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Spinos D, Coulson C, Beech T, Mehta N, Smith ME, Lee J, Nieto HR, Muzaffar J. Advances in remote otology and rhinology service delivery: A scoping review. Am J Otolaryngol 2024; 45:104399. [PMID: 39153399 DOI: 10.1016/j.amjoto.2024.104399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/16/2024] [Indexed: 08/19/2024]
Affiliation(s)
- Dimitrios Spinos
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
| | - Christopher Coulson
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
| | - Thomas Beech
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
| | | | - Matthew E Smith
- Department of Clinical Neurosciences, University of Cambridge
| | - Jonathan Lee
- Department of Ear, Nose and Throat Surgery, Warwick Hospital, South Warwickshire University Hospitals NHS Foundation Trust
| | - Hannah Rachel Nieto
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust; Institute of Metabolism and Systems Research, University of Birmingham
| | - Jameel Muzaffar
- Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust
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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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Oremule B, Abbas J, Saunders G, Kluk K, Isba R, Bate S, Bruce I. Mobile audiometry for hearing threshold assessment: A systematic review and meta-analysis. Clin Otolaryngol 2024; 49:74-86. [PMID: 37828806 DOI: 10.1111/coa.14107] [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] [Received: 12/07/2022] [Revised: 08/30/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy. DESIGN AND SETTING A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. PARTICIPANTS Adults and children, with and without diagnosis of hearing impairment. MAIN OUTCOME MEASURES A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL. RESULTS Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability. CONCLUSIONS MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.
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Affiliation(s)
- Babatunde Oremule
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Jonathan Abbas
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Gabrielle Saunders
- Division of Psychology Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, University of Manchester, Manchester, UK
| | - Karolina Kluk
- Division of Psychology Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, University of Manchester, Manchester, UK
| | - Rachel Isba
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Sebastian Bate
- Research and Innovation, Manchester University NHS Foundation Trust, Manchester, UK
| | - Iain Bruce
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Siggaard LD, Jacobsen H, Hougaard DD, Hoegsbro M. Effects of remote ear-nose-and-throat specialist assessment screening on self-reported hearing aid benefit and satisfaction. Int J Audiol 2023:1-10. [PMID: 38149795 DOI: 10.1080/14992027.2023.2298506] [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: 03/29/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To explore the impact of remote versus in-person ear-nose-and-throat (ENT) specialist screening before hearing treatment on self-reported hearing aid (HA) benefit and satisfaction among adult first-time HA users. DESIGN Participants were randomised to either remote or in-person ENT assessment before treatment initiation. Hearing ability, hearing quality, and treatment satisfaction were assessed pre- and post-HA treatment using the SSQ12, IOI-HA, and selected items from the 2021 Danish national Patient-Reported Experience Measures. Average daily HA usage was also recorded. STUDY SAMPLE 751 adult potential first-time HA users with self-reported hearing impairment were included; 501 participants were remotely assessed in private or public audiological clinics, and 250 control group participants were assessed in-person by private ENT specialists. Of the 658 participants who completed the entire trial, 454 received HAs. RESULTS No significant post-treatment HA benefit differences were found between groups. Remotely assessed HA recipients in private clinics expressed slightly higher staff and waiting time satisfaction. Participants with normal hearing and mild/moderate hearing loss reported higher pre-treatment hearing ability and quality. No significant difference in average daily HA usage was observed between groups. CONCLUSIONS Findings suggest that remote screening does not compromise patient-reported HA benefit and satisfaction when compared to in-person screening.
