Cheong Jamie, Lowe Emily, Lee Chang Woo, Barbosa Claudia, Gillen Lise, King Emma, Premachandra Presanna, Shah Anand, Drobniewski Francis
Imperial College London, London, UK
Royal Brompton and Harefield Hospitals, London, UK.
BMJ Open. 2025 May 22;15(5):e097550. doi: 10.1136/bmjopen-2024-097550.
Hearing loss (HL) affects 20% of the world's population, with shortages of audiologists and audiometric sound booths unable to meet demand for hearing care services. We aimed to assess the accuracy of tablet-based audiometry (TA) to screen for HL at standard (0.25-8 kHz) and extended high frequencies (>8 kHz).
Diagnostic accuracy study.
Two secondary care audiology and ear, nose and throat outpatient clinics in the UK between April 2022 and September 2023.
Adults aged≥16 years undergoing sound booth audiometry (SBA).
TA, hearing-related questionnaires and patient usability questionnaires.
Sensitivity, specificity and accuracy of TA compared with SBA for detecting HL. Patient usability assessment of TA and SBA.
129 patients were enrolled with 127 patients (254 ears) included in the final analysis. Median age was 43 years (IQR 33-56), 55% (70/127) were women. 76% (96/127) and 68% (86/127) of patients had HL defined by British Society of Audiology (BSA) and American Speech-Language-Hearing Association (ASHA) criteria. Age was significantly associated with HL (p<0.0001); however, hearing-related questionnaire scores were not significantly different between those with or without HL. There was no significant difference in detecting HL between TA and SBA using either BSA or ASHA criteria at each frequency. Overall, 92% (1612/1751) of TA results were within 10 dB agreement with SBA results. Sensitivity and specificity of TA for detecting HL were 77-100% and >85%, respectively, between 0.25 and 12.5 kHz. In terms of patient usability, TA showed significantly higher scores in attractiveness (p<0.0001), novelty (p<0.0001), efficiency (p=0.0003), stimulation (p=0.003) and perspicuity (p=0.02).
TA demonstrated good sensitivity with high specificity for detecting HL at frequencies 0.25-12.5 kHz and would be an acceptable accurate alternative to SBA. This would increase the accessibility of HL screening and has the potential to be used as a diagnostic test in those without tinnitus where resources are limited.
NCT05847556.
听力损失（HL）影响全球20%的人口，听力学家短缺且听力测试隔音室无法满足听力保健服务需求。我们旨在评估基于平板电脑的听力测试（TA）在标准频率（0.25 - 8kHz）和扩展高频（>8kHz）下筛查HL的准确性。
诊断准确性研究。
2022年4月至2023年9月期间英国的两家二级护理听力及耳鼻喉门诊诊所。
年龄≥16岁且正在接受隔音室听力测试（SBA）的成年人。
TA、听力相关问卷和患者可用性问卷。
与SBA相比，TA检测HL的敏感性、特异性和准确性。TA和SBA的患者可用性评估。
共纳入129例患者，最终分析纳入127例患者（254只耳）。中位年龄为43岁（四分位间距33 - 56岁），55%（70/127）为女性。根据英国听力学会（BSA）和美国言语语言听力协会（ASHA）标准，分别有76%（96/127）和68%（86/127）的患者患有HL。年龄与HL显著相关（p<0.0001）；然而，有或无HL患者的听力相关问卷得分无显著差异。在每个频率下，使用BSA或ASHA标准时，TA和SBA检测HL无显著差异。总体而言，92%（1612/1751）的TA结果与SBA结果在10dB范围内一致。在0.25至12.5kHz之间，TA检测HL的敏感性和特异性分别为77 - 100%和>85%。在患者可用性方面，TA在吸引力（p<0.0001）、新颖性（p<0.0001）、效率（p = 0.0003）、刺激性（p = 0.003）和清晰度（p = 0.02）方面得分显著更高。
TA在0.25 - 12.5kHz频率下检测HL具有良好的敏感性和高特异性，将是SBA可接受的准确替代方法。这将提高HL筛查的可及性，并有可能在资源有限且无耳鸣的人群中用作诊断测试。
NCT05847556。
