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Chang HY, Lo TS. Validation of a Bluetooth Self-Fitting Device for People With Mild-to-Moderate Hearing Loss in Quiet or Noisy Environments. Am J Audiol 2024:1-13. [PMID: 39024518 DOI: 10.1044/2024_aja-23-00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the benefits of a Bluetooth self-fitting device using an in situ hearing screening test and self-fitting processes. METHOD Thirty Mandarin-speaking individuals (16 men and 14 women) with mild-to-moderate hearing loss participated in this study. The hearing screening test was conducted using neckband earphones of a Bluetooth self-fitting device controlled by a smartphone app. The hearing screening tests were compared with the pure-tone audiometry in an audiometric booth. The amplification benefits of the self-fitting program-aided condition were evaluated and compared with those of unaided and preset program-aided conditions using the Mandarin Hearing in Noise Test (MHINT) and questionnaires. RESULTS The pure-tone audiometry and hearing screening test results exhibited strong positive correlations at all test frequencies. In the environment with 90° noise, the sentence reception thresholds (SRTs) obtained for the self-fitting program-aided condition were significantly lower (p = .032) than those obtained for the unaided condition, whereas no significant difference was observed between the preset program-aided and the unaided conditions. Moreover, the participants' satisfaction ratings for the devices were consistent with their MHINT results, with a strong positive correlation observed between satisfaction with self-fitting and user satisfaction in smartphone app's control, functionality, and learning. Younger participants were significantly more satisfied in learning to use the app. CONCLUSIONS Bluetooth self-fitting devices can be used for simplified in situ hearing screenings with a sensitivity of 90.4%. The satisfaction ratings and improvements in SRTs indicate significant clinical benefits of the self-fitting program compared with the preset program, particularly in the 90°-noise environments.
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Affiliation(s)
- Hung-Yue Chang
- Department of Mechanical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Tun-Shin Lo
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
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Masalski M, Turski M, Zatoński T. Self-assessment of bone conduction hearing threshold using mobile audiometry: comparison with pure tone audiometry. Int J Audiol 2024; 63:535-542. [PMID: 37162277 DOI: 10.1080/14992027.2023.2208287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 04/21/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The aim of the research was to evaluate the feasibility of measuring the bone conduction hearing threshold using self-administered mobile audiometry. DESIGN A single-centre, closed, cross-over trial was carried out on patients from the ENT Department. A mobile-based, self-administered, audiologist-assisted assessment of the bone conduction hearing threshold was carried out by means of the open-access, freeware app Hearing Test using two types of bone conduction headphones: professional B71 bone transducer and commercially available AfterShokz Openmove open-ear headphones. STUDY SAMPLE Seventy-seven ears. RESULTS A test-retest examination revealed the lowest standard deviation for open-ear headphones at 3.33 dB (95% CI 2.92-3.79). When compared with pure tone audiometry, the intraclass correlations of 0.95 (95% CI 0.94-0.96) and 0.90 (95% CI 0.88-0.92) were obtained for the bone transducer and for the open-ear headphones, indicating excellent and good reliability, respectively. However, the regression slope of 0.67 was found for the air-bone gap when using open ear headphones, which was significantly different from 1 (p < 0.001). CONCLUSIONS Open-ear headphones provide an alternative for estimating bone conduction once the air-bone gap has been adjusted by a factor of 1/0.6 7 ≅1.5. They demonstrate improved reproducibility over the bone transducer and are much easier to use with a mobile device. Trial Registration: Wroclaw Medical University, Science Support Centre, BW60/2020.
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Affiliation(s)
- Marcin Masalski
- Department of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Marcin Turski
- Department of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Tomasz Zatoński
- Department of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland
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Schneider E, Shilo S, Ungar OJ. Validated mobile applications in otolaryngology head and neck surgery for patient and physicians: A systematic literature review. Am J Otolaryngol 2024; 45:104287. [PMID: 38613927 DOI: 10.1016/j.amjoto.2024.104287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
IMPORTANCE Mobile apps in the field of ORL-HNS, are widely used by patients and physicians, but neither necessarily developed in collaboration with healthcare professionals nor subjected to regulations by the United States Food and Drug Administration guidelines, with a resultant potential of risk for its users. OBJECTIVE To provide the ORL-HNS physician with an updated list of scientific peer review literature- validated mobile apps for safe use for both the clinician and the patients, for screening, diagnosis, therapy and follow up for various ORL-HNS pathologies. EVIDENCE REVIEW A comprehensive systematic review of the scientific literature was conducted in "PubMed," "EMBASE," and "Web of Science" without limitation of publication date up to January 1st, 2023. The included papers validated mobile apps in the ORL-HNS discipline. Each study was evaluated using the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) tool. FINDINGS From the thousands of unregulated ORL-HNS mobile apps available for download and use in the various app stores, only 17 apps were validated for safe use by the clinician and/or patient. Their information is listed. CONCLUSIONS AND RELEVANCE The limited number of validated mobile apps highlights the importance to use validated apps in clinical practice, to improve evidence-based medicine and patient safety. Physician are encouraged to use and recommend their patients to use validated mobile apps only, like any other tool in clinical practice in the evidence-based era.
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Affiliation(s)
- Eyal Schneider
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Guryon University, Faculty of Health Sciences, Ashdod, Israel
| | - Shahaf Shilo
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Omer J Ungar
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Lee SY, Seo HW, Jung SM, Lee SH, Chung JH. Assessing the accuracy and reliability of application-based audiometry for hearing evaluation. Sci Rep 2024; 14:7359. [PMID: 38548854 PMCID: PMC10978977 DOI: 10.1038/s41598-024-57944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/23/2024] [Indexed: 04/01/2024] Open
Abstract
Pure-tone audiometry (PTA) is the gold standard for assessing hearing loss. However, traditional PTA tests require specialized equipment, trained personnel, and a soundproof environment. Recently, smartphone-based PTA tests have been developed as an alternative method for hearing assessment. The aim of this study was to validate the accuracy and reliability of a smartphone application-based audiometry test. This study was conducted to assess the performance of application-based audiometry from November 2021 to January 2022. Pure-tone thresholds were measured using a smartphone application-based PTA test and compared with results obtained using a traditional audiometer in a sound-treated booth. The smartphone application used in this study was the "Care4Ear (Care4ear, version 1.0.6, MIJ Co., Ltd.)". Hearing thresholds less than 35 dB HL were classified as group A, 35-64 dB HL as group B, and 65 dB HL or greater as group C for the classification of hearing levels. We evaluated the accuracy of smartphone audiometry for each group and compared the results of frequency-specific hearing tests. Additionally, we examined the results of smartphone audiometry in individuals (n = 27) with asymmetric hearing loss. Seventy subjects completed both conventional audiometry and smartphone application-based hearing tests. Among the ears assessed, 55.7% were classified as group A, while 25.7% and 18.6% were classified as group B and group C, respectively. The average hearing threshold obtained from conventional pure-tone audiometry was 37.7 ± 25.2 dB HL, whereas the application-based hearing test yielded thresholds of 21.0 ± 23.0 dB HL. A significant correlation (r = 0.69, p < 0.01) was found between the average hearing thresholds obtained from the application-based and conventional pure-tone audiometry tests. The application-based test achieved a 97.4% hit rate for classifying hearing thresholds as class A, but lower rates of 22.2% for class B and 38.5% for class C. Notably, a discrepancy was observed between the hearing threshold measured by the application and the conventional audiometry for the worse ear with asymmetric hearing. The smartphone-based audiometry is a feasible method for hearing evaluation especially in persons with normal hearing. In cases of hearing loss or asymmetric hearing loss, the results of the application-based audiometry may be inaccurate, limiting its diagnostic utility.
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Affiliation(s)
- Seung Yeol Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, College of Medicine, Hanyang University, 222-Wangshimni-ro, Seongdong-gu, Seoul, 133-792, Korea
| | - Hee Won Seo
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, College of Medicine, Hanyang University, 222-Wangshimni-ro, Seongdong-gu, Seoul, 133-792, Korea
| | - Seon Min Jung
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, College of Medicine, Hanyang University, 222-Wangshimni-ro, Seongdong-gu, Seoul, 133-792, Korea
| | - Seung Hwan Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, College of Medicine, Hanyang University, 222-Wangshimni-ro, Seongdong-gu, Seoul, 133-792, Korea
| | - Jae Ho Chung
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, College of Medicine, Hanyang University, 222-Wangshimni-ro, Seongdong-gu, Seoul, 133-792, Korea.
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Sienko A, Thirunavukarasu AJ, Kuzmich T, Allen L. An Initial Validation of Community-Based Air-Conduction Audiometry in Adults With Simulated Hearing Impairment Using a New Web App, DigiBel: Validation Study. JMIR Form Res 2024; 8:e51770. [PMID: 38271088 PMCID: PMC10853851 DOI: 10.2196/51770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Approximately 80% of primary school children in the United States and Europe experience glue ear, which may impair hearing at a critical time for speech acquisition and social development. A web-based app, DigiBel, has been developed primarily to identify individuals with conductive hearing impairment who may benefit from the temporary use of bone-conduction assistive technology in the community. OBJECTIVE This preliminary study aims to determine the screening accuracy and usability of DigiBel self-assessed air-conduction (AC) pure tone audiometry in adult volunteers with simulated hearing impairment prior to formal clinical validation. METHODS Healthy adults, each with 1 ear plugged, underwent automated AC pure tone audiometry (reference test) and DigiBel audiometry in quiet community settings. Threshold measurements were compared across 6 tone frequencies and DigiBel test-retest reliability was calculated. The accuracy of DigiBel for detecting more than 20 dB of hearing impairment was assessed. A total of 30 adults (30 unplugged ears and 30 plugged ears) completed both audiometry tests. RESULTS DigiBel had 100% sensitivity (95% CI 87.23-100) and 72.73% (95% CI 54.48-86.70) specificity in detecting hearing impairment. Threshold mean bias was insignificant except at 4000 and 8000 Hz where a small but significant overestimation of threshold measurement was identified. All 24 participants completing feedback rated the DigiBel test as good or excellent and 21 (88%) participants agreed or strongly agreed that they would be able to do the test at home without help. CONCLUSIONS This study supports the potential use of DigiBel as a screening tool for hearing impairment. The findings will be used to improve the software further prior to undertaking a formal clinical trial of AC and bone-conduction audiometry in individuals with suspected conductive hearing impairment.
