Screening Tool For Hearing Loss Research Articles

A Variable-Stimulus Distortion Product Otoacoustic Emission Screening Method to Match Cochlear Place-Specific Properties.

Distortion product otoacoustic emissions (DPOAEs) are a popular screening tool for hearing loss in specific populations (e.g., newborns). Current screening protocols use stimulus conditions that are agnostic to local mechanical properties of the cochlea and are also limited to a narrow frequency range. We have recently reported locally optimized stimulus frequency ratio and level combinations for recording DPOAEs up to stimulus frequencies of 19 kHz. In normally functioning cochlea, optimized stimuli improved the signal to noise ratios and allowed the registration of higher DPOAE levels, especially at higher frequencies. The purpose of this study was to evaluate the clinical performance of these physiologically motivated, locally appropriate, stimulus parameters for a screening application to identify the presence of hearing loss. Subjects were 24 adults with sensorineural hearing loss and 31 adults with normal hearing. The cubic DPOAE was measured and analyzed up to frequencies of 16 kHz using a range of stimulus conditions. Receiver operating characteristic curves were used to identify stimulus combinations most sensitive to screening for hearing loss. Receiver operating characteristic curves demonstrated improved test efficacy for hearing loss detection when using stimulus frequency ratios and levels that are frequency-dependent and consistent with known mechanical properties of the cochlea. We propose a new DPOAE recording paradigm (variable-stimuli DP) using stimuli aligned to local cochlear properties which may improve early and accurate detection of decline in cochlear function.

Screen-H Website Audiometry as a Diagnostic Tool for Hearing Screening in Patients with Hearing Loss

Background Hearing loss, affecting 16.8% of Indonesians, impacts quality of life and daily activities. Limited access to hearing loss evaluation and treatment, due to demographic and socioeconomic conditions, particularly in remote areas, hinders early detection and intervention. Website audiometry Screen-H, accessible on mobile phones, tablets, and computers, offers a fast, painless, and non-invasive solution. Purpose This study aimed to assess the agreement between Screen-H and gold standard pure-tone audiometry. Methods In this analytical observational study with a cross-sectional design, participants over 10 years old with hearing loss were consecutively sampled at the Audiology Clinic of Otorhinolaryngology-Head and Neck Surgery, Dr. Hasan Sadikin General Hospital, Bandung. The sensitivity and specificity of Screen-H® were evaluated, and the Kappa score measured agreement with pure-tone audiometry. Results We included 321 patients, comprising 150 women (47%) and 171 men (53%). Screen-H® showed 82.8% sensitivity and 94.1% specificity in the right ear, and 80.8% sensitivity and 93.1% specificity in the left ear. Conclusion The high specificity and sensitivity of Screen-H, combined with its speed, ease of use, non-invasiveness, and cost-effectiveness, make it an effective screening tool for hearing loss in environments with noise levels ≤ 40 dB HL, starting from 35 dB HL stimuli.

Accuracy and Pitfalls in the Smartphone-Based Audiometry Examination.

Approximately 466 million people suffer from hearing loss worldwide, with Indonesia ranking fourth in Southeast Asia. However, conventional pure-tone audiometry is not yet available in many areas because of its high cost. Numerous available smartphone-based audiometry applications are potential alternative screening tools for hearing loss, especially in Indonesia. This study examined the findings on the validation of smartphone-based audiometry applications to assess hearing functions available in Indonesia. Based on the established eligibility criteria, this study was conducted by browsing the relevant literature validating smartphone-based audiometry applications in Indonesia. Relevant study data, such as the author, year, location, implementation procedures, and outcomes, were extracted and summarized. This systematic review found 17 relevant and eligible publications. Of the six applications tested, 5 were found to have good validity, such as uHearTM, Audiogram MobileTM, AudCalTM, Hearing TestTM e-audiologia, and WuliraTM. All smartphone-based audiometry was tested only for the air conduction threshold and was influenced by several factors. Because smartphone-based audiometry is inexpensive, simple, and more accessible than conventional audiometric testing, it can be useful as a screening modality or alternative approach to assess hearing function. Unfortunately, smartphone-based audiometry cannot replace conventional audiometry in diagnosing hearing impairment.

