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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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Swords C, Twumasi E, Fitzgerald M, Fitzsimons-West E, Luo M, Dunne H, Lim KH, Jones O, Law S, Myuran T, Smith G, Tailor BV, Wakelam O, de Cates C, Borsetto D, Tysome J, Donnelly N, Axon P, Bance M, Smith ME. A Multicenter Validity Study of Four Smartphone Hearing Test Apps in Optimized and Home Environments. Laryngoscope 2024; 134:2864-2870. [PMID: 38214403 DOI: 10.1002/lary.31256] [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: 06/18/2023] [Revised: 10/20/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Pure tone audiometry (PTA) is the gold standard for hearing assessment. However, it requires access to specialized equipment. Smartphone audiometry applications (apps) have been developed to perform automated threshold audiometry and could allow patients to perform self-administered screening or monitoring. This study aimed to assess the validity and feasibility of patients using apps to self-assess hearing thresholds at home, with comparison to PTA. METHODS A multi-center, prospective randomized study was conducted amongst patients undergoing PTA in clinics. Participants were randomly allocated to one of four publicly-available apps designed to measure pure tone thresholds. Participants used an app once in optimal sound-treated conditions and a further three times at home. Ear-specific frequency-specific thresholds and pure tone average were compared using Pearson correlation coefficient. The percentage of app hearing tests with results within ±10 dB of PTA was calculated. Patient acceptability was assessed via an online survey. RESULTS One hundred thirty-nine participants submitted data. The results of two at-home automated smartphone apps correlated strongly/very strongly with PTA average and their frequency-specific median was within ±10 dB accuracy. Smartphone audiometry performed in sound-treated and home conditions were very strongly correlated. The apps were rated as easy/very easy to use by 90% of participants and 90% would be happy/very happy to use an app to monitor their hearing. CONCLUSION Judicious use of self-performed smartphone audiometry was both valid and feasible for two of four apps. It could provide frequency-specific threshold estimates at home, potentially allowing assessments of patients remotely or monitoring of fluctuating hearing loss. LEVEL OF EVIDENCE 2 Laryngoscope, 134:2864-2870, 2024.
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Affiliation(s)
- Chloe Swords
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cambridge Hearing Group, University of Cambridge, Cambridge, UK
| | - Emmanuel Twumasi
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Maisie Fitzgerald
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Erin Fitzsimons-West
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Michael Luo
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Henry Dunne
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kim Hui Lim
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Oliver Jones
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sarah Law
- Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - Tharsika Myuran
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - Gareth Smith
- Southend Hospital, Mid and South Essex NHS Foundation Trust, Colchester, UK
| | - Bhavesh V Tailor
- Colchester Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - Oliver Wakelam
- Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - Catherine de Cates
- Southend Hospital, Mid and South Essex NHS Foundation Trust, Colchester, UK
| | - Daniele Borsetto
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James Tysome
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Neil Donnelly
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Patrick Axon
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Manohar Bance
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cambridge Hearing Group, University of Cambridge, Cambridge, UK
| | - Matthew E Smith
- Department of Otology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cambridge Hearing Group, University of Cambridge, Cambridge, UK
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Lin MJ, Chen CK. Breaking Sound Barriers: Exploring Tele-Audiology's Impact on Hearing Healthcare. Diagnostics (Basel) 2024; 14:856. [PMID: 38667501 PMCID: PMC11049182 DOI: 10.3390/diagnostics14080856] [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: 03/10/2024] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare.
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Affiliation(s)
- Mien-Jen Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
| | - Chin-Kuo Chen
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204201, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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Yang TH, Chen YF, Cheng YF, Huang JN, Wu CS, Chu YC. Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S. BioData Min 2023; 16:35. [PMID: 38098102 PMCID: PMC10722728 DOI: 10.1186/s13040-023-00351-z] [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: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVES The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults. METHODS We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model-which had the greatest AUC of 0.83 (95% CI 0.81-0.85)-was then only used on the holdout testing data. RESULTS On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79-0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques-specifically, the LGBM classifier-with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects. CONCLUSIONS Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.
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Affiliation(s)
- Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan
- General Education Center, University of Taipei, Taipei, 10671, Taiwan
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Fu Chen
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
| | - Yen-Fu Cheng
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Jue-Ni Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Chuan-Song Wu
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan.
- College of Science and Engineering, Fu Jen University, Taipei, 243, Taiwan.
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Big Data Center, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan.
