Screening For Hearing Impairment Research Articles

Diabetes and Hearing Impairment: Knowledge, Attitudes, and Practices Among Providers and Patients.

The purpose of this study was to assess the knowledge, attitudes, and practices among providers and patients regarding hearing impairment and screening referrals in people with diabetes. A cross-sectional survey design among health care providers and patients at an academic medical center in Oklahoma was used to gather knowledge, attitudes, and practices data. Only 25.6% of providers selected hearing impairment as a complication of diabetes, whereas 96.7% selected retinopathy, kidney dysfunction, and foot infection. Reported barriers to referring patients for hearing impairment screenings were being unfamiliar with recommended screening frequency (57.3%) and existence of higher priorities (35.4%). When asked to select parts of the body affected by diabetes, 21.0% of patients surveyed selected ears, 88.0% selected feet, and 85.0% selected eyes and kidneys. Fewer patients reported being told hearing impairment is a complication of diabetes compared to retinopathy (8.1% vs 85.9%). Additionally, 24.2% of patients reported having a hearing impairment screening, and 96.0% reported having a dilated eye exam. Most providers and patients at an academic medical center are unaware of the relationship between diabetes and hearing impairment. Providers reported there are several barriers that need to be overcome to refer patients to audiologists.

Hearing Screening of Newborns and Infants by Otoacoustic Emission

Introduction: This study was undertaken to assess the hearing of newborns and infants using otoacoustic emission as a screening tool. Screening of hearing impairment in infants is done before the third month of life, and intervention, if any, required by the age of 6 months is of prime importance. The aim of this study was to screen 215 newborns for hearing.Materials and Methods: About 215 neonates and infants were included after a thorough ENT examination and history taking. Two stage DPOAE was done on the newborns with 2, 3, 4, and 6 kHz frequencies in both ears. Newborns who failed the first OAE in any ear were tested for a second OAE in both ears within 15 days to 3 months.Result: Out of 215 cases, 10.2% (n = 22) babies had referred results for 1st DPOAE in which low birth weight, prematurity, respiratory distress syndrome, post-natal sepsis, and maternal anemia and pregnancy-induced hypertension were among the identified infantile and maternal risk factors respectively. For these infants, repeated DPOAE screening was done. On repeat DPOAE testing, all babies passed the DPOAE 2nd test.Conclusion: This study was an attempt to show the importance of developing a hearing screen with DPOAE when repeated appropriately. The hearing of all infants should be screened at no later than one month of age; those that do not pass screening should have a comprehensive audiological evaluation at no later than three months of age, and infants with confirmed hearing loss should receive appropriate intervention by six months of age.

The Cost Effectiveness of Newborn Hearing Screening Program: New Approach of Iran Ministry of Health and Medical Education in 2022

Background: In Iran’s newborn hearing screening (NHS) program, OAE and AABR are administered to early identify hearing impairment in the primary health care (PHC) system. Objectives: The aim of this study was to conduct a cost-effectiveness analysis of this program integrated into Iran's health system. Methods: We examined the cost-effectiveness of AABR and OAE screening procedures in infants less than 1 month old. TreeAge 2022 software was used for cost-effective modeling. In this study, QoL and QALY were considered as the outcome measures. To evaluate the robustness of the modeling results, we used one-way sensitivity analysis. A ± 20% variation was utilized to determine target variables and estimate the costs per identification. Results: In 2022, a total of 1,106,072 babies were born in Iran, of whom 1,006,293 underwent hearing impairment screening (coverage rate: 90.97%). Overall, 3,359 of the newborns screened were diagnosed with hearing problems, indicating a mean prevalence of 3.3 per 1000 births. The ICER was equal to 3297.2 US PPP (Purchasing Power Parity) per QALY. According to our results, the dominant cost-effective strategy for hearing impairment screening was OAE plus AABR. After 1000 iterations, the second cost-effective strategy was found to be OAE alone, according to Monte Carlo simulation modeling. Conclusions: In this study, we evaluated the cost-effectiveness of the NHS program for detecting hearing impairment in over a million births in Iran. A two-step screening approach, including OAE and AABR, was found to be the dominant cost-effective strategy to identify newborns with hearing impairment.

A Screening Platform for Hearing Loss and Cognitive Decline: WHISPER (Widespread Hearing Impairment Screening and PrEvention of Risk).

