American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

National Health and Medical Research Council
Whispered Voice Test for Screening for Hearing Impairment in Adults and Children: Systematic Review

Pirozzo, S., Papinczak, T., et al. (2003).
BMJ, 327(7421), 967.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a review of cross-sectional studies exploring the sensitivity and specificity of the whispered voice test in comparison to audiometry to screen for hearing loss in children and adults.

Question(s) Addressed:

Question not specifically stated.

Population: Children and adults, not further specified.

Intervention/Assessment: Whispered voice test

Number of Studies Included: 8

Years Included: 1966 – June 2002

Findings:

Conclusions:

  • Assessment/Diagnosis
    • Assessment Instruments
      • Hearing Screening
        • Whispered Voice Test (Adults)
          • “In the three comparable studies the sensitivity of the whispered voice test was either 90% or 100% and specificity ranged from 80% to 87%. Positive likelihood ratios ranged from 4.6 to 7.7, showing that a positive test is moderately strong in ruling in hearing impairment. Negative likelihood ratios were zero or close to it, showing no hearing impairment when the test is negative” (p. 3 of 5).
          • “One area of concern is the reproducibility of the whispered voice test. The results of the studies that measured reliability indicate that the test can be reliable if a standard procedure is used. At the moment there is considerable room for improvement in standardizing the technique of conducting the test and in setting the threshold for hearing impairment by the whispered voice test” (p. 4 of 5).
        • Whispered Voice Test (Children)
          • Overall, the whispered voice test in children was less sensitive but more specific than in adults (sensitivity 80-96%, specificity 90-98%). As compared to the adult studies, the positive likelihood ratios were higher than in the studies on adults, so a positive test argues even more strongly for hearing impairment. However, the higher negative likelihood ratios were less convincing in ruling out disease" (p. 3 of 5).
          • “One area of concern is the reproducibility of the whispered voice test. The results of the studies that measured reliability indicate that the test can be reliable if a standard procedure is used. At the moment there is considerable room for improvement in standardizing the technique of conducting the test and in setting the threshold for hearing impairment by the whispered voice test” (p. 4 of 5).

Keywords: Hearing Screening

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Added to Compendium: March 2012

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