Li Lok-Yee Joyce, Wang Shin-Yi, Yang Jinn-Moon, Chen Chih-Jou, Tsai Cheng-Yu, Wu Lucas Yee-Yan, Wu Te-Fang, Wu Cheng-Jung
Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei 111, Taiwan.
School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
J Pers Med. 2021 Oct 16;11(10):1035. doi: 10.3390/jpm11101035.
Hearing impairment is a frequent human sensory impairment. It was estimated that over 50% of those aged >75 years experience hearing impairment in the United States. Several hearing impairment-related factors are detectable through screening; thus, further deterioration can be avoided. Early identification of hearing impairment is the key to effective management. However, hearing screening resources are scarce or inaccessible, underlining the importance of developing user-friendly mobile health care systems for universal hearing screening. Mobile health (mHealth) applications (apps) act as platforms for personalized hearing screening to evaluate an individual's risk of developing hearing impairment. We aimed to evaluate and compare the accuracy of smartphone-based air conduction and bone conduction audiometry self-tests with that of standard air conduction and bone conduction pure-tone audiometry tests. Moreover, we evaluated the use of smartphone-based air conduction and bone conduction audiometry self-tests in conductive hearing loss diagnosis. We recruited 103 patients (206 ears) from an otology clinic. All patients were aged ≥20 years. Patients who were diagnosed with active otorrhea was excluded. Moderate hearing impairment was defined as hearing loss with mean hearing thresholds >40 dB. All patients underwent four hearing tests performed by a board-certified audiologist: a smartphone-based air conduction audiometry self-test, smartphone-based bone conduction audiometry self-test, standard air-conduction pure-tone audiometry, and standard bone conduction pure-tone audiometry. We compared and analyzed the results of the smartphone-based air conduction and bone conduction audiometry self-tests with those of the standard air conduction and bone conduction pure-tone audiometry tests. The sensitivity of the smartphone-based air conduction audiometry self-test was 0.80 (95% confidence interval CI = 0.71-0.88) and its specificity was 0.84 (95% CI = 0.76-0.90), respectively. The sensitivity of the smartphone-based bone conduction audiometry self-test was 0.64 (95% CI = 0.53-0.75) and its specificity was 0.71 (95% CI = 0.62-0.78). Among all the ears, 24 were diagnosed with conductive hearing loss. The smartphone-based audiometry self-tests correctly diagnosed conductive hearing loss in 17 of those ears. The personalized smartphone-based audiometry self-tests correctly diagnosed hearing loss with high sensitivity and high specificity, and they can be a reliable screening test to rule out moderate hearing impairment among the population. It provided patients with moderate hearing impairment with personalized strategies for symptomatic control and facilitated individual case management for medical practitioners.
听力障碍是一种常见的人类感官障碍。据估计，在美国，75岁以上人群中有超过50%患有听力障碍。通过筛查可检测出一些与听力障碍相关的因素，从而避免病情进一步恶化。早期识别听力障碍是有效管理的关键。然而，听力筛查资源稀缺或难以获取，这凸显了开发用户友好型移动医疗系统以进行普遍听力筛查的重要性。移动健康（mHealth）应用程序（app）作为个性化听力筛查的平台，用于评估个体发生听力障碍的风险。我们旨在评估并比较基于智能手机的气导和骨导听力测定自我测试与标准气导和骨导纯音听力测试的准确性。此外，我们评估了基于智能手机的气导和骨导听力测定自我测试在传导性听力损失诊断中的应用。我们从一家耳科诊所招募了103名患者（206只耳朵）。所有患者年龄≥20岁。被诊断为活动性耳漏的患者被排除。中度听力障碍定义为平均听力阈值>40dB的听力损失。所有患者均接受了由具备专业资格的听力学家进行的四项听力测试：基于智能手机的气导听力测定自我测试、基于智能手机的骨导听力测定自我测试、标准气导纯音听力测试和标准骨导纯音听力测试。我们将基于智能手机的气导和骨导听力测定自我测试结果与标准气导和骨导纯音听力测试结果进行了比较和分析。基于智能手机的气导听力测定自我测试的灵敏度为0.80（95%置信区间CI = 0.71 - 0.88），其特异性为0.84（95%CI = 0.76 - 0.90）。基于智能手机的骨导听力测定自我测试的灵敏度为0.64（95%CI = 0.53 - 0.75），其特异性为0.71（95%CI = 0.62 - 0.78）。在所有耳朵中，有24只被诊断为传导性听力损失。基于智能手机的听力测定自我测试在其中17只耳朵中正确诊断出了传导性听力损失。基于智能手机的个性化听力测定自我测试能够以高灵敏度和高特异性正确诊断听力损失，并且可以作为一种可靠的筛查测试，用于排除人群中的中度听力障碍。它为中度听力障碍患者提供了对症控制的个性化策略，并为医生的个案管理提供了便利。