The WHISPER (Widespread Hearing Impairment Screening and PrEvention of Risk) platform was recently developed for screening for hearing loss (HL) and cognitive decline in adults. It includes a battery of tests (a risk factors (RF) questionnaire, a language-independent speech-in-noise test, and cognitive tests) and provides a pass/fail outcome based on the analysis of several features. Earlier studies demonstrated high accuracy of the speech-in-noise test for predicting HL in 350 participants. In this study, preliminary results from the RF questionnaire (137 participants) and from the visual digit span test (DST) (78 participants) are presented. Despite the relatively small sample size, these findings indicate that the RF and DST may provide additional features that could be useful to characterize the overall individual profile, providing additional knowledge related to short-term memory performance and overall risk of HL and cognitive decline. Future research is needed to expand number of subjects tested, number of features analyzed, and the range of algorithms (including supervised and unsupervised machine learning) used to identify novel measures able to predict the individual hearing and cognitive abilities, also including components related to the individual risk.

Development of a smartphone-based Turkish digits in noise test

BackgroundPure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing.MethodsThe digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss.ResultsThe Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p < .01). In addition, the results of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with conductive hearing loss (36.88 ± 6.31) (p < .01).ConclusionAn easy and accessible Turkish Digit in Noise Test mobile application has been developed using which one can assess his/her hearing.

Screening for Hearing Impairment in School-Age Children and Adolescents With Developmental Disabilities in an Ethnically Diverse Community.

Screening for Hearing Impairment in School-Age Children and Adolescents With Developmental Disabilities in an Ethnically Diverse Community.

Výtěžnost sluchové zkoušky šepotem společně s vyšetřením screeningových otoakustických emisí v záchytu nedoslýchavosti

Summary Introduction: The aim of this paper is to evaluate the ability of a whisper hearing test together with an examination of transiently evoked otoacoustic emissions (TEOAE) to detect a hearing loss at the first contact with an adult patient with the indicated hearing impairment. This can be helpful in situations when a threshold pure tone audiometry cannot be performed. Methodology: We included a group of patients who were examined simultaneously with a classical whisper hearing test, TEOAE and a pure tone audiometry at the Department of Otorhinolaryngology and Head and Neck Surgery of the Pardubice Hospital. Sixty-two patients with a hearing impairment and 14 healthy subjects were tested. Results: A sensitivity of the whisper hearing test alone was 85% and that of TEOAE was 71%. The sensitivity increased to 94%, when both of them were used. At the same time, a relatively high specificity (75%) of the examination was present. Using the whisper hearing test and TEOAE, we did not detect 3.3% of patients with hearing loss detected by pure tone audiometry. Conclusion: In the situation when no pure tone audiometry is available a combination of the whisper hearing test and TEOAE may be used to detect a hearing loss. The combination of these two methods can be considered for a recently much-discussed screening for hearing impairment in the elderly. Key words whisper hearing test – transient evoked otoacoustic emissions – TEOAE – hearing loss – screening

Screening for Hearing Impairment in High-Risk Neonates in a Rural Tertiary Care Center

Introduction: Among the many congenital problems, loss of hearing is one of the most common treatable diseases. Hearing loss in early life can have deleterious effects on the child's psychosocial, scholastic, and social-emotional development. Aims: The aim of this study was to estimate the incidence of neonatal hearing loss in high-risk neonates admitted in a rural tertiary care center. To determine the risk factors predictive of hearing impairment in these neonates. Materials and Methods: About 200 high-risk neonates were included in the study. The first screening by otoacoustic emission (OAE) was conducted before the neonate's discharge from the hospital. If it failed, OAE was repeated after 4 weeks or at the first immunization visit. If it again failed, then Brainstem Evoked Response Audiometry (BERA) was conducted within no more than 3 months. Statistical Analysis Used: It was performed using IBM SPSS Statistics (IBM SPSS Version 28.0. Armonk, NY). The Chi-square test was used to calculate the P value. P &lt; 0.05 was considered statistically significant. Results: In the initial screening, 49 out of 200 high-risk neonates had referred OAE. Out of 49, 20 failed in repeat OAE. Out of these 20 neonates, hearing loss was confirmed in 15 neonates (7.5%) by BERA. The risk factors most commonly associated with hearing loss in the present study were neonatal intensive care unit admission &gt;24 h (7%), hyperbilirubinemia (3%), meningitis (3%), and ototoxic drugs (3%). In the neonates who had hearing loss (15), 93.33% were having more than one risk factor. Conclusions: Our study concludes that there is significant hearing impairment in high-risk neonates. Screening for hearing loss and early identification is needed to modulate the period of neural plasticity, preventing them to banish into a world of social isolation, and educational malaise. The health-care facilities in rural regions have limited settings. Hence, at least a targeted screening is recommended for early detection of hearing loss and rehabilitation.