A study on the IOS application "uHear" as a screening tool for hearing loss in Bangkok.

This study was designed to compare the results of hearing tests performed using the uHear application with those of standard audiometry in Thai people in Bangkok. From December 2018 to November 2019, a prospective observational study was conducted involving Thai participants aged between 18 and 80 years. All participants were tested using standard audiometry and the uHear application in a soundproof booth and in a typical hearing environment. This study included 52 participants (12 males and 40 females). The Bland-Altman plot with the Minimal Clinical Meaningful Difference of 10dB between standard audiometry and the uHear in a soundproof booth found agreement at 2000 Hz. The uHear in a soundproof booth showed high sensitivity at all frequencies (82.5%-98.9%) and high specificity at 500 and 1000 Hz (85.7%-100%). uHear in a typical hearing environment showed high sensitivity at 4000 and 6000 Hz (97.6%) and high specificity at 500 and 1000 Hz (100%). When considering the pure-tone average, uHear in a soundproof booth showed high sensitivity (94.7%) and specificity (90.7%), whereas, in a typical hearing environment, uHear showed poor sensitivity (34%) and high specificity (100%). uHear was accurate for hearing loss screening at 2000 Hz in a soundproof booth. However, uHear in a typical hearing environment lacked accuracy. The uHear application in a soundproof booth can be used to screen hearing loss in some situations where standard audiometry is impossible. II.

WULIRA APP mobile phone application to assess occupational hearing loss among industrial workers in Kampala, Uganda

BACKGROUND AND AIM: Occupational hearing loss (OHL) is among the most common causes of disabling hearing loss. Pure Tone Audiometry (PTA) is not readily available in Uganda due to the high cost and operator dependence. However, a mobile phone-health innovation, Wulira App, with a sensitivity of 91.4% in the right ear and 88.4% in the left ear and a specificity of 93.2% and 91.5% in the right and left ear respectively, provides an easy to use, and reliable alternative screening tool for hearing loss. In this study, the prevalence and associated factors of OHL among industrial workers will be determined. METHODS: We will conduct a cross-sectional study among industrial workers in Kampala. A total of 354 participants will be recruited systematically and screened for hearing loss using the Wulira App in a quiet room. Noise cancelling earphones will be used to minimize interference from any ambient noises. The study population will be described by exposure variables such as duration of work in the factory, age, sex, smoking, previous MDR-TB treatment. Categorical data will be presented as frequencies and percentages while continuous variables will be presented as means and standard deviations or medians and interquartile ranges. Proportions for categorical variables will be compared using the chi-square tests and Fisher’s exact tests after testing for assumptions whereas means of continuous variables will be compared using Student t-test for normally distributed data and Mann Whitney U test for skewed data. Inferential statistics will be used. RESULTS:Using a hearing threshold more than or equal to 26 dB as hearing loss, participants with OHL will be presented as proportions and classified according to the WHO classification of hearing loss. CONCLUSIONS:Wulira App is easy to use tool for assessing OHL. Therefore, Wulira App could be adopted in clinical and work settings to screen and monitor for hearing loss. KEYWORDS: Occupational exposure, Occupational epidemiology

