The World Health Organization's hearing-impairment grading system: an evaluation for unaided communication in age-related hearing loss

Int J Audiol. 2019 Jan;58(1):12-20. doi: 10.1080/14992027.2018.1518598. Epub 2018 Oct 15.

Abstract

Objective: This review evaluated the data from five datasets having pure-tone thresholds and functional measures of speech communication from relatively large groups of older adults to evaluate the validity of the proposed new World Health Organisation (WHO) hearing-impairment grading system, referred to here as WHO-proposed.

Design: This was a review of studies identified from the literature having both pure-tone audiometry and functional measures of speech communication from relatively large samples of older adults.

Study sample: Three population or population-sample datasets and two clinical datasets were identified with access provided to de-identified data for five of these six studies.

Results: As the WHO-proposed hearing-impairment grade progressed from "normal" to "severe" (insufficient data from older adults were available for the "profound" category), each step in this progression led to a significant difference in functional communication relative to the preceding step. Cohen's d effect sizes were moderate to very large between each successive step on the WHO-proposed hearing-impairment grading scale, with some exceptions for the step from "normal" to "mild/slight" grades.

Conclusions: The WHO-proposed hearing-impairment grading system, recently developed through expert opinion and adopted by WHO, is validated here with evidence from studies of functional communication in older adults.

Keywords: Aging; World Health Organisation (WHO); communication; hearing loss; severity.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Audiometry, Pure-Tone*
  • Audiometry, Speech*
  • Auditory Threshold*
  • Disability Evaluation*
  • Female
  • Hearing
  • Humans
  • Male
  • Middle Aged
  • Persons With Hearing Impairments / psychology*
  • Predictive Value of Tests
  • Presbycusis / classification
  • Presbycusis / diagnosis*
  • Presbycusis / physiopathology
  • Presbycusis / psychology
  • Recognition, Psychology
  • Severity of Illness Index
  • Speech Perception*
  • Terminology as Topic
  • World Health Organization*