974: FEASIBILITY OF OTOACOUSTIC EMISSIONS TESTING TO IDENTIFY HEARING IMPAIRMENT IN THE ICU

Introduction: Hearing impairment is associated with a lack of functional recovery among older adults who have survived intensive care unit (ICU) admission and is a risk factor for delirium. Identifying hearing impairment in the ICU is challenging because many patients cannot participate in hearing assessments. Otoacoustic emissions testing (OAE) is a non-invasive, non-participatory tool that is used to screen newborns for hearing impairment by detecting intracochlear motion in response to auditory stimulation. Our objective was to assess the feasibility of OAE testing to screen for hearing impairment among adults in the ICU. Methods: A feasibility study was performed in the adult Medical Intensive Care Unit at Yale-New Haven Hospital. Data were gathered on demographics, delirium, ventilation status, sedation, illness severity, OAE measurements, and ambient noise. Percentage of test completion, the average time of test completion, and barriers or facilitators of testing were measured as outcomes. A patient passed their OAE testing if at least 2 of 6 frequencies were detected in at least one ear. A pass suggested that moderate or severe hearing impairment (i.e., that would require an amplifier or a hearing aid) was not present. Results: Of 31 patients approached (mean age 64.58+/-14.06 years), 23 (74.2%) underwent testing. Among all patients, 15 (48.4%) were mechanically ventilated, 8 (25.8%) were receiving sedative infusions, and 19 (61.3%) screened positive for delirium with the CAM-ICU. Eight (25.8%) patients were unable to be tested, most commonly due to elevated ambient noise (41.6%). Among the 18 patients with complete data, 6 patients screened positive for hearing impairment. The average time for OAE test completion per ear was 152.59+/-97.57 seconds. The average ambient noise level was 50.68+/-3.96 dB for all patients, and 52.41+/-2.08 dB among those who could not be tested in both ears. Conclusions: OAE testing is a feasible method for hearing impairment screening in the ICU. Identification of hearing impairment may facilitate improved communication through interventions such as amplifiers, audiology referrals, and accommodations. Future studies should evaluate whether identification and treatment of hearing impairment in the ICU may reduce delirium and improve post-ICU recovery.

Measurement of hearing impairment among Greenlandic school-children: association between self-reported data and clinical examinations

BackgroundMultiple ear infections is causing hearing impairment among children all over the world and the health and social consequences track into early adolescence and later in life, if not treated. The monitoring of prevalence in a population is important to assess the need for interventions in a population.MethodsOne hundred eighty five children from 5 to 10th grade from Sisimiut town and the nearby settlements participated in a clinical examination to have ear-examination and pure tone audiometry. Participants filled out a questionnaire at home with their parents before the clinical examination, and hearing impairment was collected as individual self-reports and as audiometric measurements.ResultsA total of 185 children between 9 and 15 years of age (median: 11 years, IQR: 10–13) were included, 60% (n = 111) were girls. 247 (70%) of the 355 available otoscopies were clinically assessed as normal. Cohen’s Kappa coefficient was 0.31. Eighteen children (10%) were found to have hearing impairment. None of the children had hearing aids. Test performance for self-reports were that sensitivity was 56% and specificity was 87%. The predictive value of a positive test was 31%, and the predictive value of a negative test was 95%. 32 children (17%) reported hearing impairment to the extent that they were not able to keep up in school, of which half reported that it had lasted for more than one year. 7 of the 32 children reporting hearing impairment (22%) reported that the extent of their hearing impairment was affecting their classroom experience so they were not able to follow.ConclusionSelf-reported and clinically screening for hearing impairment are two different concepts. Even though the two concepts are statistically correlated, the correlation coefficients are low. The test performance indicated that self-reported data might be measuring hearing as an experience in a social environment and not directly comparable to pure tone audiometry which examines hearing in controlled testing conditions. Since both measure hearing impairment, they supplement each other in research on impaired hearing, and the choice of measure should relate to the purpose and method of the investigation.

