The use of the Washington Group on Disability Statistics questionnaires to identify hearing disability: a systematic review.
Jennifer Dantas Moreno, Larissa Hellen Viégas Bennett, Silvia Ferrite
PMID 35043863WHAT IT FOUND
The Washington Group hearing question works for large-scale screening but yields wildly different prevalence rates depending on the cut-off used.
Use the 'a lot of difficulty' threshold for consistent global comparisons, and the 'some difficulty' threshold to catch milder impairments.
Key findings
01Prevalence estimates vary significantly based on the chosen cut-off point, ranging from 0.2-2.3% for 'a lot of difficulty' versus 1.4-15.9% for 'some difficulty'.
02The 'a lot of difficulty' cut-off missed a large proportion of individuals with disabilities, particularly in hearing and vision domains where limitations are less likely to be self-reported.
03Accuracy is better when the instrument is administered by key informants like teachers compared to self-reporting, with sensitivity and specificity values varying by domain and cut-off.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only studies published in English or Portuguese were included, potentially missing relevant data from other regions. 24.6% of the included studies adapted the questionnaire response options, which compromises the ability to compare results across studies. Few studies reported accuracy measures compared to gold-standard audiometry, limiting conclusions on diagnostic validity. The review focused on the hearing question in isolation or as part of a module, but did not assess the clinical utility for individual patient management.
Declared interests
No conflicts of interest or funding sources were explicitly stated in the provided text.
The easy way to misread this
Do not treat the Washington Group hearing question as a diagnostic tool. It is a screening instrument for population-level data. The prevalence of hearing disability changes dramatically depending on whether you count 'some difficulty' or 'a lot of difficulty', so comparing studies that use different cut-offs is invalid.