Speech And Pure Tone Audiometry As A Screen For Exaggerated Hearing Loss In Industrial Claims

Abstract

We examined 596 patients referred with possible noise-induced hearing loss, by conventional and cortical evoked response audiometry. Discrepancies between the two tests identified 121 (20.3%) as exaggerating their hearing loss. We then studied the validity of simple conventional tests, which would be available in primary diagnostic facilities, in screening for the exaggerators we had identified. By selecting those whose puretone average (for 0.5 and 1 kHz) was more than 10 dB different from the speech reception threshold, or whose initial puretone threshold at 0.5 kHz was 40 dB or greater, we identified 112 (93%) of the exaggerators, at the cost of additional examination of 209 (35 % of the total) false-positive. However, this screening means that 46% of the claimants could be evaluated completely in a primary diagnostic facility, and only a small fraction of the exaggerators should be overlooked.