1. Working Paper No.3 Add.5 11 November 2005 STATISTICAL COMMISSION andSTATISTICAL OFFICE OF THE UN ECONOMIC COMMISSION FOREUROPEAN COMMUNITIES EUROPE (EUROSTAT) CONFERENCE OF EUROPEAN WORLD HEALTH STATISTICIANS ORGANIZATION (WHO) Joint UNECE/WHO/Eurostat Meeting on the Measurement of Health Status (Budapest, Hungary, 14-16 November 2005) Session 3 – Invited paper Hearing Jennifer Madans National Center for Health Statistics, U.S.A

2. Hearing Concept:  Ability to distinguish sounds  Related but not equivalent to understanding and communicating  Hearing ability/loss can vary by – The loudness of the sound The pitch of the sound The level and nature of background noise Availability of visual cues Specification of activity within the domain:  Attempt to standardize stimuli by specifying the above dimensions either directly or indirectly

3. Proposed Items for Measuring Hearing One option is to use the questions from the European Health Status Module:  Can you distinctly hear what is said in a conversation with several people without a hearing aid or other aids for hearing? Yes/No If no: Can you distinctly hear what is said in a conversation with several people with a hearing aid? Yes/No/Has no hearing aids If yes: skip next question  Can you distinctly hear what is said in a conversation with one person without a hearing aid? Yes/No If no: Can you distinctly hear what is said in a conversation with one person with a hearing aid? Yes/No/Has no hearing aids

4. Hearing: Characteristics of Proposal Questions Filter Question:  Not used Assistive Devices:  Functioning ability obtained with and without hearing aids if used Recall period/chronicity  Not specified Response categories:  Yes/No Severity:  Measured through ‘task’ – ability to hear in a conversation with several people vs. one person

5. Alternative Question Set Questions about hearing aid use (Without a hearing aid) Can….usually hear what a person says without seeing his face if he whispers to….from across a quiet room? (Without a hearing aid) Can….usually hear what a person says without seeing his face if he talks in a normal voice to….from across a quiet room? (Without a hearing aid) Can….usually hear what a person says without seeing his face if he shouts to….from across a quiet room? (Without a hearing aid) Can….usually hear what a person says if he speaks loudly into……’s better ear? (Without a hearing aid) Can …..usually tell the sound of speech from other sounds and noises? (Without a hearing aid) Can….usually tell one kind of noise from another? (Without a hearing aid) Can….hear loud noise?