Hearing Handicap Inventory

Hearing Handicap Inventory - Decision tool to assess impact of hearing loss.
[select name="Q1" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Embarrassed when meeting new people due to hearing problem
[select name="Q2" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Frustrated when speaking to family due to hearing problem
[select name="Q3" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Difficulty hearing whispered voice
[select name="Q4" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Feel impaired by hearing problem
[select name="Q5" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Hearing interferes with visiting with family and friends
[select name="Q6" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Attends religious services less often due to hearing problems
[select name="Q7" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Hearing problem result in arguments with family
[select name="Q8" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Hearing problem interferes with listening to television and radio
[select name="Q9" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Hearing problem interferes with social life
[select name="Q10" value="Yes: 4 points=4|Sometimes: 2 points=2|No: 0 points=0"] <-- Hearing problem interferes with communication in a restaurant
Score --> [calc memo="Score" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)"] out of 40 points
Interpretation --> [calc memo="Interpretation" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10);score>25?'Severe hearing handicap likelihood (refer)':score>9?'Moderate hearing hadicap likelihood (refer)':'Low hearing handicap likelihood'"]
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:  
[link url="//www.ncbi.nlm.nih.gov/pubmed/6626295" memo="#1"] Ventry (1983) ASHA 25(7): 37-42
[link url="//www.fpnotebook.com/ent/Exam/HrngHndcpInvntryFrThEldrly.htm" memo="#2"] Family Practice Notebook Page[/conditional]