ABSTRACT
BACKGROUND: In Germany the guideline for the hearing loss quantification and the resulting assessment of the reduction in earning capacity is the Königsteiner Merkblatt (KM). The quantification depends on the results of the tone and speech audiogram in silence. However, speech discrimination tests in noise may provide additional information about the impairment of the ENT patients. Especially, the impairment of persons with a slight hearing loss, characterized by high-frequency hearing loss, in noisy environment can not be indicated by the measurement in silence, which is proposed in the KM. METHODS UND PATIENTS: The Göttingen sentence test in noise was applied as a supplement to the routine ENT procedures of the medical estimate in 135 test persons. Based on these measurement results a table for the percentage hearing loss in noise is defined. Furthermore, an integration of the hearing loss in noise in the assessment of the reduction in earning capacity is proposed in addition to the hearing loss in silence. RESULTS: Using the newly introduced hearing loss for speech in noise, a suitable assessment for persons with a slight hearing loss is achieved. By integrating it into the assessment procedure additionally to the hearing loss in silence, the hearing impairment of all patients can be rated depending on their speech test results in silence and in noise. In comparison to the results obtained by the KM, the new procedure does not lead to higher values for the proposed reduction in earning capacity in general, but instead seems to be equally suitable for all groups of patients.
Subject(s)
Disability Evaluation , Hearing Loss/diagnosis , Hearing Loss/economics , Hearing Tests/economics , Income/statistics & numerical data , Speech Discrimination Tests/economics , Work Capacity Evaluation , Adolescent , Adult , Aged , Female , Germany/epidemiology , Hearing Loss/epidemiology , Hearing Tests/methods , Hearing Tests/statistics & numerical data , Humans , Male , Middle Aged , Prevalence , Reproducibility of Results , Risk Assessment , Risk Factors , Sensitivity and Specificity , Speech Discrimination Tests/methods , Speech Discrimination Tests/statistics & numerical data , Young AdultABSTRACT
Spondees (N:15) chosen from the literature as having relatively homogeneous intelligibility were re-recorded to preserve this feature. ST's were collected twice from 60 normal-hearing young adults by each of 6 combinations of method (ascending, descending, bracketing) and step size (2-, 5-db). A cost-benefit analysis (test-retest reliability, time required, agreement with PTA) yielded the descending-2-db combination as superior to other combinations.