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Affiliation(s)
- Anna Sienko
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Tanya Kuzmich
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Louise Allen
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
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Wang K, Wei W, Shi J, Qi B, Zhu Z, Li Z. Diagnostic Accuracy of Mobile Health-Based Audiometry for the Screening of Hearing Loss in Adults: A Systematic Review and Meta-Analysis. Telemed J E Health 2023; 29:1433-1445. [PMID: 36862527 DOI: 10.1089/tmj.2022.0427] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Background: Hearing loss is one of the most prevalent chronic health conditions. Traditional pure tone audiometry (PTA) is the gold standard for hearing loss screening, but is not widely available outside specialized clinical centers. Mobile health (mHealth)-based audiometry could improve access and cost-effectiveness, but its diagnostic accuracy varies widely between studies. Therefore, we aimed to evaluate the diagnostic accuracy of mHealth-based audiometry for hearing loss screening in adults compared with traditional PTA. Methods: Ten English and Chinese databases were searched from inception until April 30, 2022. Two researchers independently selected studies, extracted data, and appraised methodological quality. The bivariate random-effects model was adopted to estimate the pooled sensitivity and specificity for each common threshold (i.e., the threshold to define mild or moderate hearing loss). The hierarchical summary receiver operating characteristic model was used to assess the area under the receiver operating characteristic curve (AUC) across all thresholds. Results: Twenty cohort studies were included. Only one study (n = 109) used the mHealth-based speech recognition test (SRT) as the index test. Nineteen studies (n = 1,656) used mHealth-based PTA as the index test, and all of them were included in the meta-analysis. For detecting mild hearing loss, the pooled sensitivity and specificity were 0.91 (95% confidence interval [CI] 0.80-0.96) and 0.90 (95% CI 0.82-0.94), respectively. For detecting moderate hearing loss, the pooled sensitivity and specificity were 0.94 (95% CI 0.87-0.98) and 0.87 (95% CI 0.79-0.93), respectively. For all PTA thresholds, the AUC was 0.96 (95% CI 0.40-1.00). Conclusions: mHealth-based audiometry provided good diagnostic accuracy for screening both mild and moderate hearing loss in adults. Given its high diagnostic accuracy, accessibility, convenience, and cost-effectiveness, it shows enormous potential for hearing loss screening, particularly in primary care sites, low-income regions, and settings with in-person visit limitations. Further work should evaluate the diagnostic accuracy of the mHealth-based SRT tests.
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Affiliation(s)
- Kairong Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wanrui Wei
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiyuan Shi
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Beier Qi
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Department of Neuro-otology Department, Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing, China
| | - Zheng Zhu
- Fudan University Center for Evidence-based Nursing, A Joanna Briggs Institute Center of Excellence, School of Nursing, Fudan University, Shanghai, China
| | - Zheng Li
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Génin A, Louchet A, Balcon M, Ceccato JC, Venail F. Validation of a tablet-based application for hearing self-screening in an adult population. Int J Audiol 2023:1-9. [PMID: 37768031 DOI: 10.1080/14992027.2023.2260950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE This study evaluated the diagnostic performances of a tablet-based hearing screening test by assisted-test and self-test modes. DESIGN/METHOD Measurements were performed with the SoTone tests in normal hearing and hearing-impaired adult participants using an Android tablet and calibrated Bluetooth headphones. The duration of assisted- and self-test modes were compared. Receiver operating characteristic (ROC) curves were plotted after calculations of sensitivity and specificity at 20, 30, and 35 dB HL cut-off values. STUDY SAMPLE 217 participants performed the tests. The effect of test mode (assisted versus self) was compared in a sample of 103 participants. RESULTS Self-test duration (89 s) was significantly longer than the assisted-test duration (75 s) (p = 0.003, Wilcoxon test). For the 20, 30, and 35 dB HL cut-off values, sensitivity was between 92% and 96%, and specificity was between 79 and 90%. Concordance of results between assisted-test and self-test modes was excellent (Cohen's kappa = 0.81, p < 0.001). CONCLUSIONS The SoTone hearing screening test is accurate for identifying the presence of a suspected hearing loss at 20 dB HL or more in adults. It can be used either in assisted-test or self-test modes.
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Affiliation(s)
- Arnaud Génin
- Département ORL&CMF, CHU et Université de Montpellier, Montpellier, France
- Institut des Neurosciences de Montpellier - INSERM U1298, Montpellier, France
- SONUP - Montpellier, Montpellier, France
| | - Auxence Louchet
- Département ORL&CMF, CHU et Université de Montpellier, Montpellier, France
- Institut des Neurosciences de Montpellier - INSERM U1298, Montpellier, France
- Audiocampus - Montpellier, Montpellier, France
| | | | - Jean-Charles Ceccato
- Institut des Neurosciences de Montpellier - INSERM U1298, Montpellier, France
- Audiocampus - Montpellier, Montpellier, France
| | - Frédéric Venail
- Département ORL&CMF, CHU et Université de Montpellier, Montpellier, France
- Institut des Neurosciences de Montpellier - INSERM U1298, Montpellier, France
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Wiseman K, Slotkin J, Spratford M, Haggerty A, Heusinkvelt M, Weintraub S, Gershon R, McCreery R. Validation of a tablet-based assessment of auditory sensitivity for researchers. Behav Res Methods 2023; 55:2838-2852. [PMID: 35962308 PMCID: PMC10228289 DOI: 10.3758/s13428-022-01933-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 01/01/2023]
Abstract
Quantifying hearing acuity is increasingly important across a wide range of research areas in the behavioral and neurosciences. Scientists have relied on either self-reported hearing status or the availability of diagnostic hearing assessment in past studies. There remains a need for a valid and reliable assessment of auditory sensitivity that can provide estimates of the magnitude of hearing loss, if present, without requirements for professional audiologists, facilities, and equipment that are needed to conduct a diagnostic hearing assessment. The goal of this experiment was to validate the NIH Toolbox® Hearing Threshold Test (HTT), a tablet-based hearing assessment available via iPad application that uses consumer-grade headphones, on a clinical sample of children and adults with varying degrees of hearing acuity. Electroacoustic analysis of the hearing assessment application and headphones demonstrated acoustic outputs within established conformity standards for hearing assessment. Twenty-seven children and 63 adults participated in a standard diagnostic hearing assessment and the experimental tablet-based assessment. The results showed that thresholds from the tablet-based assessment were highly correlated with thresholds from the clinical hearing assessment (r = .83-.93) for children and adults for all frequencies and across a range of levels of hearing acuity. The HTT also met clinical test-retest reliability standards (Cronbach's α > .86). The tablet-based hearing assessment provides acceptable estimates of hearing levels for children and adults when diagnostic audiometric assessment capabilities are not available.
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Affiliation(s)
- Kathryn Wiseman
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | | | - Meredith Spratford
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | - Amberlee Haggerty
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | - Maggie Heusinkvelt
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Richard Gershon
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Ryan McCreery
- The Audibility, Perception, and Cognition Laboratory, Center for Hearing Research, Boys Town Research Hospital, 555 North 30th Street, Omaha, NE, 68131, USA.
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Abrams HB, Singh J. Preserving the Role of the Audiologist in a Clinical Technology, Consumer Channel, Clinical Service Model of Hearing Healthcare. Semin Hear 2023; 44:302-318. [PMID: 37484986 PMCID: PMC10361794 DOI: 10.1055/s-0043-1769627] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
The past decade has been characterized by significant changes in the distribution and sale of hearing aids. Alternatives to the clinical technology, clinical channel, clinical service (i.e., traditional) hearing healthcare delivery model have been driven by growth in hearing aid dispensaries housed in large retail establishments and direct-to-consumer hearing aid sales by internet-based companies unaffiliated with major hearing aid manufacturers (e.g., Eargo). These developments have been accompanied by acceleration in the growth of teleaudiology services as a direct result of the COVID-19 pandemic. The resulting development of nontraditional hearing aid distribution and sales models can be categorized into distinct archetypes as reviewed earlier in this publication. This article will review the Clinical Technology-Consumer Channel-Clinical Service model as exemplified by Jabra Enhance. We will describe a completely digital model of hearing aid distribution and sales that maintains the professional service component throughout the client journey to include an online tone test, the use of a risk mitigation questionnaire, virtual consultations, remote hearing aid adjustments, and the establishment and monitoring of client-centered treatment goals. Furthermore, this article will review the Jabra Enhance model within the context of consumer healthcare decision-making theory with a focus on the Consumer Decision-Making Model.
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Affiliation(s)
- Harvey B. Abrams
- Jabra Enhance, New York, New York
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida
| | - Jasleen Singh
- Auditory Research Laboratory, Northwestern University, Evanston, Illinois
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Cunha MLSD, Lopes MDS, Meira TC, Corona AP. Hearing screening using the uHear™ smartphone-based app: reproducibility of results from two response modes. Codas 2023; 35:e20210143. [PMID: 37098938 PMCID: PMC10137764 DOI: 10.1590/2317-1782/20232021143pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 04/17/2022] [Indexed: 04/27/2023] Open
Abstract
PURPOSE Estimate the reproducibility of hearing screening results using the uHear™ smartphone-based app in two response modes: self-test response and test-operator. METHODS Reliability study conducted with 65 individuals aged ≥18 years assisted at the Speech-language and Hearing Therapy clinic of a public higher-education institution. Hearing screening was conducted by a single researcher using the uHear app and earbud headphones in a soundproof booth. Participants responded to sound stimuli in both self-test response mode and test-operator mode. The order in which these two uHear test modes were applied was altered according to the entrance of each participant in the study. The correspondence between the hearing thresholds obtained from each response mode was analyzed and their Intraclass Correlation Coefficient (ICC) was estimated. RESULTS A correspondence of ±5 dBHL >75% was observed between these hearing thresholds. The ICC values showed excellent agreement between the two response modes at all frequencies >40 dBHL tested. CONCLUSION The two hearing screening response modes using the uHear app presented high reproducibility, suggesting that the test-operator mode is a viable alternative when the self-test response mode is not recommended.
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Affiliation(s)
| | - Márcia da Silva Lopes
- Departamento de Fonoaudiologia, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil
| | - Tatiane Costa Meira
- Departamento de Fonoaudiologia, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil
| | - Ana Paula Corona
- Departamento de Fonoaudiologia, Universidade Federal da Bahia - UFBA - Salvador (BA), Brasil
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Liu H, Du B, Liu B, Fu X, Wang Y. Clinical comparison of two automated audiometry procedures. Front Neurosci 2022; 16:1011016. [PMID: 36303947 PMCID: PMC9595274 DOI: 10.3389/fnins.2022.1011016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Automated pure-tone audiometry has been shown to provide similar hearing threshold estimates to conventional audiometry, but lower correlations were reported at high and low frequencies in audiometric tests than those of manual tests, while the correlations were better in the middle frequencies. In this paper, we used the same equipment and different test procedures for automated testing, and compared the results with manual test results. Design One hundred subjects aged 18–36 years were randomly divided into two groups to perform air-conduction pure-tone audiometry (0.25, 0.5, 1, 2, 4, 8 kHz) using the ascending and shortened ascending protocols built-in to the automated audiometer, respectively. Recorded testing time, the total number of responses and the subject’s preference tests were compared with those of manual tests. Results Significant difference was found at 250 Hz regarding the distribution of the absolute difference between the two automated and the manual thresholds. The testing time spend in the ascending method (9.8 ± 1.4 min, mean ± SD) was significantly longer than in the shorted ascending method (5.8 ± 0.9 min). The total numbers of responses of the ascending method (90.5 ± 10.8 times) and shorted ascending method (62.0 ± 11.4 times) were significantly different. Finally, no significant difference was found in preferences between automated and manual procedures. Conclusion The shorted ascending method can save lots of testing time. The difference between the two automated thresholds at 250 Hz is caused by the different test procedures, and the difference at 8,000 Hz between the automated test and the manual test can be due to the transducer types and allowable differences in calibration.
