Prediction of hearing loss from acoustic-reflex thresholds in the older adult population.

The clinical applicability of prediction of hearing loss in 126 ears of 83 adults more than 44 years of age was investigated. The method of hearing-loss prediction was based on that proposed by Silman, Silverman, Showers, and Gelfand (J Speech Hear Res 1984;27:12-9). This method, which utilized the acoustic reflex thresholds for hearing-loss prediction, was modified to create a more clinically feasible procedure; 5 dB rather than 1 dB intensity increments and visual monitoring of needle deflection rather than the use of a graphic level recorder were used. This modified method yielded a high predictive accuracy for at least mild and/or high-frequency hearing impairment. Criteria based on acoustic-reflex threshold levels were developed to identify the presence of significant hearing loss (pure-tone average = or greater than 30 dB HL) in adults more than 44 years of age. The results have implications for hearing screenings for the difficult-to-test population such as the elderly.