[Assessing ear noise in expert opinion: Possibility, plausibility and probability]

Area of Science:

• Audiology
• Occupational Health
• Forensic Medicine

Background:

• Tinnitus is a subjective sensation, making objective proof challenging.
• Distinguishing tinnitus from physiological hearing sensations is crucial in assessments.
• Legal frameworks, like the German Königsteiner Recommendation, necessitate stringent examination for accident-related tinnitus.

Purpose of the Study:

• To review a proposed plausibility check for assessing accident-related tinnitus.
• To establish a comprehensible and comparable basis for tinnitus causality assessment.
• To determine if the proposed criteria meet the required standard of proof.

Main Methods:

• A review of a 5-criterion plausibility check was conducted.
• Criteria included: appropriate event, immediacy, reproducibility (tinnitus masking/matching), persistence/fixation, and non-suggestive questioning.
• Psychoacoustic procedures and open-ended questions were incorporated.

Main Results:

• The review confirmed that the proposed steps fulfill the requirements for the standard of proof.
• The plausibility criteria systematically increase the probability of tinnitus presence.
• The method allows for comprehensible causal consideration between an event and reported tinnitus.

Conclusions:

• The 5-criterion plausibility check provides a robust framework for assessing accident-related tinnitus.
• This approach enhances the objective evaluation of subjective ear noise.
• It supports evidence-based decision-making in insurance and legal contexts.