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Tananuchittikul P, Yimtae K, Chayaopas N, Thanawirattananit P, Kasemsiri P, Piromchai P. App-Based Hearing Screenings in Preschool Children With Different Types of Headphones: Diagnostic Study. JMIR Mhealth Uhealth 2023; 11:e44703. [PMID: 37962900 PMCID: PMC10662668 DOI: 10.2196/44703] [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: 12/08/2022] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 11/15/2023] Open
Abstract
Background Hearing disability in preschool children can delay or impact oral communication and social skills. Provision of hearing screening tests by standard audiometry in low- to middle-income countries is problematic due to a lack of pediatric audiologists, standard hearing equipment, and standard soundproof rooms. Therefore, an innovative hearing screening tool that is easily accessible and inexpensive such as a mobile app should be considered. Headphones have been a crucial part of hearing screenings. Audiometric headphones, which serve as the reference standard, have been used in most studies. However, since audiometric headphones are not accessible in rural areas, we hypothesized that generic headphones can also be used in hearing screenings. Objective This study aimed to determine the sensitivity, specificity, κ coefficiency, and time consumption of the PASS-Pro (Preschool Audiometry Screening System-Pro) app when using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones compared to standard conditioned play audiometry. Methods We recruited preschool children aged 4 to 5 years to participate in this study. The children received 3 PASS-Pro screening tests using different types of headphones in a quiet room and 1 standard conditioned play audiometry in a soundproof room. All tests were administered in random order. The agreement coefficient, sensitivity, specificity, and mean test duration were determined. Results A total of 44 children participated in this study. For mild hearing loss screening, the κ coefficients between standard conditioned play audiometry and the PASS-Pro app using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones were 0.195, 0.290, and 0.261 (P=.02, P=.002, and P=.004), respectively. The sensitivity for all headphones was 50% and the specificity was more than 88%. For moderate hearing loss screening, the κ coefficients were 0.206, 0.272, and 0.235 (all Ps=.001), respectively. The sensitivity for all headphones was 100% and the specificity was more than 92%. There were no statistical differences in sensitivity and specificity between the reference headphone (TDH39), Beyerdynamic DT 770 PRO headphone, and generic earmuff headphones (all Ps >.05). The PASS-Pro app used significantly less time to carry out hearing tests than conditioned play audiometry (P<.001). Conclusions The PASS-Pro app, used with generic headphones, is effective for conducting hearing screening tests in preschool children with high sensitivity and specificity.
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Affiliation(s)
- Pornsek Tananuchittikul
- Department of Otolaryngology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kwanchanok Yimtae
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nichtima Chayaopas
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panida Thanawirattananit
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pornthep Kasemsiri
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patorn Piromchai
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Cheng HL, Han JY, Chu YC, Cheng YF, Lin CM, Chiang MC, Wu SL, Lai YH, Liao WH. Evaluating the hearing screening effectiveness of active noise cancellation technology among young adults: A pilot study. J Chin Med Assoc 2023; 86:105-112. [PMID: 36300992 DOI: 10.1097/jcma.0000000000000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The population of young adults who are hearing impaired increases yearly, and a device that enables convenient hearing screening could help monitor their hearing. However, background noise is a critical issue that limits the capabilities of such a device. Therefore, this study evaluated the effectiveness of commercial active noise cancellation (ANC) headphones for hearing screening applications in the presence of background noise. In particular, six confounders were used for a comprehensive evaluation. METHODS We enrolled 12 young adults (a total of 23 ears with normal hearing) to participate in this study. A cross-sectional self-controlled study was conducted to explore the effectiveness of hearing screening in the presence of background noise, with a total of 240 test conditions (=3 ANC models × 2 ANC function statuses × 2 noise types × 5 noise levels × 4 frequencies) for each test ear. Subsequently, a linear regression model was used to prove the effectiveness of ANC headphones for hearing screening applications in the presence of background noise with six confounders. RESULTS The experimental results showed that, on average, the ANC function of headphones can improve the effectiveness of hearing screening tasks in the presence of background noise. Specifically, the statistical analysis showed that the ANC function enabled a significant 10% improvement ( p < 0.001) compared with no ANC function. CONCLUSION This study confirmed the effectiveness of ANC headphones for young adult hearing screening applications in the presence of background noise. Furthermore, the statistical results confirmed that as confounding variables, noise type, noise level, hearing screening frequency, ANC headphone model, and sex all affect the effectiveness of the ANC function. These findings suggest that ANC is a potential means of helping users obtain high-accuracy hearing screening results in the presence of background noise. Moreover, we present possible directions of development for ANC headphones in future studies.
