Associations between the probabilities of frequency-specific hearing loss and unaided APHAB scores

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire reports subjective hearing impairments in four typical conditions. We investigated the association between the frequency-specific probability of hearing loss and scores from the unaided APHAB (APHAB_u) to determine whether the APHAB_u could be useful in primary diagnoses of hearing loss, in addition to pure tone and speech audiometry. This retrospective study included database records from 6558 patients (average age 69.0 years). We employed a multivariate generalised linear mixed model to analyse the probabilities of hearing losses (severity range 20-75 dB, evaluated in 5-dB steps), measured at different frequencies (0.5, 1.0, 2.0, 4.0, and 8.0 kHz), for nearly all combinations of APHAB_u subscale scores (subscale scores from 20 to 80%, evaluated in steps of 5%). We calculated the probability of hearing loss for 28,561 different combinations of APHAB_u subscale scores (results available online). In general, the probability of hearing loss was positively associated with the combined APHAB_u score (i.e. increasing probability with increasing scores). However, this association was negative at one frequency (8 kHz). The highest probabilities were for a hearing loss of 45 dB at test frequency 2.0 kHz, but with a wide spreading. We showed that the APHAB_u subscale scores were associated with the probability of hearing loss measured with audiometry. This information could enrich the expert's evaluation of the subject's hearing loss, and it might help resolve suspicious cases of aggravation. The 0.5 and 8.0 kHz frequencies influenced hearing loss less than the frequencies in-between, and 2.0 kHz was most influential on intermediate degree hearing loss (around 45 dB), which corresponded to the frequency-dependence of speech intelligibility measured with speech audiometry.