Streppel M, Brusis T
Institut für Begutachtungen, Köln, Deutschland.
HNO. 2010 Feb;58(2):126-31. doi: 10.1007/s00106-009-2064-3.
The effect of an incorrect audiological medical assessment of noise trauma deafness can be substantial. The impact will be demonstrated using a case example. The reasons for incorrect assessment are often insufficient examination conditions or simulation and aggression of the subject. The results of a study on this topic will be presented.
A total of 61 patients who underwent a psycho-acoustic medical assessment were grouped into 1 of 4 categories ranging from category 0 for no simulation or aggravation to category III for severe simulation and aggravation. For category III reliable and valid thresholds of pure tone audiometry can only be achieved using objective audiological measurements. The frequency, extent and socio-economic factors were evaluated.
Of the 61 individuals 26 showed no simulation or aggravation behavior (category 0), 10% were grouped into category III and 48% into categories I and II. The tendency to simulation and aggravation increased with the patients' age, the level of education and the frequency of medical examinations prior to this investigation.
Simulation and aggravation is a more frequent phenomenon than previously assumed (approximately 58% of all audiological examinations). The effect in terms of economical damage could be substantial. The usage of a well-defined classification is highly recommended in order to improve the quality of medical assessment in ENT.
对噪声性创伤性耳聋进行不正确的听力学医学评估可能会产生重大影响。将通过一个案例来展示这种影响。评估不正确的原因通常是检查条件不足或受检者的伪装及夸大表现。将展示关于该主题的一项研究结果。
总共61例接受心理声学医学评估的患者被分为4类中的1类，从0类（无伪装或夸大）到III类（严重伪装和夸大）。对于III类患者，只有使用客观听力学测量才能获得可靠且有效的纯音听力测定阈值。对频率、程度和社会经济因素进行了评估。
61名个体中，26人无伪装或夸大行为（0类），10%被归为III类，48%被归为I类和II类。伪装和夸大的倾向随着患者年龄、教育程度以及本次调查前的医学检查频率而增加。
伪装和夸大是一种比之前设想更为常见的现象（约占所有听力学检查的58%）。在经济损害方面的影响可能很大。强烈建议使用明确的分类方法，以提高耳鼻喉科医学评估的质量。