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Affiliation(s)
- Hsiu-Lien Cheng
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ji-Yan Han
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yuan-Chia Chu
- Department of Information Management, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Big Data Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chia-Mei Lin
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shang-Liang Wu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Hui Lai
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Medical Device Innovation & Translation Center, National Yang Ming Chiao Tung, University, Taipei, Taiwan, ROC
| | - Wen-Huei Liao
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Huang CS, Tai FC, Lien HH, Wong JU, Huang CC. Long-term Follow-up of Patients With Hernia Using the Hernia-Specific Quality-of-Life Mobile App: Feasibility Questionnaire Study. JMIR Form Res 2022; 6:e39759. [PMID: 36260390 PMCID: PMC9635442 DOI: 10.2196/39759] [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: 05/22/2022] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hernia repair is one of the most common surgical procedures; however, the long-term outcomes are seldom reported due to incomplete follow-up. OBJECTIVE The aim of this study was to examine the use of a mobile app for the long-term follow-up of hernia recurrence, complication, and quality-of-life perception. METHODS A cloud-based corroborative system drove a mobile app with the HERQL (Hernia-Specific Quality-of-Life) questionnaire built in. Patients who underwent hernia repair were identified from medical records, and an invitation to participate in this study was sent through the post. RESULTS The response rate was 11.89% (311/2615) during the 1-year study period, whereas the recurrence rate was 1.0% (3/311). Causal relationships between symptomatic and functional domains of the HERQL questionnaire were indicated by satisfactory model fit indices and significant regression coefficients derived from structural equational modeling. Regarding patients' last hernia surgeries, 88.7% (276/311) of the patients reported them to be satisfactory or very satisfactory, 68.5% (213/311) of patients reported no discomfort, and 61.1% (190/311) of patients never experienced mesh foreign body sensation. Subgroup analysis for the most commonly used mesh repairs found that mesh plug repair inevitably resulted in worse symptoms and quality-of-life perception from the group with groin hernias. CONCLUSIONS The mobile app has the potential to enhance the quality of care for patients with hernia and facilitate outcomes research with more complete follow-up.
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Affiliation(s)
- Ching-Shui Huang
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Feng-Chuan Tai
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
| | - Heng-Hui Lien
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Jia-Uei Wong
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
| | - Chi-Cheng Huang
- Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
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Cheng HL, Han JY, Zheng WZ, Cheng YF, Chu YC, Lin CM, Chiang MC, Liao WH, Lai YH. Objective Signal Analysis for Investigating Feasibility of Active Noise Cancellation in Hearing Screening. SENSORS (BASEL, SWITZERLAND) 2022; 22:7329. [PMID: 36236430 PMCID: PMC9572409 DOI: 10.3390/s22197329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
With the development of active noise cancellation (ANC) technology, ANC has been used to mitigate the effects of environmental noise on audiometric results. However, objective evaluation methods supporting the accuracy of audiometry for ANC exposure to different levels of noise have not been reported. Accordingly, the audio characteristics of three different ANC headphone models were quantified under different noise conditions and the feasibility of ANC in noisy environments was investigated. Steady (pink noise) and non-steady noise (cafeteria babble noise) were used to simulate noisy environments. We compared the integrity of pure-tone signals obtained from three different ANC headphone models after processing under different noise scenarios and analyzed the degree of ANC signal correlation based on the Pearson correlation coefficient compared to pure-tone signals in quiet. The objective signal correlation results were compared with audiometric screening results to confirm the correspondence. Results revealed that ANC helped mitigate the effects of environmental noise on the measured signal and the combined ANC headset model retained the highest signal integrity. The degree of signal correlation was used as a confidence indicator for the accuracy of hearing screening in noise results. It was found that the ANC technique can be further improved for more complex noisy environments.
