Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven.
Yale School of Medicine, New Haven, Connecticut.
Otol Neurotol. 2018 Aug;39(7):823-828. doi: 10.1097/MAO.0000000000001857.
The principal aim of this study was to examine the feasibility of hearing screening using tablet audiometry among a cohort of school-aged children in rural Dominican Republic. The authors hypothesized that the tablet audiometer would serve as an expeditious means for hearing loss screening in various remote locations.
Cross-sectional.
Twenty-three remote locations in and around the city of La Romana, Dominican Republic. The quietest location available in each site was used for testing.
Inclusion criteria comprised children aged 5 to 17 currently residing in the testing location. Children aged <5 years or >18 years were excluded.
Screening.
For each subject, air conduction thresholds were obtained bilaterally at 500, 1000, 2000, and 4000 Hz; testing duration was also measured. Hearing loss was suspected if any threshold measured ≥30 dB.
In this cohort of 423 subjects, 44 (10.4%) failed the screening protocol. The mean thresholds for 500, 1000, 2000, and 4000 Hz frequencies were 26.05, 22.73, 17.57, and 17.15 dB, respectively. Of the 658 thresholds obtained at ≥30 dB, the majority were at 500 or 1000 Hz. The mean testing duration was 494 seconds.
These results suggest that children living in remote communities can be screened quickly for hearing loss using a tablet audiometer. However, significant background noise during testing negatively impacted the low-frequency measurements, thus compromising test reliability. Despite extending the reach of existing audiological services, the value of tablet audiometry is not entirely clear in rural environments with uncontrollable background noise.
本研究的主要目的是检验在多米尼加共和国农村地区的学龄儿童中使用平板电脑听力计进行听力筛查的可行性。作者假设平板电脑听力计将成为各种偏远地区听力损失筛查的快速手段。
横断面研究。
多米尼加共和国拉罗马纳市及其周边的 23 个偏远地点。每个地点使用可获得的最安静的位置进行测试。
纳入标准包括目前居住在测试地点的年龄在 5 至 17 岁的儿童。年龄<5 岁或>18 岁的儿童被排除在外。
筛查。
对于每个受试者，在 500、1000、2000 和 4000 Hz 频率下双侧获得气导阈值；还测量了测试持续时间。如果任何测量的阈值≥30 dB，则怀疑有听力损失。
在这 423 名受试者的队列中，有 44 人（10.4%）未能通过筛查方案。500、1000、2000 和 4000 Hz 频率的平均阈值分别为 26.05、22.73、17.57 和 17.15 dB。在≥30 dB 的 658 个阈值中，大多数在 500 或 1000 Hz。平均测试持续时间为 494 秒。
这些结果表明，使用平板电脑听力计可以快速筛查居住在偏远社区的儿童的听力损失。然而，测试过程中存在显著的背景噪声对低频测量产生负面影响，从而影响测试的可靠性。尽管平板电脑听力计扩展了现有的听力服务范围，但在背景噪声不可控的农村环境中，其价值尚不完全清楚。
