Lancaster Paul, Krumm Mark, Ribera John, Klich Richard
Hearing and Balance Centers at the Elks, Nampa, ID, USA.
Am J Audiol. 2008 Dec;17(2):114-22. doi: 10.1044/1059-0889(2008/07-0008). Epub 2008 Oct 7.
Telehealth (telepractice) is the provision of health care services using telecommunications. Telehealth technology typically has been employed to increase the level of health care access for consumers living in rural communities. In this way, audiologists can use telehealth to provide services in the rural school systems. This is important because school hearing screening programs are the foundation of educational audiology programs. Therefore, the goal of this study was to determine the feasibility of providing hearing screening services by telehealth technology to school-age children.
Hearing screening services-including otoscopy, pure-tone, and immittance audiometry-were conducted on 32 children in 3rd grade attending an elementary school in rural Utah. Each child received 1 screening on-site and another through telehealth procedures.
Immittance and otoscopy results were identical for on-site and telehealth screening protocols. Five children responded differently to pure-tone stimuli presented by the telehealth protocol than by the on-site protocol. However, no statistically significant difference was found for pure-tone screening results obtained by telehealth or on-site screening procedures (binomial test, p = .37). Likewise, overall screening results obtained by traditional and telehealth procedures were not statistically significant (binomial test, p = .37).
The results of this study suggest that school hearing screenings may be provided using telehealth technology. This study did find that 5 students performed differently to pure-tone screenings administered by the telehealth protocol in contrast to on-site hearing screening services. Further research is necessary to identify factors leading to false responses to pure-tone hearing screening when telehealth technology is used. In addition, telehealth hearing screening protocols should be conducted with participants of different age groups and experiencing a wide range of hearing loss to further clarify the value of telehealth technology.
远程医疗（远程诊疗）是利用电信技术提供医疗保健服务。远程医疗技术通常用于提高农村社区居民获得医疗保健服务的水平。通过这种方式，听力学家可以利用远程医疗为农村学校系统提供服务。这很重要，因为学校听力筛查项目是教育听力学项目的基础。因此，本研究的目的是确定通过远程医疗技术为学龄儿童提供听力筛查服务的可行性。
对犹他州农村一所小学的32名三年级儿童进行了听力筛查服务，包括耳镜检查、纯音测听和声导抗测听。每个孩子在现场接受了一次筛查，并通过远程医疗程序接受了另一次筛查。
现场和远程医疗筛查方案的声导抗和耳镜检查结果相同。5名儿童对远程医疗方案呈现的纯音刺激的反应与现场方案不同。然而，通过远程医疗或现场筛查程序获得的纯音筛查结果在统计学上没有显著差异（二项式检验，p = 0.37）。同样，传统和远程医疗程序获得的总体筛查结果在统计学上也没有显著差异（二项式检验，p = 0.37）。
本研究结果表明，可以使用远程医疗技术进行学校听力筛查。本研究确实发现，与现场听力筛查服务相比，5名学生对远程医疗方案进行的纯音筛查表现不同。有必要进行进一步研究，以确定使用远程医疗技术时导致对纯音听力筛查出现错误反应的因素。此外，应针对不同年龄组和患有各种听力损失的参与者进行远程医疗听力筛查方案，以进一步阐明远程医疗技术的价值。