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Affiliation(s)
- Hui Liu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Bingqing Du
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Bo Liu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Xinxing Fu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Medical School, The University of Western Australia, Crawley, WA, Australia
- Ear Science Institute Australia, Subiaco, WA, Australia
- *Correspondence: Xinxing Fu,
| | - Yao Wang
- School of Life Sciences, Tiangong University, Tianjin, China
- School of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Yao Wang,
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Barros VV, Nunes-Araújo ADDS, da Silva ARX, Cavalcanti HG, Ferrari DV, Balen SA. Digits-in-noise test in Brazilian Portuguese: how demographic and socioeconomic variables influence normal-hearing subjects. Codas 2022; 34:e20210274. [PMID: 35544883 PMCID: PMC9886289 DOI: 10.1590/2317-1782/20212021274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/03/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Verify how demographic and socioeconomic variables on the in-noise speech recognition threshold (SRT) from the digits-in-noise test (DIN) in Brazilian Portuguese influence normal-hearing subjects. METHODS Cross-sectional, prospective study. The convenience sample had 151 normal-hearing subjects between 12 and 79 years (mean=34.66) who underwent pure tone audiometry and digits-in-noise test with white noise using a sequence of three numbers in diotic stimulus (in-phase) on the same day. The DIN was performed using a Motorola Z3 Play smartphone with internet access and in-ear headphones. In-noise digit speech recognition threshold (SRT) was analyzed for gender, age, educational levels, and socioeconomic status. We used the non-parametric version of the Kruskal-Wallis and Mann-Whitney U tests to compare independent samples adopting a significance level of 5%. RESULTS The mean SRT was -8.47 dBNA (SD -3.89) with a median of -9.6 dBNA. The SRT was proportionally inverse to educational levels and socioeconomic status and more negative (better) with lower age groups. Gender did not influence the DIN SRT. CONCLUSION Age, educational levels, and socioeconomic status influenced the DIN threshold. These variables must be considered when analyzing DIN performance in Brazilian Portuguese in normal-hearing subjects.
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Melo IMM, Silva ARX, Camargo R, Cavalcanti HG, Ferrari DV, Taveira KVM, Balen SA. Accuracy of smartphone-based hearing screening tests: a systematic review. Codas 2022; 34:e20200380. [PMID: 35239828 PMCID: PMC9769434 DOI: 10.1590/2317-1782/20212020380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/22/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To verify the accuracy of smartphone apps to identify hearing loss. RESEARCH STRATEGIES A systematic review followed the PRISMA-DATA checklist. The search strategies were applied across four databases (Lilacs, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey, and ProQuest Dissertations and Thesis). SELECTION CRITERIA The acronym PIRD was used in review. This included populations of any gender and all age groups. The Index test is the smartphone-based hearing screening test; the Reference test is the pure-tone audiometry, which is considered the gold reference for hearing diagnostics; the diagnosis was performed via validity data (sensitivity and specificity) to identify hearing loss and diagnostic studies. DATA ANALYSIS Two reviewers selected the studies in a two-step process. The risk of bias was assessed according to the criteria of the QUADAS-2. RESULTS Of 1395 articles, 104 articles were eligible for full-text reading and 17 were included. Only four met all criteria for methodological quality. All of the included studies were published in English between 2015 and 2020. The applications Digits-in noise Test (5 articles), uHear (4 articles), HearScreen (2 articles), hearTest (2 articles) and Hearing Test (2 articles) were the most studied. All this application showed sensitivity and specificity values between 75 and 100%. The other applications were EarScale, uHearing Test, Free field hearing (FFH) and Free Hearing Test. CONCLUSION uHear, Digit-in-Noise Test, HearTest and HearScreen have shown significant values of sensitivity and specificity and can be considered as the most accurate methods for screening of hearing impairment.
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Affiliation(s)
| | | | - Rodolpho Camargo
- Faculdade de Odontologia de Bauru, Universidade de São Paulo - FOB/USP, Bauru (SP), Brasil
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Li LYJ, Wang SY, Yang JM, Chen CJ, Tsai CY, Wu LYY, Wu TF, Wu CJ. Validation of a Personalized Hearing Screening Mobile Health Application for Persons with Moderate Hearing Impairment. J Pers Med 2021; 11:jpm11101035. [PMID: 34683176 PMCID: PMC8538050 DOI: 10.3390/jpm11101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
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.
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Affiliation(s)
- Lok-Yee Joyce Li
- 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;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
| | - Shin-Yi Wang
- Department of Nursing, National Taiwan University Hospital, Hsinchu Branch, Hsinchu 300, Taiwan;
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan;
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Chih-Jou Chen
- Master Program in School of Nursing, Taipei Medical University, Taipei 110, Taiwan;
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2BT, UK;
| | - Lucas Yee-Yan Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
| | - Te-Fang Wu
- Department of Otolaryngology—Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan;
| | - Cheng-Jung Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Ph.D. Degree Program in Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence:
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15
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Garcia A, Chari DA, Stankovic KM, Lee DJ, Kozin ED, Franck KH. Implementation of Mobile Audiometry During the COVID-19 Pandemic. Otolaryngol Head Neck Surg 2021; 167:465-468. [PMID: 34609938 DOI: 10.1177/01945998211051588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, the utility of portable audiometry became more apparent as elective procedures were deferred in an effort to limit exposure to health care providers. Herein, we retrospectively evaluated mobile-based audiometry in the emergency department and outpatient otology and audiology clinics. Air conduction thresholds with mobile audiometry were within 5 dB in 66% of tests (95% CI, 62.8%-69.09%) and within 10 dB in 84% of tests (95% CI, 81.4%-86.2%) as compared with conventional audiometry. No significant differences were noted between mobile-based and conventional audiometry at any frequencies, except 8 kHz (P < .05). The sensitivity and specificity for screening for hearing loss were 94.3% (95% CI, 91.9%-96.83%) and 92.3% (95% CI, 90.1%-94.4%), respectively. While automated threshold audiometry does not replace conventional audiometry, mobile audiometry is a promising screening tool when conventional audiometry is not available.
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Affiliation(s)
- Alejandro Garcia
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Divya A Chari
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Konstantina M Stankovic
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Elliott D Kozin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Chen CH, Lin HYH, Wang MC, Chu YC, Chang CY, Huang CY, Cheng YF. Diagnostic Accuracy of Smartphone-Based Audiometry for Hearing Loss Detection: Meta-analysis. JMIR Mhealth Uhealth 2021; 9:e28378. [PMID: 34515644 PMCID: PMC8477297 DOI: 10.2196/28378] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/22/2021] [Accepted: 06/17/2021] [Indexed: 01/04/2023] Open
Abstract
Background Hearing loss is one of the most common disabilities worldwide and affects both individual and public health. Pure tone audiometry (PTA) is the gold standard for hearing assessment, but it is often not available in many settings, given its high cost and demand for human resources. Smartphone-based audiometry may be equally effective and can improve access to adequate hearing evaluations. Objective The aim of this systematic review is to synthesize the current evidence of the role of smartphone-based audiometry in hearing assessments and further explore the factors that influence its diagnostic accuracy. Methods Five databases—PubMed, Embase, Cochrane Library, Web of Science, and Scopus—were queried to identify original studies that examined the diagnostic accuracy of hearing loss measurement using smartphone-based devices with conventional PTA as a reference test. A bivariate random-effects meta-analysis was performed to estimate the pooled sensitivity and specificity. The factors associated with diagnostic accuracy were identified using a bivariate meta-regression model. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results In all, 25 studies with a total of 4470 patients were included in the meta-analysis. The overall sensitivity, specificity, and area under the receiver operating characteristic curve for smartphone-based audiometry were 89% (95% CI 83%-93%), 93% (95% CI 87%-97%), and 0.96 (95% CI 0.93-0.97), respectively; the corresponding values for the smartphone-based speech recognition test were 91% (95% CI 86%-94%), 88% (95% CI 75%-94%), and 0.93 (95% CI 0.90-0.95), respectively. Meta-regression analysis revealed that patient age, equipment used, and the presence of soundproof booths were significantly related to diagnostic accuracy. Conclusions We have presented comprehensive evidence regarding the effectiveness of smartphone-based tests in diagnosing hearing loss. Smartphone-based audiometry may serve as an accurate and accessible approach to hearing evaluations, especially in settings where conventional PTA is unavailable.
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Affiliation(s)
- Chih-Hao Chen
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan, Taipei City, Taiwan
| | - Heng-Yu Haley Lin
- Department of Medical Education, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Mao-Che Wang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan, Taipei City, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei City, Taiwan.,Medical AI Development Center, Taipei Veterans General Hospital, Taipei City, Taiwan.,Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Chun-Yu Chang
- Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chii-Yuan Huang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan, Taipei City, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taiwan, Taipei City, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei City, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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Abstract
Purpose of the Review The goal of this review is to highlight current approaches to diagnosis and treatment for adult-onset hearing loss in patients likely to present to a neurologist's office. The review will discuss primary and secondary causes of acute and chronic hearing loss, and will discuss common situations that can be managed by a neurologist as well as situations that require immediate care and referral for further management by an otolaryngologist-head and neck surgeon. Recent Findings Hearing screening assessments using mobile applications and tablet devices are now available and can be integrated into many clinical practice settings, including in the evaluation of hearing concerns related to various neurological pathologies. For patients presenting with a sudden worsening in hearing, bedside evaluation, including with objective measures of hearing, can inform neurologists about diagnosis and subsequent management. For patients who present with gradual worsening in hearing, particularly those related to neurologic disorders, hearing care can be an important adjunct to ongoing neurologic care. More commonly encountered, age-related hearing loss is highly prevalent among older adults and may affect overall neurological assessment, including neurocognitive testing, as well as patient-provider communication, patient satisfaction, and care outcomes. Hearing loss is increasingly recognized as a potentially modifiable risk factor for dementia. Neurologists can support the hearing health of their patients through the routine use of communication strategies and by integrating simple, low-cost technology with their current clinical practices. Summary Both acute and chronic hearing loss can be a symptom of many conditions managed by neurologists. Few conditions are emergent, requiring immediate referral to and treatment by an otolaryngologist-head and neck surgeon. Despite the range of hearing interventions available, including hearing aids, over-the-counter devices, and aural rehabilitation, hearing loss is a common and under-treated chronic health condition. By promptly addressing a patient's hearing concerns, neurologists can improve patients' awareness of the deficit and support the overall importance of maintaining sensory health across the life course.
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18
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Seluakumaran K, Shaharudin MN. Calibration and initial validation of a low-cost computer-based screening audiometer coupled to consumer insert phone-earmuff combination for boothless audiometry. Int J Audiol 2021; 61:850-858. [PMID: 34455907 DOI: 10.1080/14992027.2021.1969455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To undertake calibration and preliminary validation of a custom-designed computer-based screening audiometer connected to consumer insert phone-earmuff combination for adult pure tone audiometry. DESIGN Part 1 involved electroacoustic measurement and biological calibration of a laptop-earphone pair used for the computer-based audiometry (CBA). Part 2 compared CBA thresholds obtained without a sound booth with those measured using the gold-standard clinical audiometry. STUDY SAMPLE 17 young normal-hearing volunteers (Part 1) and 43 normal and hearing loss subjects (Part 2) recruited from an audiology clinic via convenience sampling. RESULTS The transducer-device combination produced outputs suitable for measuring thresholds down to 0 dB HL. Threshold pairs obtained from the CBA and clinical audiometry were highly correlated (Spearman's correlation coefficient, ρ = 0.92, p < 0.0001) and had a good degree of agreement (mean difference of -1.06 ± 7.63 dB). Also, the CBA showed about 90% sensitivity and 80% specificity for detecting hearing loss based on low (0.5, 1, 2 kHz) and high frequency (4, 8 kHz) pure tone averages of >25 dB HL. CONCLUSIONS The use of a computer-based audiometer application with consumer insert phone-earmuff combination can offer a cost-effective solution for boothless screening audiometry.
