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LITERATURE UPDATE
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Year : 2005  |  Volume : 7  |  Issue : 29  |  Page : 40--41

Medicolegal decision making in noise-induced hearing loss-related tinnitus

PH Dejonckere, J Lebacq 
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Correspondence Address:
P H Dejonckere
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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;7:40-41


How to cite this URL:
Dejonckere P H, Lebacq J. Medicolegal decision making in noise-induced hearing loss-related tinnitus. Noise Health [serial online] 2005 [cited 2022 May 22 ];7:40-41
Available from: https://www.noiseandhealth.org/text.asp?2005/7/29/40/31880


Full Text

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.