Geriatrics

Sleeping enough is associated with a reduced risk of mortality and dementia. New evidence support regular physical exercise, including at home, as a corner stone intervention to prevent falls and fractures. In contrast, supplementation with high doses of vitamin D is ineffective and even deleterious in this indication and a routine screening in asymptomatic adults is not recommended. Several studies illustrate our difficulties in prescribing and deprescribing in frail older patients and a study suggests that statins in cardiovascular primary prevention should considered only when a patient's life expectancy exceeds 2.5 years. Finally, several studies have fueled the debate about screening for hearing impairment.

Accuracy of smartphone-based hearing screening tests: a systematic review.

To verify the accuracy of smartphone apps to identify hearing loss. A systematic review followed the PRISMA-DATA checklist. The search strategies were applied across four databases (Lilacs, PubMed, Scopus and Web of Science) and grey literature (Google Scholar, OpenGrey, and ProQuest Dissertations and Thesis). The acronym PIRD was used in review. This included populations of any gender and all age groups. The Index test is the smartphone-based hearing screening test; the Reference test is the pure-tone audiometry, which is considered the gold reference for hearing diagnostics; the diagnosis was performed via validity data (sensitivity and specificity) to identify hearing loss and diagnostic studies. Two reviewers selected the studies in a two-step process. The risk of bias was assessed according to the criteria of the QUADAS-2. Of 1395 articles, 104 articles were eligible for full-text reading and 17 were included. Only four met all criteria for methodological quality. All of the included studies were published in English between 2015 and 2020. The applications Digits-in noise Test (5 articles), uHear (4 articles), HearScreen (2 articles), hearTest (2 articles) and Hearing Test (2 articles) were the most studied. All this application showed sensitivity and specificity values between 75 and 100%. The other applications were EarScale, uHearing Test, Free field hearing (FFH) and Free Hearing Test. uHear, Digit-in-Noise Test, HearTest and HearScreen have shown significant values of sensitivity and specificity and can be considered as the most accurate methods for screening of hearing impairment.

Brain stem auditory evoked potential response in neonates after recovery from hyperbilirubinemia: A neurophysiological approach to screening neuronal hearing loss

Objectives: Neonatal hyperbilirubinemia leads to neurological damages including encephalopathy and hearing loss. This study aimed to screen and evaluate the hearing loss in neonates after recovery from hyperbilirubinemia using the Brainstem evoked response audiometry (BERA) test. Materials and Methods: This cross-sectional comparative study was conducted in Physiology Department at Chitwan Medical College, Nepal. It included 20 age and sex-matched neonates recently recovered from hyperbilirubinemia and 20 normal healthy controls. The external acoustic canals of subjects were checked for any blockage or collapse before BERA testing. The BERA recordings were performed after the neonate’s natural sleep following a standard lab protocol explained by Taylor’s Evoked Potential in Clinical Testing. Results: The BERA wave latencies were delayed with a higher number of case group neonates I (IL-75%, IR-80%), III (IIIL-70%, III R-80%), and V (VL-80%, VR-85%) than those of controls. The percentage of neonates with delayed interwave latencies was comparable between groups. The neonate’s hearing sensitivity assessed using the grades of hearing impairment by WHO revealed slight (threshold of hearing left ear [THL]-25% and threshold of hearing right ear [THR]-30%) and moderate (THL-40% and THR-35%) grades among cases whereas no impairment (THL-60% and THR-55%) in controls. The hearing thresholds were more in cases. Conclusion: The auditory pathway is highly sensitive to elevated serum bilirubin. BERA detects even a minute degree of hearing damage seen after complete treatment of hyperbilirubinemia. Therefore, BERA is a helpful tool in the early screening of hearing impairment in neonates. This improves prognosis by early management so that the neurosensory systems develop to their full extent and one can enjoy a normal social life.

