Evaluation of Diagnostic Measures in Veterans With Self-Perceived Hearing Handicap Despite Normal Audiometric Thresholds: A Rapid Scoping Review.

Abstract

Purpose: This rapid scoping review examined clinical test measure literature among veterans with self-perceived hearing handicap with normal audiometric threshold configurations (SPHH-NA) and those with normal audiometric thresholds and no self-perceived hearing handicap to determine which tests differentiate these groups.

Method: A rapid scoping review in the PubMed and CINAHL databases was completed. Articles included met the following criteria: experimental studies, written in English, with full online article access, participants who were U.S. military members or veterans reporting SPHH-NA completing at least one diagnostic test. Effect sizes from the articles meeting the inclusion criteria were calculated using Hedges' g measure of effect size to determine the clinical significance.

Results: Eleven of an initially identified 1,836 articles met the inclusion criteria. Twenty-seven test measures were completed across the 11 studies. Fifteen test measures found a significant difference between groups in at least one study. Some studies using the same test measures did not find a significant difference. Twelve other test measures did not show any significant differences. Self-report questionnaires were the only measures to find large effect sizes across multiple studies. Five speech-in-noise tests were administered with only one instance finding a large effect size.

Conclusions: Traditionally, readily available audiometric tests have been applied to those with SPHH-NA. The results of this study support the need to carefully consider what underlying mechanisms may differentiate these populations. Improved diagnostic approaches targeting higher level processing may support targeted treatments. Given the large number of measures evaluated that do not show any differences, we recommend changing our approach for future research to consider factors that extend beyond only evaluating the auditory system.