Screening Tools for Identifying Hearing-Impaired Elderly in Primary Care

Michael J. Lichtenstein, Fred H. Bess, Susan A. Logan

Research output: Contribution to journalArticlepeer-review

214 Scopus citations


Two instruments for the detection of hearing impairment, the Welch-Allyn audioscope (Welch-Allyn Inc, Skaneateles Falls, NY) and the Hearing Handicap Inventory for the Elderly—Screening Version (HHIE-S), were validated against pure tone audiometry in 178 patients over 65 years old screened in primary care practice. The prevalence of hearing impairment in this sample was 30%. The audioscope yielded reproducible results in the physicians’ offices and a hearing center. The sensitivity of the audioscope was 94% in both locations, while its specificity was 90% in the hearing center and 72% in the physicians’ offices. The HHIE-S yielded reproducible results between the two test locations. An HHIE-S score from 0 to 8 resulted in a likelihood ratio of 0.36 (95% confidence interval, 0.19 to 0.68), and a score of 26 or more yielded a likelihood ratio of 12.00 (95% confidence interval, 2.62 to 55.00) for predicting the presence of hearing impairment. Used together, the two instruments had a test accuracy of 83%. The audioscope and HHIE-S are valid, reliable, inexpensive tools for detecting hearing impairment in the elderly.

Original languageEnglish (US)
Pages (from-to)2875-2878
Number of pages4
JournalJAMA: The Journal of the American Medical Association
Issue number19
StatePublished - May 20 1988
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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