102 PROMOTING BRAIN HEALTH IN AN INTEGRATED CARE OUTREACH PROGRAMME

Abstract Background Lifestyle modifications, in older at risk populations, may prevent or slow the rate of cognitive decline. Promotion of brain health has been recommended by the WHO and other governing bodies. Supporting patients in making these lifestyle changes, however, can be complex. Generic guidance may not apply to all in a heterogenous and frail patient cohort, when physical mobility may be limited and weight loss/nutrition a concern. We sought to review current practices and barriers to brain health guidance in a regional integrated care outreach programme (ICOP). Methods From March–June’21 the comprehensive geriatric assessment (CGA) of consecutive patients were reviewed. Those presenting with cognitive complaints, for their first assessment, were included. Demographic data and data on screening for hearing impairment and sleep disturbance were collected, in addition to information on physical activity and nutritional risk. Whether information and guidance on aspects of brain health was given was also assessed. Results 30 patients met the inclusion criteria. The mean age was 80.3 and the mean clinical frailty scale (CFS) was 4.4. Hearing impairment was present in 20% (n = 6), with no information available in 10% (n = 3). All patients were screened for sleep disturbance, with 13% (n = 4) not fully satisfied with their sleep. Mobility aids, assistance or supervision were required in 40% (n = 12), and 23% (n = 7) were at medium or high malnutrition risk. Only 30% (n = 9) cooked their own meals. Generic brain health advice, or advice about sleep was documented in 30 (n = 9), without hearing impairment advice documented in any patient. Conclusion There are several barriers to brain health advice in the ICOP setting, with only 30% of patients having brain health advice documented. We are currently developing patient information leaflets on brain health, that will take potential barriers into account. Dedicated and specific information on local hearing services is also in development, as part of an ongoing quality improvement project.

Knowledge and Challenges Associated With Hearing Impairment in Affected Individuals From Cameroon (Sub-Saharan Africa).

Background: This study aimed to gain an understanding of the challenges faced by people with hearing impairment (HI) in Cameroon, their understanding of the causes of HI, and how challenges could be remedied to improve the quality of life of persons with HI.Methods: Semi-structured one-on-one in-depth interviews and observation of participant behaviour when answering questions were used to collect data from 10 HI professionals (healthcare workers and educationists), and 10 persons affected by HI (including caregivers).Results: The results show that the different groups associate the causes of HI to genetics, environmental factors, and a spiritual curse. There were reported cases of stigma and discrimination of persons with HI, with people sometimes referring to HI as an “intellectual disorder.” Interviewees also highlighted the difficulty persons with HI have in accessing education and healthcare services and suggested the need for the government and health researchers to develop strategies for the prevention and early diagnosis of HI. These strategies include (1) the awareness of the general population regarding HI, (2) the development of facilities for the proper management and new-born screening of HI, and (3) the implementation of a premarital screening to reduce the burden of HI of genetic origin.Conclusions: This study confirms the difficult social interaction and access to proper management faced by persons with HI in Cameroon and further highlights the need to educate populations on the causes of HI for a better acceptance of individuals with HI in the Cameroonian society.

The Association Between Hearing Loss and Surgical Complications in Older Adults

Objectives: In this study, we sought to evaluate whether older patients with hearing loss who underwent surgery were at greater risk of postsurgical complications, increased inpatient length-of-stay (LOS), and hospital readmission. Design: This was a retrospective cohort study of patients receiving surgery at a tertiary medical center. Utilizing electronic health record data from two merged datasets, we identified patients 65 years and older, undergoing major surgery between January 1, 2014 and January 31, 2017, and who had audiometric evaluation before surgery. Patients were classified as having either normal hearing or hearing loss based on pure-tone average in the better ear. A Generalized Estimating Equations approach was used to fit multivariable regression models for outcome variables of interest. Results: Of patients ≥65 years undergoing major surgery in our time frame, a total of 742 surgical procedures were performed on 621 patients with available audiometric data. After adjusting for age, sex, race, and comorbidities, hearing loss was associated with an increase in the odds of developing postoperative complications. Every 10 dB increase in hearing loss was associated with a 14% increase in the odds of developing a postoperative complication (odds ratio = 1.14, 95% confidence interval = 1.01–1.29, p = 0.031). Hearing loss was not significantly associated with increased hospital LOS, 30-day readmission, or 90-day readmission. Conclusions: Hearing loss was significantly associated with developing postoperative complications in older adults undergoing major surgery. Screening for hearing impairment may be a useful addition to the preoperative assessment and perioperative management of older patients undergoing surgery.

French Version of the Antiphasic Digits-in-Noise Test for Smartphone Hearing Screening.

