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KMID : 0361020220650010010
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Korean Journal of Otolaryngology - Head and Neck Surgery
2022 Volume.65 No. 1 p.10 ~ p.17
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Test-Retest Differences of the Speech Discrimination Score in Patients with Hearing Loss
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Lim Tae-Hun
Oh Joo-Hyung
Hwang Jun-Ho
Joo Joon-Bum
Cho Ju-Eun
Kim Jong-Yang
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Abstract
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Background and Objectives The diagnosis of hearing impairment is based on repeatedaudiometry, including pure tone audiometry (PTA), speech reception threshold test (SRT), andspeech discrimination test (SDT). SDT results particularly show a wide discrepancy upon repeatedtesting, while malingering is suspected when having more than 12% difference between3 individual SDT results. Therefore, in this study, we compared the proportion of malingeringfound in repeated SDT with that found in other audiometric tests and analyzed the characteristicsof malingering group in order to reevaluate the current criteria of defining malingering.
Subjects and Method We retrospectively assessed the audiometry results of 113 patients(226 ears) with hearing impairment. Each ear was divided into a malingering group and a truehearing loss group. The proportion of ears corresponding to each malingering criterion wascompared using a chi-square test. An independent sample t-test was performed to identify thedifferences between the characteristics between the two groups.
Results The number of ears that met the malingering criteria were 19 (8.41%) in PTA, 15(6.64%) in SRT, and 75 (33.19%) in SDT. There was a significant difference in the proportionof malingering between the 3 hearing test modalities (p<0.001). There was no significant differencein auditory brainstem response, mean age and sex distribution between the malingeringgroup and the true hearing loss group.
Conclusion When conducting repeated SDT, there is a risk of misdiagnosing an actualhearing loss patient as a malingering patient under the current malingering criteria. Therefore,the current criteria on SDT requires reevaluation.
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KEYWORD
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Hearing loss, Malingering, Speech audiometry, Speech discrimination tests
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