Ramkumar Vidya, Vanaja C S, Hall James W, Selvakumar K, Nagarajan Roopa
a Department of Speech, Language and Hearing Sciences , Sri Ramachandra University , Chennai , India.
b Department of Audiology & Speech Language Pathology , Bharati Vidyapeeth Deemed University , Pune , India.
Int J Audiol. 2018 May;57(5):370-375. doi: 10.1080/14992027.2018.1425001. Epub 2018 Jan 15.
This study assessed the validity of DPOAE screening conducted by village health workers (VHWs) in a rural community. Real-time click evoked tele-auditory brainstem response (tele-ABR) was used as the gold standard to establish validity.
A cross-sectional design was utilised to compare the results of screening by VHWs to those obtained via tele-ABR. Study samples: One hundred and nineteen subjects (0 to 5 years) were selected randomly from a sample of 2880 infants and young children who received DPOAE screening by VHWs.
Real time tele-ABR was conducted by using satellite or broadband internet connectivity at the village. An audiologist located at the tertiary care hospital conducted tele-ABR testing through a remote computing paradigm. Tele-ABR was recorded using standard recording parameters recommended for infants and young children. Wave morphology, repeatability and peak latency data were used for ABR analysis.
Tele-ABR and DPOAE findings were compared for 197 ears. The sensitivity of DPOAE screening conducted by the VHW was 75%, and specificity was 91%. The negative and positive predictive values were 98.8% and 27.2%, respectively.
The validity of DPOAE screening conducted by trained VHW was acceptable. This study supports the engagement of grass-root workers in community-based hearing health care provision.
本研究评估了乡村卫生工作者（VHWs）在农村社区进行畸变产物耳声发射（DPOAE）筛查的有效性。实时短声诱发远程听觉脑干反应（tele-ABR）被用作确立有效性的金标准。
采用横断面设计，将VHWs的筛查结果与通过tele-ABR获得的结果进行比较。研究样本：从2880名接受VHWs进行DPOAE筛查的婴幼儿样本中随机选取119名受试者（0至5岁）。
在村庄通过卫星或宽带互联网连接进行实时tele-ABR检测。位于三级护理医院的听力学家通过远程计算模式进行tele-ABR测试。使用针对婴幼儿推荐的标准记录参数记录tele-ABR。波形形态、重复性和峰潜伏期数据用于ABR分析。
对197只耳朵的tele-ABR和DPOAE结果进行了比较。VHWs进行的DPOAE筛查的敏感性为75%，特异性为91%。阴性和阳性预测值分别为98.8%和27.2%。
经过培训的VHWs进行的DPOAE筛查的有效性是可以接受的。本研究支持基层工作者参与基于社区的听力保健服务。