In France 58% of persons with hearing loss still do not wear hearing aids. Pure-tone audiometry is the traditional gold standard in assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. The antiphasic digits-in-noise (DIN) test does not require calibrated material and can run on a standard headset or earbuds connected to a smartphone or a computer. The DIN test is highly correlated with pure tone audiometry and has already shown to be effective in hearing loss screening in its English version promoted by the WHO. The aim of the present study was to develop and validate a French version of the antiphasic DIN test for implementation on a national screening test offered as a smartphone app. The audio files recorded from a French native female speaker were selected and normalized in intensity according to their recognition probability. The French DIN test application was then tested on normal hearing- and hearing-impaired subjects. Based on the strong correlation between pure tone audiometry (PTA) and DIN SRT, we calculated ROC curves and Z-score. For PTA > 20 dB HL, a SNR cutoff of 12.9 dB corresponds to a sensitivity and specificity of 0.96 and 0.93, respectively. To detect moderate and more severe hearing loss (PTA > 40 dB HL), the SNR cutoff was −10.9 dB, corresponding to a sensitivity and specificity of 0.99 and 0.83, respectively. The Z-score was calculated to define statistical criteria of normality for speech-in-noise evaluation. While a score of 0 roughly corresponds to the normality (DIN SRT = −15.4 dB SNR), a subject with DIN SRT > −12.2 (Z-score > 2) is ranked in the hearing loss population. Next, the French antiphasic DIN test was implemented in the Höra iOS and Android apps. In total, 19,545 Höra tests were completed and analyzed. Three quarters of them were classified as normal (74 %) and one quarter presented mild (9%) or more severe loss (17%). Together, results argue for the use of the French version of antiphasic DIN test in the general population to improve the screening of hearing-impaired individuals.

Whisper voice test for screening of hearing loss in nursing home residents with cognitive impairmen

Recent studies establish association between hearing loss and cognitive function and evidence exist that hearing damage can exacerbate the negative impact of cognitive impairment in quality of life. Prevalence of hearing loss increases among elderly people living in nursing homes, but the number of residents without hearing aids is high. Whisper voice test is a valid test for screening for hearing impairment. It is frequently used in Primary Care. We applied the voice test in older residents with cognitive impairment and we observed that these subjects failed the repetition of letters. Consequently, we decided to modify the habitual test procedure and employ familiar phrases as screening sound stimulus, on the assumption that they are more easily recognizable. The objective of our study is to establish whether this new technique can be used to screen for hearing loss in older people with mild-moderate cognitive impairment. 62 older residents (mini mental scores &gt; 14) participated in this research. First results reveal that the voice test has high sensitivity and specificity, as well as elevated positive and negative predictive values. The proposed technique could be used as hearing screening tool in a population with similar characteristics.

Screening of Hearing in Infants at Risk in a Tertiary Care Centre: A Descriptive Cross- sectional Study

Background: Screening of hearing impairment in children facilitates earlier identification, management and prevention of disability. The objective of this study was to perform a screening of hearing in infants at risk in Tribhuvan University Teaching Hospital.&#x0D; Methods: A descriptive cross-sectional study was done among 228 infants who were at risk of hearing loss. All ‘at risk’ infants born to mothers in Tribhuvan University Teaching Hospital and ‘at risk’ children below one year of age admitted in the pediatric ward and intensive care unit were screened for hearing loss by automated otoacoustic emission (OAE) and automated auditory brainstem reflex (ABR). The results were categorized as pass or refer (fail). The association between hearing loss and the potential risk factors was analyzed.&#x0D; Results: Out of 228 infants screened, 117 (51%) were male and 111 (49%) were female. Seventy (30.7%) failed OAE and 44 (19.3%) failed ABR. Univariate analysis (Pearson Chi-square test) showed that the failure rate for ABR was significantly associated with preterm babies (p = 0.009), low birth weight (p = 0.009), usage of ototoxic drugs (p = 0.03), and intensive care unit stay of more than five days (p = 0.03). Only preterm birth was significantly associated with failed OAE test (p = 0.03).&#x0D; Conclusion: Premature birth (gestational age &lt; 34 weeks) was associated with failure of the ABR and OAE tests. The infants with low birth weight, history of ototoxic drugs, ICU stay more than 5 days were only associated with ABR test failure.

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.

BackgroundHearing 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.ObjectiveWe 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.MethodsIn 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.ResultsThe 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.ConclusionsSmartphone-based audiometry may be a dependable screening test to rule out moderate hearing impairment in the older population.