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Affiliation(s)
- Kumar Seluakumaran
- Auditory Lab, Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Majdina N Shaharudin
- Auditory Lab, Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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19
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Balen SA, Vital BSB, Pereira RN, Lima TFD, Barros DMDS, Lopez EA, Diniz Junior J, Valentim RADM, Ferrari DV. Accuracy of affordable instruments for hearing screening in adults and the elderly. Codas 2021; 33:e20200100. [PMID: 34231667 DOI: 10.1590/2317-1782/20202020100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/30/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the accuracy of affordable instruments for hearing screening of adults and the elderly. METHODS This study was carried out with users of a Hearing Health Service of the Unified Health System. All were screened with the MoBASA smartphone application, the Telehealth audiometer (TH) and the electronic version of the Hearing Handicap Inventory for the Elderly - screening version - eHHIE-S. The examiners were blinded to the results of the screening tests and pure tone audiometry (PTA). Hearing impairment was considered for those with a PTA quadritonal mean greater than 40 dB in the best ear. Sensitivity, specificity and positive and negative predictive values (PPV and NPV, respectively) were calculated. The Kappa index was used as an agreement indicator between the PTA and the screening results. RESULTS The sample consisted of 80 individuals between 18 and 94 years old (55.18 ± 20.21). In the PTA test, 21 individuals (26.25%) had typical hearing and 59 (73.75%) hearing loss. In the hearing screening tests, sensitivity, specificity, PPV and NPV values greater than 75% were observed with the MoBASA as well as in terms of sensitivity and NPV of the TH and the eHHIE-S. The TH and the eHHIE-S specificity and PPV were less than 75%. The Kappa index indicated a substantial agreement (0.6) between the PTA and the MoBASA screening results. The TH and the eHHIE-S showed regular agreement (0.3). CONCLUSION MoBASA proved to be an accurate method for hearing screening of adults and the elderly with disabling hearing loss.
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Affiliation(s)
- Sheila Andreoli Balen
- Departamento de Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.,Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.,Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.,Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL - Maceió (AL), Brasil.,Laboratório de Inovação Tecnológica em Saúde, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil
| | - Bianca Stephany Barbosa Vital
- Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.,Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.,Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL - Maceió (AL), Brasil.,Laboratório de Inovação Tecnológica em Saúde, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil
| | - Rhadimylla Nágila Pereira
- Laboratório de Inovação Tecnológica em Saúde, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil
| | - Taise Ferreira de Lima
- Laboratório de Inovação Tecnológica em Saúde, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil
| | - Daniele Montenegro da Silva Barros
- Laboratório de Inovação Tecnológica em Saúde, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.,Programa de Pós-graduação em Engenharia Elétrica e Computação, Universidade Federal do Rio Grande do Norte UFRN - Natal (RN), Brasil
| | - Esteban Alejandro Lopez
- Programa de Pós-graduação Interunidades em Bioengenharia - PPGIB - Escola de Engenharia de São Carlos - EESC - Universidade de São Paulo - USP - São Carlos (SP), Brasil
| | - Jose Diniz Junior
- Departamento de Cirurgia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil
| | - Ricardo Alexsandro de Medeiros Valentim
- Laboratório de Inovação Tecnológica em Saúde, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.,Programa de Pós-graduação em Engenharia Elétrica e Computação, Universidade Federal do Rio Grande do Norte UFRN - Natal (RN), Brasil.,Departamento de Engenharia Biomédica, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil
| | - Deborah Viviane Ferrari
- Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru, Universidade de São Paulo - USP - Bauru (SP), Brasil
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Patel K, Thibodeau L, McCullough D, Freeman E, Panahi I. Development and Pilot Testing of Smartphone-Based Hearing Test Application. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5529. [PMID: 34064080 PMCID: PMC8196774 DOI: 10.3390/ijerph18115529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Identifying and treating hearing loss can help improve communication skills, which often leads to improved quality of life. Many people do not seek medical treatment and, therefore, go undiagnosed for an extended period before realizing they have hearing loss. This study presents a self-administered, low-cost, smartphone-based hearing test application (HearTest) to quantify the pure-tone hearing thresholds of a user. The HearTest application can be used with commercially available smartphone devices and an earphone with the mentioned specification. METHODS Air-conduction-based pure-tone audiometry for the smartphone application was designed and implemented to detect hearing thresholds using a traditional "10 dB down and 5 dB up" approach. Employed smartphone-earphone combination was calibrated with respect to a GSI-61 audiometer and insert earphone ER-3A to maintain clinical standards with the help of subjective testing on 20 normal-hearing (NH) participants. RESULTS Further subjective testing on 14 participants with NH and retesting on five participants showed that HearTest achieves high-accuracy audiogram within clinically acceptable limits (≤10 dB HL mean difference) when compared with the reference clinical audiometer. Hardware challenges and limitations in air-conduction-based hearing tests through smartphones and ways to improve their accuracy and reliability are discussed. CONCLUSION The proposed smartphone application provides a simple, affordable, and reliable means for people to learn more about their hearing health without needing access to a formal clinical facility.
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Affiliation(s)
- Kashyap Patel
- Department of Electrical and Computer Engineering, The University of Texas at Dallas, Richardson, TX 75080, USA;
| | - Linda Thibodeau
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA; (L.T.); (D.M.); (E.F.)
| | - David McCullough
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA; (L.T.); (D.M.); (E.F.)
| | - Emma Freeman
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA; (L.T.); (D.M.); (E.F.)
| | - Issa Panahi
- Department of Electrical and Computer Engineering, The University of Texas at Dallas, Richardson, TX 75080, USA;
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Fischer F, Kleen S. Possibilities, Problems, and Perspectives of Data Collection by Mobile Apps in Longitudinal Epidemiological Studies: Scoping Review. J Med Internet Res 2021; 23:e17691. [PMID: 33480850 PMCID: PMC7864774 DOI: 10.2196/17691] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background The broad availability of smartphones and the number of health apps in app stores have risen in recent years. Health apps have benefits for individuals (eg, the ability to monitor one’s health) as well as for researchers (eg, the ability to collect data in population-based, clinical, and observational studies). Although the number of health apps on the global app market is huge and the associated potential seems to be great, app-based questionnaires for collecting patient-related data have not played an important role in epidemiological studies so far. Objective This study aims to provide an overview of studies that have collected patient data using an app-based approach, with a particular focus on longitudinal studies. This literature review describes the current extent to which smartphones have been used for collecting (patient) data for research purposes, and the potential benefits and challenges associated with this approach. Methods We conducted a scoping review of studies that used data collection via apps. PubMed was used to identify studies describing the use of smartphone app questionnaires for collecting data over time. Overall, 17 articles were included in the summary. Results Based on the results of this scoping review, there are only a few studies that integrate smartphone apps into data-collection approaches. Studies dealing with the collection of health-related data via smartphone apps have mainly been developed with regard to psychosomatic, neurodegenerative, respiratory, and cardiovascular diseases, as well as malign neoplasm. Among the identified studies, the duration of data collection ranged from 4 weeks to 12 months, and the participants’ mean ages ranged from 7 to 69 years.
Potential can be seen for real-time information transfer, fast data synchronization (which saves time and increases effectivity), and the possibility of tracking responses longitudinally. Furthermore, smartphone-based data-collection techniques might prevent biases, such as reminder bias or mistakes occurring during manual data transfers. In chronic diseases, real-time communication with physicians and early detection of symptoms enables rapid modifications in disease management. Conclusions The results indicate that using mobile technologies can help to overcome challenges linked with data collection in epidemiological research. However, further feasibility studies need to be conducted in the near future to test the applicability and acceptance of these mobile apps for epidemiological research in various subpopulations.
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Affiliation(s)
- Florian Fischer
- Institut of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany.,Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Sina Kleen
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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22
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Irace AL, Sharma RK, Reed NS, Golub JS. Smartphone-Based Applications to Detect Hearing Loss: A Review of Current Technology. J Am Geriatr Soc 2020; 69:307-316. [PMID: 33341098 DOI: 10.1111/jgs.16985] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND/OBJECTIVES Age-related hearing loss (ARHL) is a widely prevalent yet manageable condition that has been linked to neurocognitive and psychiatric comorbidities. Multiple barriers hinder older individuals from being diagnosed with ARHL through pure-tone audiometry. This is especially true during the COVID-19 pandemic, which has resulted in the closure of many outpatient audiology and otolaryngology offices. Smartphone-based hearing assessment apps may overcome these challenges by enabling patients to remotely self-administer their own hearing examination. The objective of this review is to provide an up-to-date overview of current mobile health applications (apps) that claim to assess hearing. DESIGN Narrative review. MEASUREMENTS The Apple App Store and Google Play Store were queried for apps that claim to assess hearing. Relevant apps were downloaded and used to conduct a mock hearing assessment. Names of included apps were searched on four literature databases (PubMed/MEDLINE, EMBASE, Cochrane Library, and CINAHL) to determine which apps had been validated against gold standard methods. RESULTS App store searches identified 44 unique apps. Apps differed with respect to the type of test offered (e.g., hearing threshold test), cost, strategies to reduce ambient noise, test output (quantitative vs qualitative results), and options to export results. Validation studies were identified for seven apps. CONCLUSION Given their low cost and relative accessibility, smartphone-based hearing apps may facilitate screening for ARHL, particularly in the setting of limitations on in-person medical care due to COVID-19. However, app features vary widely, few apps have been validated, and user-centered designs for older adults are largely lacking. Further research and validation efforts are necessary to determine whether smartphone-based hearing assessments are a feasible and accurate screening tool for ARHL. Key Points Age-related hearing loss is a prevalent yet undertreated condition among older adults. Why Does this Paper Matter? Smartphone-based hearing test apps may facilitate remote screening for hearing loss, but limitations surrounding app validation, usability, equipment calibration, and data security should be addressed.