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Affiliation(s)
- Hsiu-Lien Cheng
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Ji-Yan Han
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Wei-Zhong Zheng
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Big Data Center, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan
| | - Chia-Mei Lin
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Wen-Huei Liao
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Ying-Hui Lai
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Medical Device Innovation & Translation Center, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
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Vittorini P, Chamoso P, De la Prieta F. A device and an app for the diagnosis and self-management of tinnitus. J Integr Bioinform 2022; 19:jib-2022-0004. [PMID: 36039680 PMCID: PMC9534487 DOI: 10.1515/jib-2022-0004] [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: 01/14/2022] [Accepted: 06/12/2022] [Indexed: 11/22/2022] Open
Abstract
Tinnitus is an annoying ringing in the ears, in varying shades and intensities. Tinnitus can affect a person’s overall health and social well-being (e.g., sleep problems, trouble concentrating, anxiety, depression and inability to work). The diagnostic procedure of tinnitus usually consists of three steps: an audiological examination, psychoacoustic measurement, and a disability evaluation. All steps are performed by physicians, who use specialised hardware/software and administer questionnaires. This paper presents a system, to be used by patients, for the diagnosis and self-management of tinnitus. The system is made up of an app and a device. The app is responsible for executing – through the device – a part of the required audiological and psychoacoustic examinations, as well as administering questionnaires that evaluate disability. The paper reviews the quality of the automated audiometric reporting and the user experience provided by the app. Descriptive and inferential statistics were used to support the findings. The results show that automated reporting is comparable with that of physicians and that user experience was improved by re-designing and re-developing the acufenometry of the app. As for the user experience, two experts in Human-Computer Interaction evaluated the first version of the app: their agreement was good (Cohen’s K = 0.639) and the average rating of the app was 1.43/2. Also patients evaluated the app in its initial version: the satisfactory tasks (audiometry and questionnaires) were rated as 4.31/5 and 4.65/5. The unsatisfactory task (acufenometry) was improved and the average rating increased from 2.86/5 to 3.96/5 (p = 0.0005). Finally, the general usability of the app was increased from the initial value of 73.6/100 to 85.4/100 (p = 0.0003). The strengths of the project are twofold. Firstly, the automated reporting feature, which – to the best of our knowledge – is the first attempt in this area. Secondly, the overall app usability, which was evaluated and improved during its development. In summary, the conclusion drawn from the conducted project is that the system works as expected, and despite some weaknesses, also the replication of the device would not be expensive, and it can be used in different scenarios.
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Affiliation(s)
- Pierpaolo Vittorini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Pablo Chamoso
- IBSAL/BISITE Research Group, University of Salamanca, Calle Espejo 12, Edificio I+D+i, 37007 Salamanca, Spain
| | - Fernando De la Prieta
- IBSAL/BISITE Research Group, University of Salamanca, Calle Espejo 12, Edificio I+D+i, 37007 Salamanca, Spain
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10
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Pure tone audiometry as assessed by a commercially-available mobile phone application compared to formal audiometry. Am J Otolaryngol 2022; 43:103552. [DOI: 10.1016/j.amjoto.2022.103552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/25/2022] [Indexed: 11/21/2022]
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11
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Fang CH, Smith RV. COVID-19 and the resurgence of telehealth in otolaryngology. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY-HEAD AND NECK SURGERY 2022; 33:158-164. [PMID: 35505953 PMCID: PMC9047697 DOI: 10.1016/j.otot.2022.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this review is to examine the impact of the ongoing Coronavirus disease 2019 (COVID-19) pandemic on the use of telehealth in Otolaryngology. The use of telemedicine rose dramatically during the pandemic to meet the need for continued patient care while allowing for physical separation of providers and patients. Telemedicine has been used to evaluate patients with a variety of pathologies including dysphonia, vertigo, and anosmia. Innovative use of at-home exams, such as video-otoscopy has aided providers in overcoming challenges associated with a highly specialized physical exam. The use of telemedicine in Otolaryngology will likely remain essential in the post-pandemic era and has promising results for improving clinical efficiency.
