Michael J. Lichtenstein, MD, MSc
To the Editors: Lachs and colleagues (1) recommend using the "whispered voice" test to screen for hearing impairment in ambulatory, elderly patients. The data cited for this test were obtained on inpatient geriatric wards, not in ambulatory settings (2). The data about observer variability for this test are few: Important differences between observers are likely in the distances used in test administration, voice pitch, and voice intensity. An intraclass correlation of 0.67 in nondemented outpatients for whispered voice interobserver reliability has been reported (3). Derived from testing 44 ears, this value may be inflated because hearing levels in pairs of
Lichtenstein MJ. "Screening" for Disability. Ann Intern Med. ;113:557–558. doi: 10.7326/0003-4819-113-7-557
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Published: Ann Intern Med. 1990;113(7):557-558.
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