Madzivhandila Andani Gluggy, le Roux Talita, Biagio de Jager Leigh
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Int J Pediatr Otorhinolaryngol. 2024 Feb;177:111862. doi: 10.1016/j.ijporl.2024.111862. Epub 2024 Jan 18.
Increasing options are becoming available for clinicians and healthcare professionals who use smartphone-based applications (apps) to identify hearing loss. The use of smartphone-based apps for newborn hearing screening (NHS) has been proposed as an alternative screening method in NHS programs. This study aims to compare the screening outcomes of a smartphone-based otoacoustic emission (OAE) screening device to a commercially available OAE screening device.
NHS was conducted in the post-natal maternity ward and neonatal intensive care unit (NICU) of two tertiary public healthcare hospitals over a period of 8 months. Within participant DPOAE and TEOAE screening outcomes of a smartphone-based OAE device (hearOAE) were compared to that of the Otodynamics ILO V6.
A total of 176 infants (n = 352 ears; 48.9 % female) underwent NHS (DPOAE n = 176; TEOAE n = 176). The mean age at was 4.5 days (SD 11.3). Signal-to-noise ratio (SNR) were higher with the hearOAE with TEOAE NHS, and equivalent or higher SNR at four out of six frequencies with DPOAEs. Mean and total noise levels were significantly lower for the hearOAE compared to the Otodynamics with DPOAEs noise levels of five out of six frequencies being equivalent to, or lower than the Otodynamics (p < 0.001). Lower noise levels are likely to be advantageous in less-than-ideal test conditions. Inter-device DPOAE comparison indicated no statistically significant difference in the refer rate between the devices (p = 0.238). DPOAE pass rates between devices differed in 6 ears (p > 0.05), and in 20 ears for TEOAEs, with the hearOAE demonstrating a higher TEOAE pass rate (p = 0.009). The hearOAE did, however, demonstrate lower noise levels at three out five frequencies, which may have impacted the pass rate. No statistically significant correlation was found between the independent variables and the screening outcome (pass/refer) for TEOAEs using either device (p = 0.105 to 0.810). A high concordance of NHS outcomes within-participants of 89.7 % and 85.0 % for DPOAE and TEOAE respectively, was measured.
The mHealth based OAE device demonstrated good agreement in NHS outcomes compared to a commercially available device. This verifies the performance of the novel smartphone based OAE device, and may facilitate increased accessibility of decentralised NHS service in resource constrained populations.
对于使用基于智能手机的应用程序（应用）来识别听力损失的临床医生和医疗保健专业人员而言，可用的选择越来越多。有人提议将基于智能手机的应用用于新生儿听力筛查（NHS），作为NHS项目中的一种替代筛查方法。本研究旨在比较基于智能手机的耳声发射（OAE）筛查设备与市售OAE筛查设备的筛查结果。
在两家三级公立医疗保健医院的产后产科病房和新生儿重症监护病房（NICU）进行了为期8个月的NHS。将基于智能手机的OAE设备（hearOAE）的参与者内畸变产物耳声发射（DPOAE）和瞬态诱发耳声发射（TEOAE）筛查结果与Otodynamics ILO V6的结果进行比较。
共有176名婴儿（n = 352耳；48.9％为女性）接受了NHS（DPOAE n = 176；TEOAE n = 176）。平均年龄为4.5天（标准差11.3）。在TEOAE NHS中，hearOAE的信噪比（SNR）更高，在DPOAE的六个频率中的四个频率处，SNR相当或更高。与Otodynamics相比，hearOAE的平均和总噪声水平显著更低，在六个频率中的五个频率处DPOAE的噪声水平与Otodynamics相当或更低（p <0.001）。在不太理想的测试条件下，较低的噪声水平可能具有优势。设备间DPOAE比较表明，设备之间的转诊率没有统计学上的显著差异（p = 0.238）。设备之间的DPOAE通过率在6耳中有所不同（p> 0.05），在TEOAE中在20耳中有所不同，hearOAE显示出更高的TEOAE通过率（p = 0.009）。然而，hearOAE在五个频率中的三个频率处确实显示出较低的噪声水平，这可能影响了通过率。使用任何一种设备，自变量与TEOAE的筛查结果（通过/转诊）之间均未发现统计学上的显著相关性（p = 0.105至0.810）。测量得出，参与者内DPOAE和TEOAE的NHS结果的一致性分别高达89.7％和85.0％。
与市售设备相比，基于移动健康的OAE设备在NHS结果方面显示出良好的一致性。这验证了新型基于智能手机的OAE设备的性能，并可能有助于在资源有限的人群中提高分散式NHS服务的可及性。
