Evaluation of Portable Tablet-Based Audiometry in a South Indian Population
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ORIGINAL ARTICLE
Evaluation of Portable Tablet-Based Audiometry in a South Indian Population Sreeya Yalamanchali1 • Rita Ruby Albert2 • Hinrich Staecker1 • Rohit Nallani1 P Naina2 • Kevin J Sykes1
•
Received: 21 July 2020 / Accepted: 24 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract 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 4000 Hz 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 29.7 years. 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 1000 Hz (p \ 0.001), the threshold results of the tablet audiometer were within 5 dB 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 & P Naina [email protected] 1
Department of Otolaryngology, University of Kansas Medical Center, Kansas City, KS, USA
2
Department of ENT, Christian Medical College, Vellore, India
sound booths. It can accurately identify hearing impairment and offers a screening tool for hearing loss in low resource settings. Keywords Tablet audiogram Portable audiogram Global hearing health Hearing loss Screening
Introduction Results from the 2015 Global Burden of Disease Studies indicate that hearing loss was the fourth leading cause in years lived with disability (YLDs), which is an increase from the eleventh leading cause in YLDs in 2010 [1]. The major burden of disabling hearing impairment (defined as hearing impairment in the better ear of C 41 decibels in adults and C 31 in children) continues to be in low and middle income countries (LMIC)s, especially in South Asia and Sub-Saharan Africa [2]. Both children and adult can face enormous economic and personal consequences. In children, hearing loss can interfere with cognitive, emotional, and social maturation attainments leading to worse literacy rates and poor academic achievement. Adults, especially after age 60, can come to feel a sense of profound isolation and may withdraw fr
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