Usability of HHIE S as a screening test of hearing imairment in the Korean elderly

Kim, Young San; Won, Chang Won; Kim, Byoung Sung; Choi, Hyun Rim; Kim, Sung Hoon; Kim, Jun Chul; Lim, Jong Bum

Abstract

BACKGROUND: Hearing impairment is one of the most common physical handicaps of the aged. This diseases has recently attracted such amount of social attention and understanding as never attracted several years ago, and high degree of achievement was made with regard to screening test method, diagnosis, treatment and rehabilitation. However, unfortunately, even now, not enough attention is being paid upon early discovery hearing handicap for patients frequently encountered in clinics. Therefore, as a screening test method of senile hypacusis, we were to apply "Hearing Handicap Inventory for the Elderly Screening Version" (HHIE S) inquiries in Korea and studied the usability, sensitivity, specificity, positive predictive value and negative predictive value and cutoff point of this method.
METHODS
This study was performed for 120 persons over the age of 60, who visited general health screening centers of one university hospital located in Seoul, during the period of October 1997 through to March 1999. HHIE S questionnaires were used and pure tone audiometry was performed to generate gold standard.
RESULTS
Only 110 out of 120 initial subjects were included in the study because of incomplete questionnaire answers by excluded 10 subjects. We defined gold standard of hearing handicap to be (1) lower than 40 dB of hearing capability of both ears to frequency between 1000 Hz and 2000 Hz or (2) lower than 40 dB of hearing capability of an ear to frequency between 1000 Hz and 2000 Hz, as determined by pure tone audiometry. Assuming cutoff point of HHIE S as 4 points, the sensitivity and specificity resulted to be 80% and 67% each. Assuming cutoff point of HHIE S as 6 points, the sensitivity and specificity were 76% and 78% each. At 8 points, the percentages were 64% and 80%. At 10 points, the percentages were 64% and 85%. As a result of this study, the appropriate cutoff point is 6 points. In order to specify the correlation between questionnaire result and pure tone audiometry, we performed 500 Hz, 1000 Hz and 2000 Hz audiometry which are within conversational range, calculated arithmetic mean from the results, and inspected correlation between the resultant mean of the better performing ear and questionnaire resultant points. The correlation coefficient was 0.612 and Chronbach's alpha, as a measurement of internal consistency of the questionnaire was 0.9044.
CONCLUSION
HHIE S proved to be useful in screening hearing handicap in the Korean elderly.