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Affiliation(s)
- Christina H Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York
| | - Richard V Smith
- Department of Otorhinolaryngology, Head and Neck Surgery, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York
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12
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Diagnostic Validity of Self-Reported Hearing Loss in Elderly Taiwanese Individuals: Diagnostic Performance of a Hearing Self-Assessment Questionnaire on Audiometry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413215. [PMID: 34948824 PMCID: PMC8707226 DOI: 10.3390/ijerph182413215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022]
Abstract
Key Points: Question: Can the traditional Chinese version of the hearing handicap inventory for elderly screening (HHIE-S) checklist screen for age-related hearing loss (ARHL) in elderly individuals? Findings: In this cross-sectional study of 1696 Taiwanese patients who underwent annual government-funded geriatric health checkups, the Chinese version of the HHIE-S had a sensitivity of 76.9% and a specificity of 79.8% with a cutoff score greater than 6 for identifying patients with disabled hearing loss (defined as a PTA > 40 dB). Meaning: The traditional Chinese version of the HHIE-S is an effective test to detect ARHL and can improve the feasibility of large-scale hearing screening among elderly individuals. Purpose: The traditional Chinese version of the hearing handicap inventory for elderly screening (TC-HHIE-S) was translated from English and is intended for use with people whose native language is traditional Chinese, but its effectiveness and diagnostic performance are still unclear. The purpose of this study was to evaluate the validity and reliability of the traditional Chinese version of the HHIE-S for screening for age-related hearing loss (ARHL). Methods: A total of 1696 elderly people underwent the government’s annual geriatric medical examination at community hospitals. In this cross-sectional study, we recorded average conducted pure-tone averages (PTA) (0.5 kHz, 1 kHz, 2 kHz, 4 kHz), age, sex, and HHIE-S data. Receiver operating characteristic (ROC) curve analysis was used to identify the best critical point for detecting hearing impairment, and the validity of the structure was verified by the agreement between the TC-HHIE-S and PTA results. Results: The HHIE-S scores were correlated with the better-ear pure-tone threshold averages (PTAs) at 0.5–4 kHz (correlation coefficient r = 0.45). The internal consistency of the total HHIE-S score was excellent (Cronbach’s alpha = 0.901), and the test-retest reliability was also excellent (Spearman’s correlation coefficient = 0.60, intraclass correlation coefficient = 0.75). In detecting disabled hearing loss (i.e., PTA at 0.5–4 kHz > 40 dB), the HHIE-S cutoff score of > 6 had a sensitivity of 76.9% and a specificity of 79.8%. Conclusions: The traditional Chinese version of the HHIE-S is a valid, reliable, and efficient tool for large-scale screening for ARHL.
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13
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Guo Z, Yu G, Zhou H, Wang X, Lu Y, Meng Q. Utilizing True Wireless Stereo Earbuds in Automated Pure-Tone Audiometry. Trends Hear 2021; 25:23312165211057367. [PMID: 34796771 PMCID: PMC8606721 DOI: 10.1177/23312165211057367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
True wireless stereo (TWS) earbuds have become popular and widespread in recent years, and numerous automated pure-tone audiometer applications have been developed for portable devices. However, most of these applications require specifically designed earphones to which the public may not have access. Therefore, the present study investigates the accuracy of automated pure-tone audiometry based on TWS earbuds (Honor FlyPods). The procedure for developing an automated pure-tone audiometer is reported. Calibration of the TWS earbuds was accomplished by electroacoustic measurements and establishing corrected reference equivalent threshold sound pressure levels. The developed audiometer was then compared with a clinical audiometer using 20 hearing-impaired participants. The average signed and absolute deviations between hearing thresholds measured using the two audiometers were 3.1 dB and 6.7 dB, respectively. The overall accuracy rate in determining the presence/absence of hearing loss was 81%. The results show that the proposed procedure for an automated air-conduction audiometer based on TWS earbuds is feasible, and the system gives accurate hearing level estimation using the reported calibration framework.
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Affiliation(s)
- Zhenyu Guo
- School of Architecture, South China University of Technology, Guangzhou, China
- School of Physics and Optoelectronics, South China University of Technology, Guangzhou, China
| | - Guangzheng Yu
- School of Physics and Optoelectronics, South China University of Technology, Guangzhou, China
| | - Huali Zhou
- School of Physics and Optoelectronics, South China University of Technology, Guangzhou, China
| | - Xianren Wang
- Department of Otorhinolaryngology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yigang Lu
- School of Physics and Optoelectronics, South China University of Technology, Guangzhou, China
| | - Qinglin Meng
- School of Physics and Optoelectronics, South China University of Technology, Guangzhou, China
- Qinglin Meng, School of Physics and Optoelectronics, South China University of Technology, No. 381, Wushan Rd, Guangzhou 510641, China.
