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Multicenter Study
. 2020 Aug;75(8):632-639.
doi: 10.1136/thoraxjnl-2019-214177. Epub 2020 May 14.

Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

Anitha Vijayasingam  1 , Emily Frost  2 , Julie Wilkins  2 , Lise Gillen  3 , Presanna Premachandra  3 , Kate Mclaren  1 , Desmond Gilmartin  1 , Lorenzo Picinali  4 , Alberto Vidal-Diez  5 , Simone Borsci  5   6 , Melody Zhifang Ni  5 , Wai Y Tang  7   8 , Deborah Morris-Rosendahl  7   8 , Jonny Harcourt  9 , Caroline Elston  10 , N J Simmonds  1   8 , Anand Shah  11   8
Affiliations
Multicenter Study

Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

Anitha Vijayasingam et al. Thorax. 2020 Aug.

Abstract

Introduction: Individuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF.

Methods: Hearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined.

Results: Prevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz.

Conclusions: Adults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.

Keywords: cystic fibrosis; respiratory Infection; systemic disease and lungs.

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Conflict of interest statement

Competing interests: AS has received grant funding from Vertex Pharmaceuticals and Gilead Sciences and received personal fees for lecturing from Gilead Sciences. NJS has received personal fees for consultancy and lecturing from Vertex, Teva and Zambon Pharmaceuticals, Chiesi Ltd, Novartis International, Pulmocide Ltd, Roche and Gilead Sciences. CE has received personal fees for consultancy and lecturing from Gilead Sciences, Teva and Zambon Pharmaceuticals.

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