EFFECTIVENESS OFSCREENING TOOLS EMPLOYED FOR IDENTIFYING HEARING LOSSIN OLDER ADUL

The study evaluated the effectiveness of screening tests by identifying hearing loss in 127 adults of the older age groups (aged 60–87). We performed a quantitative assessment of the HHIE-S questionnaire (accuracy, sensitivity, specificity) comparing to the puretone threshold audiometry (the gold standard for detecting hearing loss). The analysis of hearing impairment prevalence in the target population relied on both methods. We have observed a high rate of hearing loss — 81% in the patients of the older age group, of which 30% had mild hearing loss, 38% — moderate hearing loss, 9% — severe hearing loss, the remaining 4% with profound hearing loss. We have evaluated the average accuracy (62.2%), sensitivity (64.0%), specificity (54.0%) as well as the positive predictive value (85.7%) of the HHIE-S questionnaire, whereas it was the negative predictive value only that revealed a low rate (26%). The study outcomes confirm the possibility of using HHIE-S questionnaire as a screening tool for hearing loss in the older age group. HHIE-S can prove particularly useful for primary care physicians as well as for physical examination due to its reliable accuracy and ease of use. The probability of a false positive outcome and an overestimated hearing impairment in the older age group is relatively low. However, pure-tone threshold audiometry is required in patients with detected hearing loss.

The effective screening tools for detecting hearing loss in elderly population: HHIE-ST Versus TSQ

BackgroundGlobally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults.MethodsThis prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard.ResultsThe prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%.ConclusionsEither the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation.Trial registrationThe study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. Date of registration October 14, 2015.

Evaluation of Portable Tablet-Based Audiometry in a South Indian Population.

While a comprehensive booth audiogram is the gold standard for diagnosis of hearing loss, access to this may not be available in remote and low resource settings. The aims of this study were to validate a tablet-based audiometer in a tertiary medical center in India and explore its capacity in improving access to hearing healthcare. Subjects presenting to Ear-Nose-Throat clinics for conventional booth audiometry testing were recruited for subsequent tablet-based audiometric testing. Testing with the tablet was conducted in a non-sound-treated hospital clinic room. Bilateral air and bone conduction hearing threshold data from 250 through 4000Hz were validated against conventional booth audiometry. In addition, a small feasibility study was conducted in rural clinics. 70 participants (37 adults and 33 children between the ages 5-18) were assessed. 69% were male, with a mean age of 29.7years. Sensitivity and specificity for the tablet were 89% (95% CI 80-94%) and 70% (95% CI 56-82%), respectively. While median differences in air conduction thresholds between conventional and tablet audiograms showed statistical significance at 250, 500, and 1000Hz (p < 0.001), the threshold results of the tablet audiometer were within 5dB of the conventional audiogram and not clinically significant. Ten patients were successfully screened in rural clinics with tablet audiometry. Tablet portable audiometry is a valid tool for air and bone conduction threshold assessment outside of conventional sound booths. It can accurately identify hearing impairment and offers a screening tool for hearing loss in low resource settings.

Screening for hearing loss in the Hong Kong Cantonese-speaking elderly using tablet-based pure-tone and word-in-noise test

Objective: The present study aimed to establish the test-retest reliability and validity of a tablet-based automated pure-tone screening test and a word-in-noise test as hearing screening tools for older Hong Kong Cantonese-speaking adults.Design and study sample: It was a cross-sectional within-subject study. One hundred and thirty-two older adults participated in this study, and 112 of them completed the automated pure-tone screening test, word-in-noise test, and conventional pure-tone audiometry. Pure-tone threshold of 40 dB HL at each of the tested frequencies including 500, 1000, 2000 and 4000 Hz, obtained with conventional pure-tone audiometry was set as the pass/refer criterion, for the calculation of sensitivity and specificity of the tablet-based screening tools.Results: The tablet-based automated pure-tone screening test yielded a sensitivity of 0.93 and specificity of 0.82, while the word-in-noise test yielded a sensitivity of 0.81 and specificity of 0.70 with the cut-off chosen as a speech reception threshold of −3.5 dB signal-to-noise ratio. Both tests require around 3 minutes to be completed on both ears.Conclusions: The tablet-based pure-tone test and word-in-noise test are reliable and valid to be used as screening tools for hearing loss in the Hong Kong Cantonese-speaking elderly.

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Application-Based Hearing Screening in the Elderly Population.