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14
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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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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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16
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Optimization of the Speech Test Material in a Group of Hearing Impaired Subjects: A Feasibility Study for Multilingual Digit Triplet Test Development. Audiol Res 2021; 11:342-356. [PMID: 34287230 PMCID: PMC8293168 DOI: 10.3390/audiolres11030032] [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: 03/11/2021] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The development of the global digit-in-noise test requires optimization of each language version on a group of normal-hearing native-speakers. An alternative solution may be an adaptive optimization during ongoing tests in a group of subjects with unknown hearing impairments. The objective of the research was to compare the optimization results between these groups. Methods: Digit triplets consisting of three pseudo-randomly selected digits were presented in speech-shaped noise at various signal-to-noise ratios (SNRs), according to the protocol of the final speech test. Digit-specific and position-specific speech reception thresholds (SRTs) were determined and compared between groups. Results: The study sample consisted of 82 subjects, 26 normal-hearing subjects and 56 patients with diverse hearing disorders. Statistically significant differences in digit-specific SRTs between the control and the investigated group were obtained for three digits in continuous noise (digits 0, 4, 6; p-value of 0.04, 0.03, 0.05) and two in modulated noise (digits 1 and 6; p-value of 0.05 and 0.01). An analysis including only ears with SRTs within the range of the normal hearing control group showed no statistically significant differences between digits. Conclusion: Optimization of speech material can be carried out in a group of subjects with unknown hearing impairments, provided the ears with scores outside normal range are rejected.
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17
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Yoon YS, Boren CM, Diaz B. Effect of Realistic Test Conditions on Spectral and Temporal Processing in Normal-Hearing Listeners. Am J Audiol 2021; 30:160-169. [PMID: 33621127 DOI: 10.1044/2020_aja-20-00120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose To measure the effect of testing conditions (in the soundproof booth vs. quiet room), test order, and number of test sessions on spectral and temporal processing in normal-hearing (NH) listeners. Method Thirty-two adult NH listeners participated in the three experiments. For all three experiments, the stimuli were presented to the left ear at the subjects' most comfortable level through headphones. All tests were administered in an adaptive three-alternative forced-choice paradigm. Experiment 1 was designed to compare the effect of soundproof booth and quiet room test conditions on amplitude modulation detection threshold and modulation frequency discrimination threshold with each of the five modulation frequencies. Experiment 2 was designed to compare the effect of two test orders on the frequency discrimination thresholds under the quiet room test conditions. The thresholds were first measured in the ascending and descending order of four pure tones, and then with counterbalanced order. For Experiment 3, the amplitude discrimination threshold under the quiet room testing condition was assessed 3 times to determine the effect of the number of test sessions. Then the thresholds were compared over the sessions. Results Results showed no significant effect of test environment. The test order is an important variable for frequency discrimination, particularly between piano tunes and pure tones. Results also show no significant difference across test sessions. Conclusions These results suggest that a controlled test environment may not be required in spectral and temporal assessment for NH listeners. Under the quiet test environment, a single outcome measure is sufficient, but test orders should be counterbalanced.
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Affiliation(s)
- Yang-Soo Yoon
- Department of Communication Sciences and Disorders, Baylor University, Waco, TX
| | | | - Brianna Diaz
- Department of Speech, Language and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock
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18
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Lin HYH, Chu YC, Lai YH, Cheng HL, Lai F, Cheng YF, Liao WH. A Smartphone-Based Approach to Screening for Sudden Sensorineural Hearing Loss: Cross-Sectional Validity Study. JMIR Mhealth Uhealth 2020; 8:e23047. [PMID: 33174845 PMCID: PMC7688380 DOI: 10.2196/23047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/10/2020] [Accepted: 10/21/2020] [Indexed: 12/20/2022] Open
Abstract
Background Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that warrants urgent management. Pure-tone audiometry remains the gold standard for definitively diagnosing SSNHL. However, in clinical settings such as primary care practices and urgent care facilities, conventional pure-tone audiometry is often unavailable. Objective This study aimed to determine the correlation between hearing outcomes measured by conventional pure-tone audiometry and those measured by the proposed smartphone-based Ear Scale app and determine the diagnostic validity of the hearing scale differences between the two ears as obtained by the Ear Scale app for SSNHL. Methods This cross-sectional study included a cohort of 88 participants with possible SSNHL who were referred to an otolaryngology clinic or emergency department at a tertiary medical center in Taipei, Taiwan, between January 2018 and June 2019. All participants underwent hearing assessments with conventional pure-tone audiometry and the proposed smartphone-based Ear Scale app consecutively. The gold standard for diagnosing SSNHL was defined as the pure-tone average (PTA) difference between the two ears being ≥30 dB HL. The hearing results measured by the Ear Scale app were presented as 20 stratified hearing scales. The hearing scale difference between the two ears was estimated to detect SSNHL. Results The study sample comprised 88 adults with a mean age of 46 years, and 50% (44/88) were females. PTA measured by conventional pure-tone audiometry was strongly correlated with the hearing scale assessed by the Ear Scale app, with a Pearson correlation coefficient of .88 (95% CI .82-.92). The sensitivity of the 5–hearing scale difference (25 dB HL difference) between the impaired ear and the contralateral ear in diagnosing SSNHL was 95.5% (95% CI 87.5%-99.1%), with a specificity of 66.7% (95% CI 43.0%-85.4%). Conclusions Our findings suggest that the proposed smartphone-based Ear Scale app can be useful in the evaluation of SSNHL in clinical settings where conventional pure-tone audiometry is not available.
