Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, University of São Paulo , São Paulo, Brazil .
Telemed J E Health. 2017 Sep;23(9):747-752. doi: 10.1089/tmj.2016.0253. Epub 2017 Feb 22.
Hearing loss (HL) affects people worldwide, many of whom are children. Especially in developing countries, epidemiological data on the prevalence of HL are insufficient to implement effective health promotion programs. In this preliminary study with young adults, we describe and validate a tablet-based hearing screening test developed for interactive remote hearing screening and compare the performance of an audiometry screening tablet application with conventional audiometry. In addition, the sensitivity, specificity, and predictive values of the tablet-based method and the concordance between the two methods were analyzed.
Thirty volunteers participated in a double-blind study assessing two auditory threshold screening methods: tablet-based hearing screening and sweep audiometry. For both methods, a correct response to a minimum of two tones out of three emitted at 20 dBHL for the frequencies of 1, 2, and 4 kHz and 30 dBHL for 0.5 kHz in both ears, was considered a negative screening result (normal hearing), whereas hearing impairment was considered a positive screening result.
According to both methods, 26 participants had normal hearing and four had HL. The Kappa coefficient indicated perfect concordance between methods. The tablet-based hearing screening method had a sensitivity of 100% (confidence interval [CI]: 30.5-100.0), a specificity of 100% (CI: 87.1-100.0), a positive predictive value of 100% (CI: 30.5-100.0), and a negative predictive value of 100% (CI: 87.1-100.0).
The tablet-based hearing screening test was shown to be a reliable and an accurate method for hearing screening that can be used effectively in places with Internet access and where local audiologists are not available.
听力损失(HL)影响着全世界的人们,其中许多是儿童。特别是在发展中国家,HL 的流行率的流行病学数据不足以实施有效的健康促进计划。在这项针对年轻成年人的初步研究中,我们描述并验证了一种用于交互式远程听力筛查的基于平板电脑的听力筛查测试,并比较了听力筛查平板电脑应用程序与常规听力测试的性能。此外,还分析了基于平板电脑的方法的敏感性、特异性和预测值,以及两种方法之间的一致性。
30 名志愿者参加了一项双盲研究,评估了两种听觉阈值筛查方法:基于平板电脑的听力筛查和扫频听力测试。对于这两种方法,如果双耳在 1、2 和 4 kHz 的频率和 0.5 kHz 的频率下至少对三个发出的音调中的两个作出反应,且每个音调的强度为 20 dBHL,或者对两个音调中的一个作出反应,且每个音调的强度为 30 dBHL,则被认为是阴性筛查结果(正常听力),而听力障碍则被认为是阳性筛查结果。
根据这两种方法,26 名参与者的听力正常,4 名参与者的听力有障碍。Kappa 系数表明两种方法具有完美的一致性。基于平板电脑的听力筛查方法的敏感性为 100%(置信区间[CI]:30.5-100.0),特异性为 100%(CI:87.1-100.0),阳性预测值为 100%(CI:30.5-100.0),阴性预测值为 100%(CI:87.1-100.0)。
基于平板电脑的听力筛查测试是一种可靠且准确的听力筛查方法,可在有互联网接入且没有当地听力学家的地方有效使用。