Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 11, 2023
Date Accepted: Jan 3, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
An initial validation study of community-based air-conduction audiometry in adults with simulated hearing impairment using DigiBel, a new web-application
ABSTRACT
Background:
Approximately 80% of primary school children suffer from glue ear, which may impair hearing at a critical time for speech acquisition and social development. An online application, DigiBel, has been developed primarily to identify individuals with conductive hearing impairment who may benefit from temporary use of bone-conduction (BC) assistive technology in the community.
Objective:
This preliminary study aims to determine the screening accuracy and usability of DigiBel self-assessed air-conduction (AC) pure tone audiometry (PTA) in adult volunteers with simulated hearing impairment prior to formal clinical validation.
Methods:
Healthy adults, each with one ear plugged, underwent automated AC PTA (reference test) and DigiBel audiometry in quiet community settings. Threshold measurements were compared across six tone frequencies and DigiBel test-retest reliability was calculated. The accuracy of DigiBel for detecting more than 20 decibels of hearing impairment was assessed.
Results:
30 adults (30 unplugged ears and 30 plugged ears) completed both audiometry tests. DigiBel had 100% sensitivity (95%CI 87.23-100) and 72.73% (95%CI 54.48-86.70) specificity in detecting hearing impairment. Threshold mean bias was insignificant except at 4000 and 8000Hz where a small but significant over-estimation of threshold measurement was identified. All 24 subjects completing feedback rated the DigiBel test good or excellent and 21(87.5%) agreed or strongly agreed that they would be able to do the test at home without help.
Conclusions:
This study supports the potential use of DigiBel as a screening tool for hearing impairment. The findings will be used to improve the software further prior to undertaking a formal clinical trial of AC and BC audiometry in individuals with suspected conductive hearing impairment.
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