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Affiliation(s)
- Heng-Yu Haley Lin
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei, Taiwan.,Big Data Center, Taipei Veterans General Hospital, Taipei, Taiwan.,Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Ying-Hui Lai
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Hsiu-Lien Cheng
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics & Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.,Department of Computer Science & Information Engineering, National Taiwan University, Taipei, 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.,School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Huei Liao
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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19
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Li LYJ, Wang SY, Wu CJ, Tsai CY, Wu TF, Lin YS. Screening for Hearing Impairment in Older Adults by Smartphone-Based Audiometry, Self-Perception, HHIE Screening Questionnaire, and Free-Field Voice Test: Comparative Evaluation of the Screening Accuracy With Standard Pure-Tone Audiometry. JMIR Mhealth Uhealth 2020; 8:e17213. [PMID: 33107828 PMCID: PMC7655471 DOI: 10.2196/17213] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/30/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
Background Hearing impairment is the most frequent sensory deficit in humans, affecting more than 360 million people worldwide. In fact, hearing impairment is not merely a health problem, but it also has a great impact on the educational performance, economic income, and quality of life. Hearing impairment is therefore an important social concern. Objective We aimed to evaluate and compare the accuracy of self-perception, Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire, free-field voice test, and smartphone-based audiometry as tests for screening moderate hearing impairment in older adults in China. Methods In this study, 41 patients were recruited through a single otology practice. All patients were older than 65 years. Patients with otorrhea and cognitive impairment were excluded. Moderate hearing impairment was defined as mean hearing thresholds at 500, 1000, 2000, and 4000 Hz >40 dB hearing loss (pure-tone average > 40 dB hearing loss). All patients completed 5 hearing tests, namely, the self-perception test, HHIE-S questionnaire test, free-field voice test, smartphone-based audiometry test, and standard pure-tone audiometry by the same audiologist. We compared the results of these tests to the standard audiogram in the better-hearing ear. Results The sensitivity and the specificity of the self-perception test were 0.58 (95% CI 0.29-0.84) and 0.34 (95% CI 0.19-0.54), respectively. The sensitivity and the specificity of the HHIE-S questionnaire test were 0.67 (95% CI 0.35-0.89) and 0.31 (95% CI 0.316-0.51), respectively. The sensitivity and the specificity of the free-field voice test were 0.83 (95% CI 0.51-0.97) and 0.41 (95% CI 0.24-0.61), respectively. The sensitivity and the specificity of the smartphone-based audiometry test were 0.92 (95% CI 0.60-0.99) and 0.76 (95% CI 0.56-0.89), respectively. Smartphone-based audiometry correctly diagnosed the presence of hearing loss with high sensitivity and high specificity. Conclusions Smartphone-based audiometry may be a dependable screening test to rule out moderate hearing impairment in the older population.
