Validity of Self-Rated Hearing Compared With Audiometric Measurement Among Construction Workers

Background A valid assessment of hearing status is important to detect hearing loss early and prevent further loss in noise-exposed individuals or older adults. Self-report is used widely in research and is often the only possible measure to evaluate hearing ability. Objectives The aims of this study were to establish the level of validity of self-rated hearing by comparing it with the results of audiograms and to examine correlations and changes in self-rated and measured hearing status over time. Methods Survey and audiogram data collected from 403 construction workers at two different time points (Years 1 and 2) were used in the hearing protection intervention study. Self-rated hearing was assessed on a 5-point rating scale using a single question ("How do you rate your hearing?"). Hearing was measured via audiograms conducted at frequencies 0.5 through 8 kHz. Three pure-tone threshold average (PTA) indicators, PTA 0.5-2 kHz, PTA 0.5-3 kHz, and PTA 4-6 kHz, of the worse ear were used and compared with self-ratings at two time points. Results Percentage of agreement between the self-rated and measured hearing was lowest in PTA 4-6 kHz and highest in PTA 0.5-3 kHz for both years. Cohen's kappas showed fair to moderate (.25-.45) agreement. Sensitivity was higher (.82-.89) in the speech frequencies and lower (.51-.55) at higher frequencies. Specificity was better at higher frequencies than at lower frequencies (.83-.89 vs .68-.74). Although there was no appreciable change in self-rated hearing and limited change in measured hearing on all 3 indicators from Years 1 to 2, correlations between self-rated and measured hearing were higher in Year 2. Discussion A single-item question about an individual's hearing ability is moderately useful and valid to assess hearing loss and can be recommended for a population-based study only if audiograms are not available, but self-report hearing screening should not be considered an adequate substitute for the standardized audiometric test. Providing audiograms and feedback on the results apparently enhanced individuals' ability to judge their hearing status.