The effects of age-related hearing loss are severe. Early detection is essential for maximum benefit. However, most hearing-impaired adults delay obtaining treatment. Diagnostic hearing testing at an appropriate facility is impractical, and new methods for screening audiometry aim to provide easy access for patients and reliable outcomes. The purpose of this study was to examine the accuracy of application-based hearing screening in an elderly population. The uHear application was downloaded to an iPad. Application-based hearing screening was performed in a non-soundproofed quiet room, and subsequently all participants underwent full diagnostic audiometry in a soundproof booth. Sixty patients were recruited and completed both tests. Significant differences were observed between the hearing results obtained with the application and the standard audiogram at all frequencies and in both ears. Following subtraction of a constant factor of 25 dB from the application-based results in order to compensate for ambient noise, no significant differences in pure tone average were found between the 2 methods. The uHear application is inaccurate in assessing hearing thresholds for screening in the elderly. However, when site-specifically corrected, the uHear application may be used as a screening tool for hearing loss in an elderly population.

The Accuracy of IOS Device-based uHear as a Screening Tool for Hearing Loss: A Preliminary Study From the Middle East.

To determine and explore the potential use of uHear as a screening test for determining hearing disability by evaluating its accuracy in a clinical setting and a soundproof booth when compared to the gold standard conventional audiometry. . Seventy Sultan Qaboos University students above the age of 17 years who had normal hearing were recruited for the study. They underwent a hearing test using conventional audiometry in a soundproof room, a self-administered uHear evaluation in a side room resembling a clinic setting, and a self-administered uHear test in a soundproof booth. The mean pure tone average (PTA) of thresholds at 500, 1000, 2000 and 4000 Hz for all the three test modalities was calculated, compared, and analyzed statistically. . There were 36 male and 34 female students in the study. The PTA with conventional audiometry ranged from 1 to 21 dB across left and right ears. The PTA using uHear in the side room for the same participants was 25 dB in the right ear and 28 dB in the left ear (3-54 dB across all ears). The PTA for uHear in the soundproof booth was 18 dB and 17 dB (1-43 dB) in the right and left ears, respectively. Twenty-three percent of participants were reported to have a mild hearing impairment (PTA > 25 dB) using the soundproof uHear test, and this number was 64% for the same test in the side room. For the same group, only 3% of participants were reported to have a moderate hearing impairment (PTA > 40 dB) using the uHear test in a soundproof booth, and 13% in the side room. . uHear in any setting lacks specificity in the range of normal hearing and is highly unreliable in giving the exact hearing threshold in clinical settings. However, there is a potential for the use of uHear if it is used to rule out moderate hearing loss, even in a clinical setting, as exemplified by our study. This method needs standardization through further research.

Smartphone-based audiometric test for screening hearing loss in the elderly.

Hearing loss is widespread among the elderly. One of the main obstacles to rehabilitation is identifying individuals with potentially correctable hearing loss. Smartphone-based hearing tests can be administered at home, thus greatly facilitating access to screening. This study evaluates the use of a smartphone application as a screening tool for hearing loss in individuals aged ≥ 65 years. Twenty-six subjects aged 84.4 ± 6.73 years (mean ± SD) were recruited. Pure-tone audiometry was administered by both a smartphone application (uHear for iPhone, v1.0 Unitron, Canada) and a standard portable audiometer by trained personnel. Participants also completed a questionnaire on their hearing. Pure-tone thresholds were compared between the two testing modalities and correlated with the questionnaire results. The cutoff point for failing screening tests was a pure tone average of 40 dB for the frequencies 250-6,000 Hz. The smartphone application's pure tone thresholds were higher (poorer hearing) than the audiometric thresholds, with a significant difference in all frequencies but 2,000 Hz. The application and the audiometric values were in agreement for 24 subjects (92 %). The application had a sensitivity of 100 % and specificity of 60 % for screening compared with the audiometer. The questionnaire was significantly less accurate, having assigned a passing score to three participants who failed both the application and audiometric tests. While a smartphone application may not be able to accurately determine the level of hearing impairment, it is useful as a highly accessible portable audiometer substitute for screening for hearing loss in elderly populations.