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Affiliation(s)
- Lene Dahl Siggaard
- Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Henrik Jacobsen
- Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
| | - Dan Dupont Hougaard
- Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Morten Hoegsbro
- Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Siggaard LD, Jacobsen H, Hougaard DD, Høgsbro M. Digital vs. physical ear-nose-and-throat specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid treatment: a randomized controlled trial. Front Digit Health 2023; 5:1182421. [PMID: 37363275 PMCID: PMC10285396 DOI: 10.3389/fdgth.2023.1182421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction This study introduces a digital assessment tool for asynchronous and remote ear-nose-and-throat (ENT) specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid (HA) treatment. The +60 population will nearly double from 12% to 22% between 2015 and 2050 increasing the incidence of age-induced hearing impairment and the need for hearing rehabilitation. If un-diagnosed, age-related hearing loss negatively affects quality of life by accelerating social distancing and early retirement as well as increasing risk of anxiety, depression, and dementia. Therefore, innovative measures are essential to provide timely diagnostics and treatment. Methods A total of 751 hearing-impaired adults without previous HA usage or experience were randomly assigned to digital or physical ENT specialist assessment screening prior to HA treatment initiation in 20 public and private hearing rehabilitation and ENT specialist clinics in the North Denmark Region. A total of 501 test group participants were assigned to digital assessment screening and 250 control group participants to physical assessment screening prior to HA treatment. Results In all, 658 (88%) participants completed the trial and were eligible for analysis. Digital screening sensitivity (0.85, 95% confidence interval (CI) 0.71-0.94) was significantly higher than physical screening sensitivity (0.2, 95% CI: 0.03-0.56). Screening specificity was high for both assessment methods. Discussion In a setting where hearing-impaired adults were assessed for HA treatment, digital ENT specialist assessment screening did not compromise patient safety or increase the risk of misdiagnosis in patients with complicated hearing loss and/or serious ear disorders when compared to physical ENT specialist assessment screening. Clinical Trial registration https://clinicaltrials.gov/ct2/show/NCT05154539, identifier: NCT05154539.
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Affiliation(s)
- Lene Dahl Siggaard
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Henrik Jacobsen
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
| | - Dan Dupont Hougaard
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Morten Høgsbro
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Metcalfe C, Gaskell P, McLelland T, Patel S, Muzaffar J, Dalton L, Coulson C. A retrospective cohort study of telephone versus face-to-face clinics for the management of new otology referrals. Eur Arch Otorhinolaryngol 2023; 280:1677-1682. [PMID: 36109380 PMCID: PMC9483526 DOI: 10.1007/s00405-022-07653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare outcomes of telephone and face-to-face consultations for new otology referrals and discuss the wider use of telemedicine in otology. METHODS Retrospective cohort study including new adult otology referrals to our unit, sampled consecutively between March 2021 and May 2021, seen in either a face-to-face or telephone clinic. Primary outcome measure was the proportion of patients with a definitive management outcome (discharged or added to waiting list for treatment) versus the proportion of patients requiring follow-up for further assessment or review. RESULTS 150 new patients referred for a routine otology consultation (75 telephone, 75 face-to-face) were included. 53/75 patients (71%) undergoing a face-to-face consultation received a definitive outcome following initial review, versus 22/75 (29%) telephone patients (χ2 < 0.001, OR 5.8). 52/75 (69%) telephone patients were followed up face-to-face for examination. The mean (SD) number of appointments required to reach a definitive outcome was 1.22 (0.58) and 1.75 (0.73) in the face-to-face and telephone cohorts, respectively (p < 0.001). CONCLUSIONS Telephone clinics in otology have played an important role as part of the COVID19 response. However, they are currently limited by a lack of clinical examination and audiometry. Remote assessment pathways in otology that incorporate asynchronous review of recorded examinations alongside audiometry, either conventional or boothless, may mitigate this problem; however, further research is required.
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Affiliation(s)
- Christopher Metcalfe
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK.
| | - Peter Gaskell
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK
| | - Thomas McLelland
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK
| | - Sanjay Patel
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK
| | - Jameel Muzaffar
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK
| | - Lucy Dalton
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK
| | - Chris Coulson
- Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TH, UK
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Ear wax management in primary care: what the busy GP needs to know. Br J Gen Pract 2023; 73:90-92. [PMID: 36702606 PMCID: PMC9888562 DOI: 10.3399/bjgp23x732009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/19/2022] [Indexed: 01/28/2023] Open
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