A clinical test battery for obscure auditory dysfunction (OAD): development, selection and use of tests

Obscure auditory dysfunction (OAD) is defined as convincing self-report of auditory disability accompanied by normal pure-tone thresholds. This has been increasingly recognized as a clinical problem, but until now there has not been a standard clinical procedure for dealing with such patients. This paper summarizes a demographic and clinical characterization of a sample of 50 OAD patients, reports new norms on the tests in the version issued, and describes a test package developed from a case-control research study that can be routinely used with OAD patients. The package enables clinicians: (i) to confirm, or otherwise, OAD as the appropriate classification for individuals presenting with OAD-like symptoms; (ii) to elucidate the underlying basis of OAD in such individuals and hence in most cases to provide explanations that are justified by test findings; and (iii) to counsel cases in a fashion appropriate for each individual. The package consists of four performance tests, a specialized clinical interview and a brief questionnaire to determine the severity of OAD. The assessment takes approximately 37 min and can be run using a two-channel audiometer and a cassette recorder.