Validation of the Thai Five-Minute Hearing Test to Screen Hearing Loss in the Community

Background: Hearing impairment affects communication, social interactions, and quality of life. Audiometry is the gold standard method for hearing assessment. However, it is impractical in a country with limited resources. This study aimed to validate the Thai version of the Five-Minute Hearing Test (Thai-FMHT) to screen hearing loss in the community. Methods: This prospective cohort study was conducted in Phu Wieng district, Khon Kaen Province, Thailand during July to September 2011. Subjects who were older than 18 years, could read or understand the Thai language, and wanted to participate were enrolled. Those who had aphasia, severe mental disability, or other conditions that precluded audiometry were excluded. The Thai-FMHT was first administered, followed by standard audiometry performed by audiologists who were blinded to the result of Thai-FMHT, and finally an ear examination was performed. This trial was registered with ClinicalTrial.gov as No. NCT01408992. Results: The 558 subjects, including 176 males (32%) and 382 females (68%), completed all of the procedures. The optimal cutoff point for hearing loss in this screen was 8. The sensitivity, specificity, and positive likelihood ratio of the Thai-FMHT to screen mild hearing loss (PTA_{0.5-2 kHz} >25 dB) were 64.7% (95% CI, 56.1-72.7%), 60.0% (95% CI, 55.1-64.7%), and 1.62 (95% CI, 1.36-1.92), respectively. Regarding screening moderate hearing loss (PTA_{0.5-2 kHz} >40 dB), the sensitivity, specificity, and positive likelihood ratio of the Thai-FMHT were 93.1% (95% CI, 77.2-99.2%), 56.5% (95% CI, 55.1-64.7%), and 2.1 (95% CI, 1.9-2.5), respectively. Conclusion: The Thai-FMHT has a lower cutoff point than does the original one. This test is suitable for use as a screening tool for hearing loss in the community.

Correlations between noninvasive and direct physiological metrics of auditory function in chinchillas with noise-induced hearing loss

Noninvasive physiological tools for assessing auditory function in humans can provide valuable information when behavioral tests are not possible. Furthermore, these tools hold promise to provide greater insight into underlying cochlear pathologies. In this study, we used noninvasive distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABRs) to estimate changes in auditory function in chinchillas with noise-induced hearing loss. Two aspects of cochlear function, sensitivity (threshold) and frequency selectivity (tuning), were measured directly using neurophysiological recordings from auditory-nerve (AN) fibers to assess the predictive value of DPOAEs and ABRs. Both DPOAE amplitude and ABR threshold were well correlated (R-square ~0.5) with AN fiber threshold near stimulus frequency. For DPOAEs, the correlation was strongest for cochlear function near F2. Correlations of both noninvasive metrics with AN tuning were weaker but statistically significant. The relatively weak correlation between DPOAE amplitude and AN tuning was unexpected because both measures are tied to the integrity of outer hair cells. Alternatively, previous results suggest ABR latency may be more predictive of AN tuning. Ultimately, DPOAEs may be a more practical clinical and research screening tool for hearing loss than ABRs due to shorter recording time. [Research supported by NIH (NIDCD) F32-DC012236 and R01-DC009838.]

