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| Year : 2005
| Volume
: 7 | Issue : 29 | Page
: 40-41 |
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| Medicolegal decision making in noise-induced hearing loss-related tinnitus |
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PH Dejonckere, J Lebacq
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How to cite this article:
Dejonckere P H, Lebacq J. Medicolegal decision making in noise-induced hearing loss-related tinnitus. Noise Health 2005;7:40-1 |
In some patients with occupational noise-induced hearing loss, a significant aspect of the handicap concerns the concomitant tinnitus; thus, this disorder must be considered in evaluating a disability percentage in the insurance context. The main difficulty comes from the lack of objective measures for tinnitus. To reach a maximum of medicolegal objectivity, a system was developed within the Belgian Institute of Occupational Disorders (Brussels) in the form of a four-level decision structure, after exhaustive but noninvasive assessment of patients. An aggregate of multiple-choice responses (affirmative, neutral, negative) to elementary questions leads to a decision of the next level, which in turn determines-together with the other decisions at the same level-the conclusion at a still higher level. A positive outcome on all four level-3 questions is required for recognition of noise-induced hearing loss-related tinnitus as an occupational disorder and for financial compensation (final decision, level 4). We assessed 10 exemplary files on which this system was applied by four experts rating independently. A variant of Cohen's Kappa for multiple raters demonstrated high interrater consistency at the first level. In all cases, the decisions at levels 3 and 4 were identical. In this way, the final medicolegal decision relies on standardized criteria and becomes perfectly transparent.
Correspondence Address:
P H Dejonckere
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 Source of Support: None, Conflict of Interest: None  | Check |
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