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

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Abstract
Patients (596) referred with possible noise-induced hearing loss were examined by conventional and cortical evoked response audiometry. Discrepancies between the 2 tests identified 121 (20.3%) as exaggerating their hearing loss. The validity of simple conventional tests, which would be available in primary diagnostic facilities, in screening for the exaggerators was studied. 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, 112 (93%) of the exaggerators were identified 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.

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