P.E.A.R.L.S: un simple susurro es efectivo en el diagnostico de dificultad auditiva


A simple whisper test is effective for diagnosing hearing impairment

Clinical Question

How useful are simple screening tests for diagnosing hearing impairment?

Bottom Line

The whispered voice tests and the audio scope are very accurate for ruling out hearing impairment (i.e if patient can hear whisper, they are unlikely to be deaf)

Context

Compared to the Weber and Rinne tuning fork tests the whispered voice test is the most accurate and may be better than the expensive audioscope, with pooled positive and negative likelihood ratios of 6.1 and 0.03 respectively.

Caveat

There is no single standard method for the whispered voice test but modified Paul Glasziou suggests the following: stand behind the patient at arm’s length (hands on their shoulders), then cover one ear (by rubbing a piece of paper over the external meatus). Exhale fully and whisper letters and numbers with different types of sound. (e.g. b, 6, k, 2, m, 9). Ask the patient to repeat the letters/numbers after each sound. Allow 1-2 errors and repeat each sound once if necessary.

Reference

Bagai A, et al. Does this patient have hearing impairment ? JAMA 2006;295:416-28

Date (Author) #20

January 2007 (Bruce Arroll/Brian McAvoy)

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