As a practitioner in the field of audiology, staying abreast of the latest research is essential for improving diagnostic accuracy and patient outcomes. One seminal piece of research that can significantly enhance your diagnostic toolkit is the study by Mencher and Boyden (1975) titled Pure Tone and Speech Bekesy Audiograms and the Malingerer. This research delves into the efficacy of Bekesy audiometry in identifying non-organic hearing loss, commonly referred to as malingering.
Jerger's initial observations in 1960 revealed an unusual pattern where continuous tones were perceived at a lower intensity than pulsed signals. This pattern, later termed Type V, was identified as a potential indicator of malingering. Subsequent studies, including those by Resnick and Burke (1962) and Stein (1963), further validated the use of Type V Bekesy patterns in detecting non-organic hearing loss.
The Mencher and Boyden study builds on this foundation by comparing normal Bekesy pure tone and speech tracings with those obtained under conditions of feigned hearing loss. Their findings indicate that while pure tone Bekesy audiograms are effective in identifying malingering, speech Bekesy audiograms do not exhibit the same diagnostic utility.
Key Findings
- Pure tone Bekesy audiograms are more reliable than speech Bekesy audiograms in identifying malingering.
- Type V patterns, characterized by a 10 dB gap between continuous and pulsed tracings over at least two octaves, are a strong indicator of non-organic hearing loss.
- Speech Bekesy audiograms tend to show normal patterns even when the subject is feigning a hearing loss.
Practical Applications
Implementing the findings from this research can significantly improve your diagnostic accuracy. Here are some practical steps:
- Utilize pure tone Bekesy audiometry as a primary tool for identifying malingering.
- Be cautious in interpreting speech Bekesy audiograms, as they may not reliably indicate non-organic hearing loss.
- Consider additional diagnostic tests to corroborate Bekesy audiometry findings.
Encouraging Further Research
While the study by Mencher and Boyden provides valuable insights, it also highlights areas for further research. For instance, exploring the potential of combining pure tone and speech Bekesy audiograms could offer a more comprehensive diagnostic approach. Additionally, investigating other audiometric patterns that may indicate malingering can further enhance diagnostic accuracy.
To read the original research paper, please follow this link: Pure Tone and Speech Bekesy Audiograms and the Malingerer.
