Review: the whispered voice test is accurate for detecting hearing impairment in children and adults

摘要

Screening for hearing impairment in older age groups is recommended,' although the benefit of screening children during the first 4 years of life has not been established.2 One screening method is the whispered voice test, the subject of this systematic review by Pirozzo et al.The methodological quality of the studies included in this review was modest: only 2 of 8 studies met all quality criteria. Studies in children had the poorest quality. The specificity and sensitivity were high in all 8 studies despite the use of 6 different techniques. For the paediatric population, the sensitivity was lower, risking failure to identify hearing loss in some children.The whispered voice test is a simple and accurate screening tool. The recommended standardised procedure for conducting this test is to have the examiner stand an arm's length behind the seated client. After exhaling, the examiner whispers a combination of numbers and letters as the client gently occludes one of their auditory canals with a finger while rubbing the tragus in a circular motion. The client is asked to repeat the sequence, and hearing is considered normal if the client responds correctly. If the client responds incorrectly, the test is repeated using a different number/letter combination. The client "passes" if able to correctly repeat 3 of the 6 numbers or letters.An area of concern is the reliability of the test. Variation in the loudness of the whisper and clinician failure to exhale before whispering can lead to variable results in the same patients when administered by different clinicians. None of the studies were done in primary care settings, and the clinicians were specialists rather than primary care practitioners. The results are particularly relevant to clinicians working with elderly populations. Further research is required to evaluate the use of the test in primary care settings and with children.