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Affiliation(s)
- Alexandria L Irace
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Rahul K Sharma
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Justin S Golub
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
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Rodrigues LC, Ferrite S, Corona AP. Validity of hearTest Smartphone-Based Audiometry for Hearing Screening in Workers Exposed to Noise. J Am Acad Audiol 2020; 32:116-121. [PMID: 33296933 DOI: 10.1055/s-0040-1718931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE This article investigates the validity of a smartphone-based audiometry for hearing screening to identify hearing loss in workers exposed to noise. RESEARCH DESIGN This is a validation study comparing hearing screening with the hearTest to conventional audiometry. The study population included all workers who attended the Brazilian Social Service of Industry to undergo periodic examinations. Sensitivity, specificity, the Youden index, and positive (PPV) and negative predictive values (NPV) for hearing screening obtained by the hearTest were estimated according to three definitions of hearing loss: any threshold greater than 25 dB hearing level (HL), the mean auditory thresholds for 0.5, 1, 2, and 4 kHz greater than 25 dB HL, and the mean thresholds for 3, 4, and 6 kHz greater than 25 dB HL. Note that 95% confidence intervals were calculated for all measurements. RESULTS A total of 232 workers participated in the study. Hearing screening with the hearTest presented good sensitivity (93.8%), specificity (83.9%), and Youden index (77.7%) values, a NPV (97.2%), and a low PPV (69.0%) for the identification of hearing loss defined as any auditory threshold greater than 25 dB HL. For the other definitions of hearing loss, we observed high specificity, PPV and NPV, as well as low sensitivity and Youden index. CONCLUSION The hearTest is an accurate hearing screening tool to identify hearing loss in workers exposed to noise, including those with noise-induced hearing loss, although it does not replace conventional audiometry.
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Affiliation(s)
- Luma Cordeiro Rodrigues
- Postgraduate Programme in Environmental Health and Work, Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Silvia Ferrite
- Postgraduate Programme in Collective Health, Institute of Collective Health, Federal University of Bahia, Salvador, Brazil.,Department of Speech-Language Pathology and Audiology, Federal University of Bahia, Salvador, Brazil
| | - Ana Paula Corona
- Postgraduate Programme in Environmental Health and Work, Faculty of Medicine, Federal University of Bahia, Salvador, Brazil.,Department of Speech-Language Pathology and Audiology, Federal University of Bahia, Salvador, Brazil
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24
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Mizrachi Y, Shahrabani S, Nachmani M, Hornik A. Obstacles to using online health services among adults age 50 and up and the role of family support in overcoming them. Isr J Health Policy Res 2020; 9:42. [PMID: 32825840 PMCID: PMC7441221 DOI: 10.1186/s13584-020-00398-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 08/07/2020] [Indexed: 01/25/2023] Open
Abstract
Background Using Online Health Services (OHS) could benefit older adults greatly and could also reduce the burden on the health system. Yet invisible obstacles or barriers appear to impede mass adoption of these services among this population group. The aim of the current research is to provide a qualitative picture of these invisible obstacles and to profile their main features, with special attention to the role of family members in supporting OHS use among this population group. Methods This qualitative study entailed a series of in-depth, semi-structured, open phone interviews conducted with 31 individuals age 50 and up in Israel, who constituted a sample of OHS users and non-users among older adults. Results Four major themes and primary observations emerge from our data:
While older adults are aware of OHS to some extent, they often do not fully understand the specific benefits of using these services; Older adults need to acquire much more experience with OHS use. OHS user interfaces still have a long way to go for older adults to feel comfortable using them. People age 50 and up seem to be less concerned about privacy and security issues than about seemingly more trivial issues such as recovering forgotten passwords; Family members can play key roles in helping older adults adopt OHS by providing technical support as well as encouragement; Older adults have worthwhile recommendations for innovations and policy improvements that would facilitate wider adoption of OHS.
Conclusions The results of the current study reveal important nuances regarding the importance of awareness, user interface and experience for OHS use among older adults, as well as the critical role of family members in OHS adoption. Based on these findings, we recommend the following: expanding advertising on media channels to emphasize the benefits of OHS use; improving HMO websites to make them more user-friendly for older people; developing HMO-run community OHS guidance programs geared to older people to reduce the gap between required skills and user competencies, thus enabling older people to benefit from OHS use.
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Affiliation(s)
- Y Mizrachi
- Sociology and Anthropology Department, The Max Stern Yezreel Valley College, 1930600, Emek Yezreel, Israel
| | - S Shahrabani
- Economics and Management Department, The Max Stern Yezreel Valley College, 1930600, Emek Yezreel, Israel.
| | - M Nachmani
- Department of Sociology and Anthropology, The Max Stern Yezreel Valley College, 1930600, Emek Yezreel, Israel
| | - A Hornik
- Department of Psychology, Bar Ilan University, 52900, Ramat Gan, Israel
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Bauer MA, Sales A, Teixeira AR, Morsch P, Lessa AH, Bós ÂJG. Development and accuracy of a hearing screening application. Braz J Otorhinolaryngol 2020; 87:711-717. [PMID: 32620319 PMCID: PMC9422535 DOI: 10.1016/j.bjorl.2020.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 02/05/2020] [Accepted: 03/20/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Hearing impairment, or hearing loss, can be caused by several factors and the implications vary according to the type, degree, cause and age of occurrence. Hearing screening should be a common procedure, allowing the pre-clinical identification and necessary referrals, avoiding the consequences of auditory deprivation. Mobile apps have shown to be a good alternative for hearing assessment. OBJECTIVE The objective was to develop an app and assess its performance in identifying hearing loss by comparing it with another validated screening tool. METHODS The application, called Ouviu, was created using audiological knowledge and tools available on the iOS platform. We evaluated 185 people, aged between 6 and 96 years, distributed into 5 age groups, performing audiometry and hearing screening using two tools: HearCheck and the application. RESULTS The results showed that the sensitivity of the application in identifying hearing loss was approximately 97%, while that of HearCheck was 79%. The positive predictive value of the application showed that the probability of a person being identified with this tool and actually having a hearing loss was 94%, while for HearCheck it was 96%. False negatives, which failed hearing loss identification, were fewer in the app (3%) than in HearCheck (21%). CONCLUSION Consequently, the developed application was shown to be effective as a hearing screening tool, surpassing HearCheck in identifying mild hearing loss. In addition to being portable, easy to apply, low cost and rapidly performed, the application has the advantage of assessing environmental noise to perform the exam, as well as the fact that it is not necessary to attach any hardware to the mobile device.
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Affiliation(s)
- Magda Aline Bauer
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Gerontologia Biomédica, Porto Alegre, RS, Brazil
| | - Afonso Sales
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | | | - Patrícia Morsch
- Faculdade de Educação e Meio Ambiente (FAEMA), Ariquemes, RO, Brazil
| | | | - Ângelo José Gonçalves Bós
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Medicina, Porto Alegre, RS, Brazil.
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26
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Sheikh W, Sheikh N. Audiometry: A model-view-viewmodel (MVVM) application framework for hearing impairment diagnosis. JOURNAL OF OPEN SOURCE SOFTWARE 2020. [DOI: 10.21105/joss.02016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Kaleem SZ, Othman S, McKinnon BJ. The use of text-messaging for telecommunications with patients in otolaryngology: A narrative review. Am J Otolaryngol 2020; 41:102509. [PMID: 32354481 DOI: 10.1016/j.amjoto.2020.102509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compile and analyze the available literature regarding the use of text-messaging for communicating with patients in otolaryngology. STUDY DESIGN Narrative review. METHODS Using the PubMed, Web of Science, CINAHL, and PsychINFO databases, a review of the literature examining for articles that discuss the usage and applications of text-messaging services in otolaryngology-based practice was conducted. Studies were categorized into six groups by content, depending upon their specific applications: Access, Engagement, Expert Model, Monitoring, No-Show, and Triage. RESULTS From 402 search results, we obtained 59 results that met inclusion criteria, from which there were 11 distinct studies included in this review. All studies found that the use of smartphones in otolaryngology is feasible and can lead to improved outcomes or increased patient engagement in their treatment. The study which was coded "Expert Model" provided a framework for creating a text-message-based platform for application in otolaryngology. CONCLUSION The current literature suggests that using mobile text-messaging is a feasible method of increasing patient engagement in treatment, improving outcomes, and monitoring patients' treatment progress and concerns over time. However, further research is required to quantify the benefits of the varied uses of text-messaging for different patient populations.
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Affiliation(s)
- Syed Z Kaleem
- Drexel University College of Medicine, 2900 W Queen Lane, Philadelphia, PA 19129, United States of America.
| | - Sammy Othman
- Drexel University College of Medicine, 2900 W Queen Lane, Philadelphia, PA 19129, United States of America
| | - Brian J McKinnon
- The University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77555, United States of America
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Colsman A, Supp GG, Neumann J, Schneider TR. Evaluation of Accuracy and Reliability of a Mobile Screening Audiometer in Normal Hearing Adults. Front Psychol 2020; 11:744. [PMID: 32411050 PMCID: PMC7201107 DOI: 10.3389/fpsyg.2020.00744] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 03/26/2020] [Indexed: 11/19/2022] Open
Abstract
Quantifying hearing thresholds via mobile self-assessment audiometric applications has been demonstrated repeatedly with heterogenous results regarding the accuracy. One important limitation of several of these applications has been the lack of appropriate calibration of their core technical components (sound generator and headphones). The current study aimed at evaluating accuracy and reliability of a calibrated application (app) for pure-tone screening audiometry by self-assessment on a tablet computer: Audimatch app installed on Apple iPad 4 in combination with Sennheiser HDA-280 headphones. In a repeated-measures design audiometric thresholds collected by the app were compared to those obtained by standardized automated audiometry and additionally test-retest reliability was evaluated. Sixty-eight participants aged 19–65 years with normal hearing were tested in a sound-attenuating booth. An equivalence test revealed highly similar hearing thresholds for the app compared with standardized automated audiometry. A test-retest reliability analysis within each method showed a high correlation coefficient for the app (Spearman rank correlation: rho = 0.829) and for the automated audiometer (rho = 0.792). The results imply that the self-assessment of audiometric thresholds via a calibrated mobile device represents a valid and reliable alternative for stationary assessment of hearing loss thresholds, supporting the potential usability within the area of occupational health care.
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Affiliation(s)
- Angela Colsman
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gernot G Supp
- Sonormed GmbH, Hamburg, Germany.,Independent Researcher, Hamburg, Germany
| | | | - Till R Schneider
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Corona AP, Ferrite S, Bright T, Polack S. Validity of hearing screening using hearTest smartphone-based audiometry: performance evaluation of different response modes. Int J Audiol 2020; 59:666-673. [PMID: 32134341 DOI: 10.1080/14992027.2020.1731767] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective: To investigate the validity of hearing screening with hearTest smartphone-based audiometry and to specify test duration addressing the two response modes and hearing loss criteria.Design: A diagnostic accuracy study comparing hearing screening with conventional audiometry.Study sample: Three hundred and forty individuals, aged between 5-92 years.Results: Of the 340 participants, 301 undertook all test procedures (273 adults and 28 children). Sensitivity and specificity were >90% for hearTest hearing screening to identify disabling hearing loss for both response modes with adults and children. We found similar sensitivity in identifying any level of hearing loss for both response modes in children, with specificity >80%, and for the self-test mode in adults. Low specificity was observed when identifying any level of hearing loss in adults using the test-operator mode. In adults, there was a significant difference between test duration for the test-operator and self-test modes.Conclusion: Hearing screening using hearTest smartphone-based audiometry is accurate for the identification of both disabling hearing loss and any level of hearing loss in adults and children in the self-test response mode. The test-operator mode is also an option for children; however, it does not provide good accuracy in identifying mild level of hearing loss in adults.
