Analysis of agreement between different tonal average criteria for defining hearing loss

ABSTRACT

Purpose  To assess the agreement among different criteria used for the classification of hearing loss.

Methods  A retrospective, cross-sectional study was conducted by collecting pure-tone thresholds from hearing assessments performed at a university clinic. A total of 240 ears with hearing loss were selected and categorized as normal, mild, or moderate according to the tritonal classification proposed by Lloyd and Kaplan (LK). Subsequently, the same ears were reclassified using the criteria established by the World Health Organization (WHO), the Bureau International d’Audiophonologie (BIAP), and Brazilian Law No. 14.768/2023, which defines the criteria for characterizing hearing disability.

Results  A comparison among the classification systems was carried out, enabling the measurement of agreement levels. Agreement between the WHO and LK classifications with BIAP was substantial, while agreement between WHO and LK was moderate. The study also compared which cases in the sample are classified as having a hearing disability according to the law versus the other classifications.

Conclusion  For a descending audiometric configuration, there is agreement among the literature-recommended classification systems. However, this agreement can be quantified to guide professionals in choosing the most appropriate classification for hearing loss when preparing a more accurate audiological report. Regarding the threshold criterion established by Brazilian legislation, the findings indicate that it fails to cover a considerable portion of the population with hearing loss.

Keywords:
Persons with hearing impairments; Audiometry; Hearing tests; Speech perception; Hearing