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Affiliation(s)
- Lok Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan.,Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shin-Yi Wang
- National Taiwan University Hospital Hsin-chu Branch, Hsin-chu, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,PhD Degree Program of Biomedical Science and Engineering, National Chiao Tung University, Hsinchu, Taiwan.,Department of Otolaryngology-Head And Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Te-Fang Wu
- Department of Otolaryngology - Head And Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yaoh-Shiang Lin
- Department of Otolaryngology-Head And Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan.,Department of Otolaryngology - Head And Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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20
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Masalski M, Morawski K. Worldwide Prevalence of Hearing Loss Among Smartphone Users: Cross-Sectional Study Using a Mobile-Based App. J Med Internet Res 2020; 22:e17238. [PMID: 32706700 PMCID: PMC7413293 DOI: 10.2196/17238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/28/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
Background In addition to the aging process, risk factors for hearing loss in adults include, among others, exposure to noise, use of ototoxic drugs, genetics, and limited access to medical care. Differences in exposure to these factors are bound to be reflected in the prevalence of hearing loss. Assessment of hearing loss can easily be carried out on a large scale and at low cost using mobile apps. Objective This study aimed to conduct a worldwide assessment of the differences in hearing loss prevalence between countries in a group of mobile device users. Methods Hearing tests were conducted using the open-access Android-based mobile app Hearing Test. The app is available free of charge in the Google Play store, provided that consent to the use of the results for scientific purposes is given. This study included hearing tests carried out on device models supported by the app with bundled headphones in the set. Calibration factors for supported models were determined using the biological method. The tests consisted of self-determining the quietest audible tone in the frequency range from 250 Hz to 8 kHz by adjusting its intensity using the buttons. The ambient noise level was optionally monitored using a built-in microphone. Following the test, the user could compare his hearing threshold against age norms by providing his or her age. The user's location was identified based on the phone’s IP address. Results From November 23, 2016 to November 22, 2019, 733,716 hearing tests were conducted on 236,716 mobile devices across 212 countries. After rejecting the tests that were incomplete, performed with disconnected headphones, not meeting the time criterion, repeated by the same user, or carried out regularly on one device, 116,733 of 733,716 tests (15.9%) were qualified for further analysis. The prevalence of hearing loss, defined as the average threshold at frequencies 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz above 25 dB HL in the better ear, was calculated at 15.6% (95% CI 15.4-15.8). Statistically significant differences were found between countries (P<.001), with the highest prevalences for Bangladesh, Pakistan, and India (>28%) and the lowest prevalences for Taiwan, Finland, and South Korea (<11%). Conclusions Hearing thresholds measured by means of mobile devices were congruent with the literature data on worldwide hearing loss prevalence. Uniform recruitment criteria simplify the comparison of the hearing loss prevalence across countries. Hearing testing on mobile devices may be a valid tool in epidemiological studies carried out on a large scale.
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Affiliation(s)
- Marcin Masalski
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland.,Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Technology, Wroclaw, Poland
| | - Krzysztof Morawski
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
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Mehdi M, Riha C, Neff P, Dode A, Pryss R, Schlee W, Reichert M, Hauck FJ. Smartphone Apps in the Context of Tinnitus: Systematic Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E1725. [PMID: 32204540 PMCID: PMC7146490 DOI: 10.3390/s20061725] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/16/2022]
Abstract
Smartphones containing sophisticated high-end hardware and offering high computational capabilities at extremely manageable costs have become mainstream and an integral part of users' lives. Widespread adoption of smartphone devices has encouraged the development of many smartphone applications, resulting in a well-established ecosystem, which is easily discoverable and accessible via respective marketplaces of differing mobile platforms. These smartphone applications are no longer exclusively limited to entertainment purposes but are increasingly established in the scientific and medical field. In the context of tinnitus, the ringing in the ear, these smartphone apps range from relief, management, self-help, all the way to interfacing external sensors to better understand the phenomenon. In this paper, we aim to bring forth the smartphone applications in and around tinnitus. Based on the PRISMA guidelines, we systematically analyze and investigate the current state of smartphone apps, that are directly applied in the context of tinnitus. In particular, we explore Google Scholar, CiteSeerX, Microsoft Academics, Semantic Scholar for the identification of scientific contributions. Additionally, we search and explore Google's Play and Apple's App Stores to identify relevant smartphone apps and their respective properties. This review work gives (1) an up-to-date overview of existing apps, and (2) lists and discusses scientific literature pertaining to the smartphone apps used within the context of tinnitus.
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Affiliation(s)
- Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, 89081 Ulm, Germany
| | - Constanze Riha
- Department of Psychology, University of Zürich, Box 1, CH-8050 Zürich, Switzerland;
| | - Patrick Neff
- Clinic and Polyclinic for Psychiatry and Psychotherapy, 93053 Regensburg, Germany; (P.N.); (W.S.)
- URPP Dynamics of Healthy Aging, University of Zürich, Box 2, CH-8050 Zürich, Switzerland
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.); (R.P.)
| | - Rüdiger Pryss
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.); (R.P.)
| | - Winfried Schlee
- Clinic and Polyclinic for Psychiatry and Psychotherapy, 93053 Regensburg, Germany; (P.N.); (W.S.)
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.); (R.P.)
| | - Franz J. Hauck
- Institute of Distributed Systems, Ulm University, 89081 Ulm, Germany
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