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Affiliation(s)
- Ana Paula Corona
- Department of Hearing and Speech Sciences, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Silvia Ferrite
- Department of Hearing and Speech Sciences, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| | - Tess Bright
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
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30
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Sandström J, Swanepoel D, Laurent C, Umefjord G, Lundberg T. Accuracy and Reliability of Smartphone Self-Test Audiometry in Community Clinics in Low Income Settings: A Comparative Study. Ann Otol Rhinol Laryngol 2020; 129:578-584. [PMID: 31965808 DOI: 10.1177/0003489420902162] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is a lack of hearing health care globally, and tele-audiology and mobile technologies have been proposed as important strategies to reduce the shortfall. OBJECTIVES To investigate the accuracy and reliability of smartphone self-test audiometry in adults, in community clinics in low-income settings. METHODS A prospective, intra-individual, repeated measurements design was used. Sixty-three adult participants (mean age 52 years, range 20-88 years) were recruited from ENT and primary health care clinics in a low-income community in Tshwane, South Africa. Air conduction hearing thresholds for octave frequencies 0.5 to 8 kHz collected with the smartphone self-test in non-sound treated environments were compared to those obtained by reference audiometry. RESULTS The overall mean difference between threshold seeking methods (ie, smartphone thresholds subtracted from reference) was -2.2 dB HL (n = 467 thresholds, P = 0.00). Agreement was within 10 dB HL for 80.1% (n = 467 thresholds) of all threshold comparisons. Sensitivity for detection hearing loss >40 dB HL in one ear was 90.6% (n = 84 ears), and specificity 94.2% (n = 84 ears). CONCLUSION Smartphone self-test audiometry can provide accurate and reliable air conduction hearing thresholds for adults in community clinics in low-income settings.
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Affiliation(s)
- Josefin Sandström
- Department of Public Health and Clinical Medicine, Unit of Family Medicine, Umeå University, Umeå, Sweden
| | - DeWet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Claude Laurent
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.,Department of Clinical Science, Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Göran Umefjord
- Department of Public Health and Clinical Medicine, Unit of Family Medicine, Umeå University, Umeå, Sweden
| | - Thorbjörn Lundberg
- Department of Public Health and Clinical Medicine, Unit of Family Medicine, Umeå University, Umeå, Sweden
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31
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Kam ACS, Fu CHT. Screening for hearing loss in the Hong Kong Cantonese-speaking elderly using tablet-based pure-tone and word-in-noise test. Int J Audiol 2019; 59:301-309. [PMID: 31794272 DOI: 10.1080/14992027.2019.1696992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The present study aimed to establish the test-retest reliability and validity of a tablet-based automated pure-tone screening test and a word-in-noise test as hearing screening tools for older Hong Kong Cantonese-speaking adults.Design and study sample: It was a cross-sectional within-subject study. One hundred and thirty-two older adults participated in this study, and 112 of them completed the automated pure-tone screening test, word-in-noise test, and conventional pure-tone audiometry. Pure-tone threshold of 40 dB HL at each of the tested frequencies including 500, 1000, 2000 and 4000 Hz, obtained with conventional pure-tone audiometry was set as the pass/refer criterion, for the calculation of sensitivity and specificity of the tablet-based screening tools.Results: The tablet-based automated pure-tone screening test yielded a sensitivity of 0.93 and specificity of 0.82, while the word-in-noise test yielded a sensitivity of 0.81 and specificity of 0.70 with the cut-off chosen as a speech reception threshold of -3.5 dB signal-to-noise ratio. Both tests require around 3 minutes to be completed on both ears.Conclusions: The tablet-based pure-tone test and word-in-noise test are reliable and valid to be used as screening tools for hearing loss in the Hong Kong Cantonese-speaking elderly.
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Affiliation(s)
- Anna Chi Shan Kam
- Department of Special Education and Counselling, The Education University of Hong Kong, Taipo, Hong Kong
| | - Christine Hiu Tung Fu
- Department of Special Education and Counselling, The Education University of Hong Kong, Taipo, Hong Kong
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Zhang M, Bi Z, Fu X, Wang J, Ruan Q, Zhao C, Duan J, Zeng X, Zhou D, Chen J, Bao Z. A parsimonious approach for screening moderate-to-profound hearing loss in a community-dwelling geriatric population based on a decision tree analysis. BMC Geriatr 2019; 19:214. [PMID: 31390985 PMCID: PMC6686404 DOI: 10.1186/s12877-019-1232-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/29/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hearing loss is one of the most common modifiable factors associated with cognitive and functional decline in geriatric populations. An accurate, easy-to-apply, and inexpensive hearing screening method is needed to detect hearing loss in community-dwelling elderly people, intervene early and reduce the negative consequences and burden of untreated hearing loss on individuals, families and society. However, available hearing screening tools do not adequately meet the need for large-scale geriatric hearing detection due to several barriers, including time, personnel training and equipment costs. This study aimed to propose an efficient method that could potentially satisfy this need. METHODS In total, 1793 participants (≥60 years) were recruited to undertake a standard audiometric air conduction pure tone test at 4 frequencies (0.5-4 kHz). Audiometric data from one community were used to train the decision tree model and generate a pure tone screening rule to classify people with or without moderate or more serious hearing impairment. Audiometric data from another community were used to validate the tree model. RESULTS In the decision tree analysis, 2 kHz and 0.5 kHz were found to be the most important frequencies for hearing severity classification. The tree model suggested a simple two-step screening procedure in which a 42 dB HL tone at 2 kHz is presented first, followed by a 47 dB HL tone at 0.5 kHz, depending on the individual's response to the first tone. This approach achieved an accuracy of 91.20% (91.92%), a sensitivity of 95.35% (93.50%) and a specificity of 86.85% (90.56%) in the training dataset (testing dataset). CONCLUSIONS A simple two-step screening procedure using the two tones (2 kHz and 0.5 kHz) selected by the decision tree analysis can be applied to screen moderate-to-profound hearing loss in a community-based geriatric population in Shanghai. The decision tree analysis is useful in determining the optimal hearing screening criteria for local elderly populations. Implanting the pair of tones into a well-calibrated sound generator may create a simple, practical and time-efficient screening tool with high accuracy that is readily available at healthcare centers of all levels, thereby facilitating the initiation of extensive nationwide hearing screening in older adults.
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Affiliation(s)
- Min Zhang
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China
| | - Zhaori Bi
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinping Fu
- Speech and Hearing Rehabilitation Department, Punan Hospital, Fudan University, Shanghai, China
| | - Jiaofeng Wang
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China
| | - Qingwei Ruan
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China
| | - Chao Zhao
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jirong Duan
- Speech and Hearing Rehabilitation Department, Punan Hospital, Fudan University, Shanghai, China
| | - Xuan Zeng
- The State Key Laboratory of ASIC & System, Department of Microelectronics, Fudan University, Shanghai, China
| | - Dian Zhou
- Department of Electrical Engineering, University of Texas at Dallas, Richardson, TX USA
| | - Jie Chen
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China
| | - Zhijun Bao
- Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Fudan University, 221 West Yan’an Road, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Majumder S, Deen MJ. Smartphone Sensors for Health Monitoring and Diagnosis. SENSORS (BASEL, SWITZERLAND) 2019; 19:E2164. [PMID: 31075985 PMCID: PMC6539461 DOI: 10.3390/s19092164] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/27/2019] [Accepted: 04/30/2019] [Indexed: 12/29/2022]
Abstract
Over the past few decades, we have witnessed a dramatic rise in life expectancy owing to significant advances in medical science and technology, medicine as well as increased awareness about nutrition, education, and environmental and personal hygiene. Consequently, the elderly population in many countries are expected to rise rapidly in the coming years. A rapidly rising elderly demographics is expected to adversely affect the socioeconomic systems of many nations in terms of costs associated with their healthcare and wellbeing. In addition, diseases related to the cardiovascular system, eye, respiratory system, skin and mental health are widespread globally. However, most of these diseases can be avoided and/or properly managed through continuous monitoring. In order to enable continuous health monitoring as well as to serve growing healthcare needs; affordable, non-invasive and easy-to-use healthcare solutions are critical. The ever-increasing penetration of smartphones, coupled with embedded sensors and modern communication technologies, make it an attractive technology for enabling continuous and remote monitoring of an individual's health and wellbeing with negligible additional costs. In this paper, we present a comprehensive review of the state-of-the-art research and developments in smartphone-sensor based healthcare technologies. A discussion on regulatory policies for medical devices and their implications in smartphone-based healthcare systems is presented. Finally, some future research perspectives and concerns regarding smartphone-based healthcare systems are described.
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Affiliation(s)
- Sumit Majumder
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON L8S 4L8, Canada.
| | - M Jamal Deen
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON L8S 4L8, Canada.
- School of Biomedical Engineering, McMaster University, Hamilton, ON L8S 4L8, Canada.
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Chu YC, Cheng YF, Lai YH, Tsao Y, Tu TY, Young ST, Chen TS, Chung YF, Lai F, Liao WH. A Mobile Phone-Based Approach for Hearing Screening of School-Age Children: Cross-Sectional Validation Study. JMIR Mhealth Uhealth 2019; 7:e12033. [PMID: 30932870 PMCID: PMC6462890 DOI: 10.2196/12033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/20/2018] [Accepted: 01/21/2019] [Indexed: 01/26/2023] Open
Abstract
Background Pure-tone screening (PTS) is considered as the gold standard for hearing screening programs in school-age children. Mobile devices, such as mobile phones, have the potential for audiometric testing. Objective This study aimed to demonstrate a new approach to rapidly screen hearing status and provide stratified test values, using a smartphone-based hearing screening app, for each screened ear of school-age children. Method This was a prospective cohort study design. The proposed smartphone-based screening method and a standard sound-treated booth with PTS were used to assess 85 school-age children (170 ears). Sound-treated PTS involved applying 4 test tones to each tested ear: 500 Hz at 25 dB and 1000 Hz, 2000 Hz, and 4000 Hz at 20 dB. The results were classified as pass (normal hearing in the ear) or fail (possible hearing impairment). The proposed smartphone-based screening employs 20 stratified hearing scales. Thresholds were compared with those of pure-tone average (PTA). Results A total of 85 subjects (170 ears), including 38 males and 47 females, aged between 11 and 12 years with a mean (SD) of 11 (0.5) years, participated in the trial. Both screening methods produced comparable pass and fail results (pass in 168 ears and fail in 2 ears). The smartphone-based screening detected moderate or worse hearing loss (average PTA>25 dB) accurately. Both the sensitivity and specificity of the smartphone-based screening method were calculated at 100%. Conclusions The results of the proposed smartphone-based self-hearing test demonstrated high concordance with conventional PTS in a sound-treated booth. Our results suggested the potential use of the proposed smartphone-based hearing screening in a school-age population.