Hearing Loss Screening Tests for Adults

Abstract Introduction The early detection of hearing loss has been studied widely in newborns due to the emerging technologies for diagnosis and treatment. There are detailed protocols for this goal. Nonetheless, hearing loss screening in adults has become more important lately with the increase of the life expectancy, an expected change in the Mexican population pyramid towards a rectangular shape in the next 50 years (with increased hearing loss prevalence) and the creation of public policies for social security such as the “Seguro Popular”. There are no Mexican studies about hearing loss screening in adults. The aim of this work was to assess a tone emission and a questionnaire as screening tools for hearing loss in adults. Methods A sample size of 500 individuals without otology pathology from the outpatient clinics at a general hospital. An otoscopy, 2 screening tests (tone emission and questionnaire) and tonal audiometry were performed on all subjects. Results The questionnaire turned out to be a sensitive test but with low specificity, whilst the tone emission was less sensitive but more specific with a higher rate of precision. In this study, the best result was achieved by a combined strategy using the two tests above, with a precision of 90%. Conclusions The best screening strategy proposed by this study for hearing loss in adults is a questionnaire and tone emission test, which guarantees complete hearing assessment in objective and subjective manners, performed quickly and without special training.

Pruebas de despistaje auditivo en adultos

IntroductionThe early detection of hearing loss has been studied widely in newborns due to the emerging technologies for diagnosis and treatment. There are detailed protocols for this goal. Nonetheless, hearing loss screening in adults has become more important lately with the increase of the life expectancy, an expected change in the Mexican population pyramid towards a rectangular shape in the next 50 years (with increased hearing loss prevalence) and the creation of public policies for social security such as the “Seguro Popular”. There are no Mexican studies about hearing loss screening in adults.The aim of this work was to assess a tone emission and a questionnaire as screening tools for hearing loss in adults. MethodsA sample size of 500 individuals without otology pathology from the outpatient clinics at a general hospital. An otoscopy, 2 screening tests (tone emission and questionnaire) and tonal audiometry were performed on all subjects. ResultsThe questionnaire turned out to be a sensitive test but with low specificity, while the tone emission was less sensitive but more specific with a higher rate of precision. In this study, the best result was achieved by a combined strategy using the two tests above, with a precision of 90%. ConclusionsThe best screening strategy proposed by this study for hearing loss in adults is a questionnaire and tone emission test, which guarantees complete hearing assessment in objective and subjective manners, performed quickly and without special training.

Investigation of the Actions Taken by Adults Who Failed a Telephone-Based Hearing Screen

Hearing impairment constitutes a highly prevalent chronic health condition among older adults worldwide which negatively impacts on communication and health-related quality of life. Irrespective of this, the majority of older adults do not seek professional help for hearing impairment and/or do not obtain hearing aids. Therefore, a new approach for detecting and promoting help-seeking for hearing impairment is needed. The purpose of this study was to investigate the actions taken by those who failed Telscreen, a telephone-based screening tool for hearing loss, and to increase our understanding of factors that influence taking action. A cohort of 193 participants (112 females, 81 males; age range 24-93 yr) who had failed Telscreen participated in a follow-up telephone interview 4 to 5 mo later. Participants were asked why they called Telscreen, about their hearing ability, their Telscreen result, and what action they had taken toward hearing rehabilitation. One outcome measure was identified: decision to seek professional help for hearing impairment (yes/no). Given that the outcome measure was dichotomized, a logistic regression model for binary outcomes was fitted to the data. Of the 193 participants who failed Telscreen, only 36% sought help from a range of sources (e.g., audiologist, hearing service or hearing aid provider, and family doctor). Results of the logistic regression analysis indicated that individuals who had considered hearing aids before calling Telscreen and/or who recalled their Telscreen result were significantly more likely to seek professional help for their hearing impairment. Nineteen participants who sought help for their hearing impairment had hearing aid fitting recommended to them. Eight participants had aid/s fitted, and of these, six reported a successful outcome. For every 100 individuals who fail a hearing screening, only 36 seek help. Of these 36 individuals who take some action, 13 are recommended hearing aids, approximately half of whom follow this advice and obtain hearing aids. Approximately three-quarters of these individuals use and value their hearing aids. Provided that the screening is automated and low cost, hearing screening via telephone has proven to change the lives of 5% of individuals who decided to seek professional help for hearing impairment at little cost to the other 95% of individuals. Suggestions for future research based on the present research findings are discussed.

