Elderly patients can be screened for significant hearing impairment by a simple free field voice test using 4 different levels in the loudness of the examiner's voice.
Test methodology:
(1) The examiner stands behind the patient to remove the possibility of lip reading.
(2) The examiner then occludes the non-tested ear by gently occluding that ear's external auditory canal.
(3) The examiner asks the patient to repeat a set of 3 random numbers spoken by the examiner under different testing conditions.
4 sets of testing conditions are performed:
(1) conversational voice at 6 inches
(2) conversational voice at 2 feet
(3) whispering voice at 6 inches
(4) whispering voice at 2 feet
Passing level - either:
(1) The patient is able to repeat all 3 numbers correctly, OR
(2) The patient is able to successfully repeat more than 50% over three triplet sets of numbers.
Failure to pass at each level of voice testing was considered a positive evidence for some degree of hearing impairment.
• The inability to hear a whispered voice at 2 feet was successful in identifying those patients likely to benefit from a hearing aid.
Validity in detection of significant hearing impairment |
sensitivity |
specificity |
positive predictive value |
failure to hear a whispered voice at 2 feet |
100% |
84% |
92% |
failure to hear a whispered voice at 6 inches |
73% |
100% |
100% |
failure to hear a conversational voice at 2 feet |
47% |
100% |
100% |
Specialty: Neurology, Otolaryngology
ICD-10: ,