Abstract
PurposeTo validate the accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss (HFHL) ‘Occupational Earcheck (OEC)’ incorporating an automatic conditional rescreening, in an occupationally noise-exposed population. Secondary objectives were to assess the effects of age on test accuracy measures, and to assess the test accuracy for different degrees of HFHL.MethodsA study was conducted on cross-sectional data of occupational audiometric examinations, including the index test OEC and reference standard pure-tone air conduction audiometry, of 80 noise-exposed workers. Sensitivity, specificity, and likelihood ratios were calculated for the OEC, after automatic conditional rescreening, for a younger and an older age group, and for two degrees of HFHL (HFHL25: PTA3,4,6 ≥ 25 dB HL, and HFHL35: PTA3,4,6 ≥ 35 dB HL, both for at least one ear).ResultsTest specificity for HFHL25 after a single test was 63%, and improved to 93% after the automatic conditional rescreen. Test sensitivity for HFHL25 decreased from 65% to 59%. Test sensitivity and specificity including automatic conditional rescreening for HFHL35 was 94% and 90%, respectively. The positive likelihood ratio for HFHL25 was 8.4, and for HFHL35 9.4. The negative likelihood ratio for HFHL35 was below 0.1.ConclusionsThe OEC is an appropriate screening test, especially for HFHL35. Normal-hearing workers who obtained a positive test result for the first test for one or two ears, benefit from having an automatic rescreen, resulting in an improvement of the test specificity, and hence prevent unnecessary referral.
Highlights
High-frequency hearing loss (HFHL), caused by excessive exposure to noise in the workplace, known as noiseinduced hearing loss (NIHL), is an important public health problem worldwide (May 2000; Sliwinska-Kowalska and Davis 2012)
This study focuses on the Occupational Earcheck (OEC), a Dutch internet-based speech-in-noise hearing screening test for occupational HFHL, developed at the Department of Audiology of the Leiden University Medical Center, commissioned by the Netherlands Hearing Health Foundation (Ellis et al 2006)
Four workers (5%) had a H FHL25 at the right ear only, and nine (11.3%) workers had a HFHL25 for the left ear only
Summary
High-frequency hearing loss (HFHL), caused by excessive exposure to noise in the workplace, known as noiseinduced hearing loss (NIHL), is an important public health problem worldwide (May 2000; Sliwinska-Kowalska and Davis 2012). Studies have shown that these tests can be used as a proper screening tool (Smoorenburg 1992; Smits et al 2004, 2006, 2013; Culling et al 2005; Jansen et al 2010; Leensen et al 2011b) These tests facilitate audiometric hearing evaluation of noise-exposed workers in the workplace: a trained audiometrist, a soundproof room, and specialized, and costly technical equipment are no longer required, as is the case for the more conventional pure-tone air conduction screening audiometry (Stenfelt et al 2011; Leensen and Dreschler 2013a). This study focuses on the Occupational Earcheck (OEC), a Dutch internet-based speech-in-noise hearing screening test for occupational HFHL, developed at the Department of Audiology of the Leiden University Medical Center, commissioned by the Netherlands Hearing Health Foundation (Ellis et al 2006). Though learning was accounted for by training, and a long individual run-up to the actual measurement was incorporated in the test, a learning effect still appeared
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