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. 2020 Oct 27;8(10):e17213.
doi: 10.2196/17213.

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

Lok Yee Joyce Li  1   2   3 , Shin-Yi Wang  4 , Cheng-Jung Wu  2   3   5   6 , Cheng-Yu Tsai  7 , Te-Fang Wu  8 , Yaoh-Shiang Lin  6   8
Affiliations

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

Lok Yee Joyce Li et al. JMIR Mhealth Uhealth. .

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.

Keywords: HHIE-S questionnaire; audiometry; free-field voice test; hearing impairment; mobile health; mobile phone; self-perception.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Hearing Handicap Inventory for the Elderly Screening Version.
Figure 2
Figure 2
Demonstration of the free-field voice hearing screening test.
Figure 3
Figure 3
Smartphone-based audiometry hearing screening test. A: Smartphone-based audiometry device. B: Demonstration of smartphone-based audiometry. C: Results of hearing sensitivity shown in a typical audiogram format.
See this image and copyright information in PMC

References

    1. Prevention of blindness and deafness. World Health Organization. [2020-10-03]. http://www.who.int/pbd/en.
    1. WHO global estimates on prevalence of hearing loss. World Health Organization. [2020-10-03]. http://www.who.int/pbd/deafness/WHO_GE_HL.pdf.
    1. Stevens G, Flaxman S, Brunskill E, Mascarenhas Maya, Mathers Colin D, Finucane Mariel, Global Burden of Disease Hearing Loss Expert Group Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. Eur J Public Health. 2013 Feb;23(1):146–52. doi: 10.1093/eurpub/ckr176. - DOI - PubMed
    1. Sound Hearing 2030 Report 2012. Sound Hearing 2030 website. [2020-10-03]. http://www.soundhearing2030.org.
    1. Szudek J, Ostevik A, Dziegielewski P, Robinson-Anagor J, Gomaa N, Hodgetts B, Ho A. Can Uhear me now? Validation of an iPod-based hearing loss screening test. J Otolaryngol Head Neck Surg. 2012 Apr;41 Suppl 1:S78–84. - PubMed

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