Establishing the appropriate hearing cut-off value for the 5-item version of the speech, spatial, and qualities of hearing scale in older adults

This study aims to validate the Chinese 5-item version of the Speech, Spatial and Qualities of Hearing scale (C-SSQ5), and to investigate the ideal cut-off value, sensitivity, and specificity of the C-SSQ5 in older adults with hearing impairment (HI). The C-SSQ5 was administered to measure self-perceived hearing ability for 114 older adults (60 ~ 88) with HI and 50 older adults (60 ~ 85) with normal hearing (NH). The optimal cut-off value for the C-SSQ5 as a hearing screening tool was calculated by comparing different cut-offs and hearing thresholds. Overall, the C-SSQ5 demonstrated good reliability, internal consistency, and high sensitivity to the older adults with HI. The C-SSQ5 scores were negatively correlated with better-ear ( r = -0.704, p < 0.001) and worse-ear (r = -0.634, p < 0.001) pure-tone average (PTA) among older adults. When better-ear PTA ≥ 35dB HL was taken as a screening criterion, the optimal cut-off score of the C-SSQ5 was 7.5, with a sensitivity of 74.4%, a specificity of 87.8%, a positive predictive value of 73.9%, and a negative predictive value of 88.2%. The C‑SSQ5 is a reliable screening tool suitable for the rapid assessment of older adults who cannot undergo conventional behavioral audiometry. As such, it holds promise as a potentially important clinical instrument for the early detection, referral, and management of hearing loss.