Accuracy of Siemens HearCheck™ Navigator as a Screening Tool for Hearing Loss

Objective: To calculate the accuracy, sensitivity, specificity and positive predictive values of the Siemens HearCheck™ Navigator in detecting hearing loss and to compare values of these parameters when the examination is done in a soundproof booth and in a quiet room.&#x0D; &#x0D; Methods:&#x0D; Design: Analytical, cross-sectional study&#x0D; Setting: Tertiary Public University Hospital&#x0D; Patients: Patients seen at the Ear Unit of a tertiary public university hospital from June 2009 to August 2010 were tested using the Siemens HearCheck™ Navigator and pure tone audiometry, inside a soundproof audiometry booth and in a quiet room with an ambient noise of 50dB, with a different investigator for each examination. Each ear was treated as a separate subject. Results obtained from the HearCheck™ Navigator were designated as observed values and were classified as “no hearing loss” for green light, and “with hearing loss” for yellow or red lights. Results were compared with pure tone air conduction averages designated as gold standard values. Normal hearing acuity (0-25 dB) was classified as no hearing loss. Pure tone air conduction averages of 26dB and above were classified as “with hearing loss” and were further stratified as mild hearing loss (26-40dB) and moderate or worse hearing loss (&gt;41 dB). Observed and gold standard values were compared and tabulated in a 2x2 table for all levels of hearing loss, mild hearing loss, and moderate or worse hearing loss. Accuracy, sensitivity, specificity, positive and negative predictive values of the Siemens HearCheck™ Navigator inside a soundproof audiometry booth and in a quiet room were determined using pure tone audiometry as the gold standard.&#x0D; &#x0D; Results: 100 patients (200 ears) were tested, with a median age of 43 years old (range 15-75), and an almost equal number of male and female participants (52 males, 48 females). Accuracy rate of the Siemens HearCheck™ Navigator inside the soundproof audiometry booth and in a quiet room were 82.5% and 84% respectively for all levels of hearing loss. Sensitivity, specificity, positive and negative predictive values were similar whether the examination was done inside the soundproof audiometry booth or in a quiet room. These values were notably higher in patients with moderate or worse hearing loss compared to patients with mild hearing loss.&#x0D; &#x0D; Conclusion: The Siemens HearCheck™ Navigator shows potential as an accurate, portable, easy-to-use tool to screen for hearing loss, especially for cases of moderate or worse hearing loss, without the need for soundproof audiometry booths or special training. It is recommended that further studies be done to differentiate degrees of hearing loss, and to evaluate its usefulness in other target populations, including school children and the elderly.&#x0D; &#x0D; Keywords: hearing screening, hearing screening tool, accuracy, hearingloss, HearCheck™ Navigator

The use of transient evoked otoacoustic emissions as a hearing screen following grommet insertion

This study aimed to evaluate the sensitivity of transient evoked otoacoustic emission testing as a screening tool for hearing loss in children, after grommet insertion. A prospective study was conducted of 48 children (91 ears) aged three to 16 years who had undergone grommet insertion for glue ear. At post-operative review, pure tone audiometry was performed followed by transient evoked otoacoustic emission testing. Outcomes for both tests, in each ear, were compared. The pure tone audiometry threshold was ≤ 20 dB in 85 ears (93.4 per cent), 25 dB in two ears (2.2 per cent) and ≥ 30 dB in four ears (4.4 per cent). Transient evoked otoacoustic emissions were detected in 69 ears (75.8 per cent). The sensitivity of transient evoked otoacoustic emission testing for detecting hearing loss was 100 per cent for ≥ 30 dB loss but only 66.7 per cent for ≥ 25 dB loss. Transient evoked otoacoustic emission testing offers a sensitive means of detecting hearing loss of ≥ 30 dB following grommet insertion in children. However, the use of such testing as a screening tool may miss some cases of mild hearing loss.