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Affiliation(s)
- Yuan-Chia Chu
- Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan.,Information Management Office, Taipei Veterans General Hospital, Taipei City, Taiwan.,Big Data Center, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ying-Hui Lai
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Yu Tsao
- Research Center for Information Technology Innovation, Academia Sinica, Taipei, Taiwan
| | - Tzong-Yang Tu
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | | | - Tzer-Shyong Chen
- Department of Information Management, Tunghai University, Taipei, Taiwan
| | - Yu-Fang Chung
- Department of Electrical Engineering, Tunghai University, Taipei, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Computer Science & Information Engineering, National Taiwan University, Taipei, Taiwan.,Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Huei Liao
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Dewyer NA, Jiradejvong P, Lee DS, Kemmer JD, Henderson Sabes J, Limb CJ. Automated Smartphone Audiometry: A Preliminary Validation of a Bone-Conduction Threshold Test App. Ann Otol Rhinol Laryngol 2019; 128:508-515. [DOI: 10.1177/0003489419828770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To develop and validate an automated smartphone app that determines bone-conduction pure-tone thresholds. Methods: A novel app, called EarBone, was developed as an automated test to determine best-cochlea pure-tone bone-conduction thresholds using a smartphone driving a professional-grade bone oscillator. Adult, English-speaking patients who were undergoing audiometric assessment by audiologists at an academic health system as part of their prescribed care were invited to use the EarBone app. Best-ear bone-conduction thresholds determined by the app and the gold standard audiologist were compared. Results: Forty subjects with varied hearing thresholds were tested. Sixty-one percent of app-determined thresholds were within 5 dB of audiologist-determined thresholds, and 79% were within 10 dB. Nearly all subjects required assistance with placing the bone oscillator on their mastoid. Conclusion: Best-cochlea bone-conduction thresholds determined by the EarBone automated smartphone audiometry app approximate those determined by an audiologist. This serves as a proof of concept for automated smartphone-based bone-conduction threshold testing. Further improvements, such as the addition of contralateral ear masking, are needed to make the app clinically useful.
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Affiliation(s)
- Nicholas A. Dewyer
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Patpong Jiradejvong
- Department of Otolaryngology–Head and Neck Surgery, UCSF, San Francisco, California, USA
| | - David S. Lee
- Department of Otolaryngology–Head and Neck Surgery, UCSF, San Francisco, California, USA
| | - Jacquelyn D. Kemmer
- Department of Otolaryngology–Head and Neck Surgery, UCSF, San Francisco, California, USA
| | | | - Charles J. Limb
- Department of Otolaryngology–Head and Neck Surgery, UCSF, San Francisco, California, USA
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Paglialonga A, Pinciroli F, Tognola G. Apps for Hearing Healthcare. ADVANCES IN MEDICAL TECHNOLOGIES AND CLINICAL PRACTICE 2019. [DOI: 10.4018/978-1-5225-8191-8.ch007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This chapter provides a picture of the evolution of mobile applications (apps) for hearing health care (HHC) in terms of availability, variety, penetration, offered services, and target users. Special emphasis is given to newly developed methods that might assist audiologists and hearing professionals to get meaningful information and guidance for informed adoption of apps for themselves as well as for patients and their families. The chapter also shows how these novel methods can be used to characterize and compare a variety of apps across a wide range of services and target user groups. A representative sample of apps, assessed by using such a standardized framework, is analyzed to derive a multifaceted picture of apps for HHC. The chapter outlines and discusses emerging trends and needs in the area and highlights the open challenges as well as potential opportunities for professionals, researchers, developers, and stakeholders at large.
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Berauk VLA, Murugiah MK, Soh YC, Sheng YC, Wong TW, Ming LC. Mobile Health Applications for Caring of Older People: Review and Comparison. Ther Innov Regul Sci 2018; 52:374-382. [DOI: 10.1177/2168479017725556] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Barczik J, Serpanos YC. Accuracy of Smartphone Self-Hearing Test Applications Across Frequencies and Earphone Styles in Adults. Am J Audiol 2018; 27:570-580. [PMID: 30242342 DOI: 10.1044/2018_aja-17-0070] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 05/31/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate smartphone-based self-hearing test applications (apps) for accuracy in threshold assessment and validity in screening for hearing loss across frequencies and earphone transducer styles. METHOD Twenty-two adult participants (10 = normal hearing; 12 = sensorineural hearing loss; n = 44 ears) underwent conventional audiometry and performed 6 self-administered hearing tests using two iPhone-based apps (App 1 = uHear [Version 2.0.2, Unitron]; App 2 = uHearingTest [Version 1.0.3, WooFu Tech, LLC.]) each with 3 different transducers (earbud earphones, supra-aural headphones, circumaural headphones). Hearing sensitivity results using the smartphone apps across frequencies and transducers were compared with conventional audiometry. RESULTS Differences in accuracy were revealed between the hearing test apps across frequencies and earphone styles. The uHear app using the iPhone standard EarPod earbud earphones was accurate to conventional thresholds (p > .002 with Bonferroni correction) at 1000, 2000, 4000, and 6000 Hz and found valid (81%-100% sensitivity, specificity, positive and negative predictive values) for screening mild or greater hearing loss (> 25 dB HL) at 500, 1000, 2000, 4000, and 6000 Hz. The uHearingTest app was accurate in threshold assessment and determined valid for screening mild or greater hearing loss (> 25 dB HL) using supra-aural headphones at 2000, 4000, and 8000 Hz. CONCLUSIONS Self-hearing test apps can be accurate in hearing threshold assessment and screening for mild or greater hearing loss (> 25 dB HL) when using appropriate transducers. To ensure accuracy, manufacturers should specify earphone model instructions to users of smartphone-based self-hearing test apps.
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Affiliation(s)
- Jessica Barczik
- Adelphi University, Department of Communication Sciences and Disorders, Garden City, NY
- Long Island Doctor of Audiology Consortium (Adelphi, Hofstra, St. John's Universities), Garden City, NY
| | - Yula C. Serpanos
- Adelphi University, Department of Communication Sciences and Disorders, Garden City, NY
- Long Island Doctor of Audiology Consortium (Adelphi, Hofstra, St. John's Universities), Garden City, NY
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Yimtae K, Israsena P, Thanawirattananit P, Seesutas S, Saibua S, Kasemsiri P, Noymai A, Soonrach T. A Tablet-Based Mobile Hearing Screening System for Preschoolers: Design and Validation Study. JMIR Mhealth Uhealth 2018; 6:e186. [PMID: 30355558 PMCID: PMC6231828 DOI: 10.2196/mhealth.9560] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 07/13/2018] [Accepted: 07/22/2018] [Indexed: 12/14/2022] Open
Abstract
Background Hearing ability is important for children to develop speech and language skills as they grow. After a mandatory newborn hearing screening, group or mass screening of children at later ages, such as at preschool age, is often practiced. For this practice to be effective and accessible in low-resource countries such as Thailand, innovative enabling tools that make use of pervasive mobile and smartphone technology should be considered. Objective This study aims to develop a cost-effective, tablet-based hearing screening system that can perform a rapid minimal speech recognition level test. Methods An Android-based screening app was developed. The screening protocol involved asking children to choose pictures corresponding to a set of predefined words heard at various sound levels offered in a specifically designed sequence. For the app, the set of words was validated, and their corresponding speech power levels were calibrated. We recruited 122 children, aged 4-5 years, during the development phase. Another 63 children of the same age were screened for their hearing abilities using the app in version 2. The results in terms of the sensitivity and specificity were compared with those measured using the conventional audiometric equipment. Results For screening purposes, the sensitivity of the developed screening system version 2 was 76.67% (95% CI 59.07-88.21), and the specificity was 95.83% (95% CI 89.77-98.37) for screening children with mild hearing loss (pure-tone average threshold at 1, 2, and 4 kHz, >20 dB). The time taken for the screening of each child was 150.52 (SD 19.07) seconds (95% CI 145.71-155.32 seconds). The average time used for conventional play audiometry was 11.79 (SD 3.66) minutes (95% CI 10.85-12.71 minutes). Conclusions This study shows the potential use of a tablet-based system for rapid and mobile hearing screening. The system was shown to have good overall sensitivity and specificity. Overall, the idea can be easily adopted for systems based on other languages.
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Affiliation(s)
- Kwanchanok Yimtae
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pasin Israsena
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Klong Luang, Pathumthani, Thailand
| | - Panida Thanawirattananit
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sangvorn Seesutas
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Klong Luang, Pathumthani, Thailand
| | - Siwat Saibua
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Klong Luang, Pathumthani, Thailand
| | - Pornthep Kasemsiri
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anukool Noymai
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Klong Luang, Pathumthani, Thailand
| | - Tharapong Soonrach
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Klong Luang, Pathumthani, Thailand
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Manganella JL, Stiles DJ, Kawai K, Barrett DL, O'Brien LB, Kenna MA. Validation of a portable hearing assessment tool: Agilis Health Mobile Audiogram. Int J Pediatr Otorhinolaryngol 2018; 113:94-98. [PMID: 30174018 DOI: 10.1016/j.ijporl.2018.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To examine if the tablet-based Agilis Health Mobile Audiogram (Agilis Audiogram) is an effective and valid measure of hearing thresholds compared to a pure-tone audiogram in an adult and pediatric population. METHODS Participants underwent an otologic exam, conventional audiometric evaluation and the self-administered Agilis Audiogram. We examined whether the difference of pure-tone average (PTA) between the two measurement techniques fell within the equivalence range of ±8 dB. The Agilis Audiogram was administered twice for each subject to assess test-retest reliability of the application. RESULTS A total of 54 ears from 27 participants were evaluated. The average time to complete the self-administered Agilis Audiogram was 10 min. Among participants with normal hearing, the average PTA from conventional audiometric evaluation was 8.9 dB (±3.8) and the average PTA from the Agilis Audiogram was 8.5 dB (±4.5), with mean difference of 0.4 dB (±4.2; 95% CI -1.0 to 1.7 dB) falling within the equivalence range (-8 to 8 dB). Among participants with confirmed hearing loss, the average PTA was 22.5 dB (±17.1) from conventional audiometric evaluation and 24.3 dB (±16.6) from the Agilis Audiogram, with mean difference of -1.8 dB (±5.4; 95% CI -4.9 to 1.3 dB), falling within the equivalence range. Overall, there was a significant correlation between conventional audiometric evaluation and the Agilis Audiogram (Pearson correlation = 0.93; p < 0.001). CONCLUSION Thresholds obtained by the Agilis Audiogram were found to be a valid measure of hearing among adults with normal hearing and children with hearing loss in the mild-moderate range.
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Affiliation(s)
- Juliana L Manganella
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. 300 Longwood Avenue, BCH-3129, Boston, MA 02115, USA
| | - Derek J Stiles
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. 300 Longwood Avenue, BCH-3129, Boston, MA 02115, USA; Department of Otolaryngology, Harvard Medical School. 25 Shattuck Street, Boston, MA 02115, USA
| | - Kosuke Kawai
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. 300 Longwood Avenue, BCH-3129, Boston, MA 02115, USA; Department of Otolaryngology, Harvard Medical School. 25 Shattuck Street, Boston, MA 02115, USA
| | - Devon L Barrett
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. 300 Longwood Avenue, BCH-3129, Boston, MA 02115, USA
| | - Laura B O'Brien
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. 300 Longwood Avenue, BCH-3129, Boston, MA 02115, USA
| | - Margaret A Kenna
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital. 300 Longwood Avenue, BCH-3129, Boston, MA 02115, USA; Department of Otolaryngology, Harvard Medical School. 25 Shattuck Street, Boston, MA 02115, USA.
