Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 26, 2019
Date Accepted: Sep 17, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Screening for Hearing Impairment in the Elderly: Comparison of Smartphone-based Audiometry, Self-perception, HHIE-S Screening Questionnarie and Free-Field Voice Test.
ABSTRACT
Background:
Sensory deficits is defined as when one of the senses; sight, hearing, touch, taste, smell is no longer functioning at normal ability. Based on available data, the two most commonly encountered sensory impairments are blindness and deafness. Hearing impairment is one of the most frequent sensory deficits in human beings. Hearing impairments have a profound effect on the life of the affected person, their families and society as a whole. With the development of mobile health technology, smartphone-based hearing tests were developed as screening tools to identify patients with hearing loss. In this study, we evaluate the smartphone-based audiometry as a test for screening moderate hearing impairment in the elderly and to validate this test against standard pure tone audiometry. This study also sets out to compare the usefulness of self-perception, the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) questionnaire and free-field voice test to screen for moderate hearing impairment in the elderly. In this article, we will discussed how accurate are the hearing-loss screening methods among elderly adults, including self-perception, HHIE-S screening questionnaire, free-field voice test, and smartphone-based audiometry.
Objective:
Hearing impairment is the most frequent sensory deficit in humans, affecting more than 360 million people worldwide. And the problem of hearing impairment, is actually not just a health problem, it's also an educational problem, and it's an economic problem, and it's a quality of life problem. We want to evaluate the self-perception, HHIE-S questionnaire, free-field voice test and smartphone-based audiometry as a test for screening moderate hearing impairment in the elderly.
Methods:
41 participants 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 the mean of hearing thresholds at 500, 1000, 2000, 4000 Hz >40 dB HL (Pure-tone average > 40 dB HL). All patients completed five hearing evaluations, including 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 better-hearing ear.
Results:
The self-perception test had a sensitivity of 0.58 (95% CI = 0.29-0.84) and specificity of 0.34 (95% CI = 0.19-0.54).；The HHIE-S questionnaire test had a sensitivity of 0.67 (95% CI = 0.35-0.89) and specificity of specificity：0.31 (95% CI = 0.316-0.51) ；The free-field voice test had a sensitivity of 0.83 (95% CI = 0.51-0.97) and specificity of 0.41 (95% CI = 0.24-0.61)；The smartphone-based audiometry test had a sensitivity of 0.92 (95% CI = 0.60-0.99) and specificity of 0.76 (95% CI = 0.56-0.89). The smartphone-based audiometry has higher sensitivity and specificity and was able to correctly diagnose the presence of hearing loss with a high sensitivity and high specificity.
Conclusions:
The smartphone-based audiometry maybe a reasonable screening test to rule out moderate hearing impairment in the elderly.
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