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Abstract
Otosclerosis is a complex and progressive disease of pathological bone remodeling that affects the otic capsule of the temporal bone, resulting in hearing loss. Although traditional diagnostic methods are still used, improvements in technology and research have paved the way for additional diagnostic techniques and advancements. The traditional treatment of otosclerosis, stapes surgery, is now being augmented or replaced by innovations in hearing aid technology and cochlear implants. Earlier diagnosis of otosclerosis can occur through understanding of the cause, risk factors, and current diagnostic testing.
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Lycke M, Lefebvre T, Cool L, Van Eygen K, Boterberg T, Schofield P, Debruyne PR. Screening Methods for Age-Related Hearing Loss in Older Patients with Cancer: A Review of the Literature. Geriatrics (Basel) 2018; 3:geriatrics3030048. [PMID: 31011085 PMCID: PMC6319208 DOI: 10.3390/geriatrics3030048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/16/2022] Open
Abstract
As people grow older, they may experience loss in hearing sensitivity. Age-related hearing loss may negatively affect the patient’s quality of life as it may lead to social isolation. In older patients with cancer, hearing loss can seriously interfere with the patient’s ability to deal properly with all aspects of their disease, and may have a cumulative effect on their already decreased quality of life. Therefore, the proper screening of those conditions is essential in order to optimise the patient’s comfort during and after treatment. This review article aims at providing a concise image of the nature of age-related hearing loss, and provides an overview of the screening methods that could be used in older patients with cancer.
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Affiliation(s)
- Michelle Lycke
- Cancer Centre, Department of Medical Oncology, General Hospital Groeninge, B-8500 Kortrijk, Belgium.
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, B-9000 Ghent, Belgium.
| | - Tessa Lefebvre
- Cancer Centre, Department of Medical Oncology, General Hospital Groeninge, B-8500 Kortrijk, Belgium.
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, B-9000 Ghent, Belgium.
| | - Lieselot Cool
- Cancer Centre, Department of Medical Oncology, General Hospital Groeninge, B-8500 Kortrijk, Belgium.
| | - Koen Van Eygen
- Cancer Centre, Department of Haematology, General Hospital Groeninge, B-8500 Kortrijk, Belgium.
| | - Tom Boterberg
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, B-9000 Ghent, Belgium.
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford CM1 1SQ, UK.
| | - Philip R Debruyne
- Cancer Centre, Department of Medical Oncology, General Hospital Groeninge, B-8500 Kortrijk, Belgium.
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford CM1 1SQ, UK.
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Mobile Hearing Testing Applications and the Diagnosis of Sudden Sensorineural Hearing Loss: A Cautionary Tale. Otol Neurotol 2018; 39:e1-e4. [PMID: 29227445 DOI: 10.1097/mao.0000000000001621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Mobile hearing applications (apps) are available for hearing testing, personal sound amplification, as well as hearing aid modulation. Hearing testing apps are gaining popularity, especially in resource-limited settings. The reliability of mobile hearing testing apps, however, is not well characterized. PATIENTS/INTERVENTIONS A case study of a single patient with a complaint of sudden hearing loss presenting to a tertiary-care hospital. MAIN OUTCOME MEASURE Comparison of a mobile hearing testing app results with standard audiogram. RESULTS A commercially available mobile hearing testing app was used after hours to determine if a patient's hearing complaints were consistent with sudden sensorineural hearing loss. The hearing app produced a rudimentary audiogram that was consistent with unilateral SSNHL. Given contraindications to oral treatment, preparations for possible intratympanic dexamethasone after a full audiometric evaluation were completed. Confirmatory audiogram the following day demonstrated normal hearing without evidence of hearing loss. Steroid treatment was aborted and appropriate counseling provided. CONCLUSION While mobile hearing testing apps offer improved access to hearing screening in resource-limited settings, caution must be exercised when interpreting data and making clinical decisions based upon results. The role of professional audiologists remains critical. Further testing and validation of specific apps is required.
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Masalski M, Grysiński T, Kręcicki T. Hearing Tests Based on Biologically Calibrated Mobile Devices: Comparison With Pure-Tone Audiometry. JMIR Mhealth Uhealth 2018; 6:e10. [PMID: 29321124 PMCID: PMC5784183 DOI: 10.2196/mhealth.7800] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/07/2017] [Accepted: 10/30/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hearing screening tests based on pure-tone audiometry may be conducted on mobile devices, provided that the devices are specially calibrated for the purpose. Calibration consists of determining the reference sound level and can be performed in relation to the hearing threshold of normal-hearing persons. In the case of devices provided by the manufacturer, together with bundled headphones, the reference sound level can be calculated once for all devices of the same model. OBJECTIVE This study aimed to compare the hearing threshold measured by a mobile device that was calibrated using a model-specific, biologically determined reference sound level with the hearing threshold obtained in pure-tone audiometry. METHODS Trial participants were recruited offline using face-to-face prompting from among Otolaryngology Clinic patients, who own Android-based mobile devices with bundled headphones. The hearing threshold was obtained on a mobile device by means of an open access app, Hearing Test, with incorporated model-specific reference sound levels. These reference sound levels were previously determined in uncontrolled conditions in relation to the hearing threshold of normal-hearing persons. An audiologist-assisted self-measurement was conducted by the participants in a sound booth, and it involved determining the lowest audible sound generated by the device within the frequency range of 250 Hz to 8 kHz. The results were compared with pure-tone audiometry. RESULTS A total of 70 subjects, 34 men and 36 women, aged 18-71 years (mean 36, standard deviation [SD] 11) participated in the trial. The hearing threshold obtained on mobile devices was significantly different from the one determined by pure-tone audiometry with a mean difference of 2.6 dB (95% CI 2.0-3.1) and SD of 8.3 dB (95% CI 7.9-8.7). The number of differences not greater than 10 dB reached 89% (95% CI 88-91), whereas the mean absolute difference was obtained at 6.5 dB (95% CI 6.2-6.9). Sensitivity and specificity for a mobile-based screening method were calculated at 98% (95% CI 93-100.0) and 79% (95% CI 71-87), respectively. CONCLUSIONS The method of hearing self-test carried out on mobile devices with bundled headphones demonstrates high compatibility with pure-tone audiometry, which confirms its potential application in hearing monitoring, screening tests, or epidemiological examinations on a large scale.
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Affiliation(s)
- Marcin Masalski
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wrocław, Poland.,Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Tomasz Grysiński
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Tomasz Kręcicki
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wrocław, Poland
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Fazel MT, Jedlowski PM, Cravens RB, Erstad BL. Evaluation and Treatment of Acute and Subacute Hearing Loss: A Review of Pharmacotherapy. Pharmacotherapy 2017; 37:1600-1616. [DOI: 10.1002/phar.2044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Maryam T. Fazel
- Department of Pharmacy Practice & Science; College of Pharmacy, University of Arizona; Tucson Arizona
- Department of Medicine; College of Medicine - Tucson, University of Arizona; Tucson Arizona
| | | | | | - Brian L. Erstad
- Department of Pharmacy Practice & Science; College of Pharmacy, University of Arizona; Tucson Arizona
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Paglialonga A, Pinciroli F, Tognola G. The ALFA4Hearing Model (At-a-Glance Labeling for Features of Apps for Hearing Health Care) to Characterize Mobile Apps for Hearing Health Care. Am J Audiol 2017; 26:408-425. [PMID: 29049624 DOI: 10.1044/2017_aja-16-0132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/24/2017] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The aim of the study was to analyze, by using the ALFA4Hearing model (At-a-Glance Labeling for Features of Apps for Hearing Health Care), a sample of apps over a wide range of services in the hearing health care (HHC) domain in order to take a first picture of the current scenario of apps for HHC. METHOD We tested 120 apps, and we characterized them by using the ALFA4Hearing model, which includes 29 features in 5 components (Promoters, Services, Implementation, Users, and Descriptive Information). We analyzed (a) the distribution of the 29 features in the sample, (b) the relationship between the Implementation features and the Services provided by the apps, and (c) the distribution of the 29 features in apps for professional use. RESULTS The analysis of our sample of apps by means of the ALFA4Hearing model highlighted interesting trends and emerging challenges. Also, results suggested many potential opportunities for research and clinical practice, such as greater involvement of stakeholders, improved evidence base, higher technical quality, and usability. CONCLUSIONS The ALFA4Hearing model is able to represent, at a glance, a large amount of information about apps for HHC, highlighting trends and challenges. It might be useful to HHC professionals as a basis for app characterization and informed decision making.
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Affiliation(s)
- Alessia Paglialonga
- Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Francesco Pinciroli
- Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni, Consiglio Nazionale delle Ricerche, Milan, Italy
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy
| | - Gabriella Tognola
- Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni, Consiglio Nazionale delle Ricerche, Milan, Italy
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Kim SY, Chang MY, Hong M, Yoo SG, Oh D, Park MK. Tinnitus therapy using tailor-made notched music delivered via a smartphone application and Ginko combined treatment: A pilot study. Auris Nasus Larynx 2017; 44:528-533. [DOI: 10.1016/j.anl.2016.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/02/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
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Brungart D, Schurman J, Konrad-Martin D, Watts K, Buckey J, Clavier O, Jacobs PG, Gordon S, Dille MF. Using tablet-based technology to deliver time-efficient ototoxicity monitoring. Int J Audiol 2017; 57:S25-S33. [DOI: 10.1080/14992027.2017.1370138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Douglas Brungart
- Walter Reed National Military Medical Center, Bethesda, MD, USA,
| | - Jaclyn Schurman
- Walter Reed National Military Medical Center, Bethesda, MD, USA,
- Army Public Hearing Center, Aberdeen Proving Ground, Aberdeen, MD, USA,
| | - Dawn Konrad-Martin
- United States Department of Veterans Affairs (VA), Office of Rehabilitation Research and Development (RR&D) Services, National Center for Rehabilitative Auditory Research, Portland, OR, USA,
- Department of Otolaryngology/HNS, Oregon Health and Science University, Portland, OR, USA,
| | - Kelly Watts
- DoD Hearing Center of Excellence, Lackland AFB, San Antonio, TX, USA,
- Naval Submarine Medical Research Laboratory, Naval Base New London, Groton, CT, USA,
- Core Business Solutions, Round Rock, TX, USA,
| | - Jay Buckey
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA,
| | | | - Peter G. Jacobs
- Department of Biomedical Engineering School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Samuel Gordon
- United States Department of Veterans Affairs (VA), Office of Rehabilitation Research and Development (RR&D) Services, National Center for Rehabilitative Auditory Research, Portland, OR, USA,
| | - Marilyn F. Dille
- United States Department of Veterans Affairs (VA), Office of Rehabilitation Research and Development (RR&D) Services, National Center for Rehabilitative Auditory Research, Portland, OR, USA,
- Department of Otolaryngology/HNS, Oregon Health and Science University, Portland, OR, USA,
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Dewyer NA, Jiradejvong P, Henderson Sabes J, Limb CJ. Automated smartphone audiometry: Validation of a word recognition test app. Laryngoscope 2017; 128:707-712. [DOI: 10.1002/lary.26638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/08/2017] [Accepted: 03/27/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Nicholas A. Dewyer
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
| | - Patpong Jiradejvong
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
| | - Jennifer Henderson Sabes
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
| | - Charles J. Limb
- Department of Otolaryngology-Head and Neck Surgery; University of California, San Francisco; San Francisco California U.S.A
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