ABSTRACT
Background: Telemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females;mean age 65.17 +/- 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females;mean age 62.17 +/- 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant's satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone. Result(s): There were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the "remote fitting" feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes). Conclusion(s): Remote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.Copyright © 2023, The Author(s).
ABSTRACT
Introduction: This study investigates the role of distortion product otoacoustic emissions (DPOAE), tympanometry, and acoustic stapedial reflex testing (ASR) and their combined potential utility in the setting of replacing classic automated auditory brainstem response (AABR) testing in newborns with referred hearing screens. This was done to determine whether these tests could be used in isolation so to reduce the follow-up burden on families and improve compliance with our screening protocols by replacing the need for additional tests, especially in a health care system with limited resources and with current travel and visitor restrictions. Method(s): Data were prospectively collected on new clinic patients with the following inclusion criteria: children 0 to 6 months old with referred newborn hearing screens via AABR from August 2020 to October 2020 at Children's Hospital of Michigan. All patients were initially rescreened with repeat AABR. ASR, DPOAE, and tympanometry data from selected patients were collected. Patients were noted to have either normal or abnormal responses from each test using preset parameters. Screening methods were then compared. Result(s): Thirty-eight children were recruited in the study including 76 ears. On repeat AABR, 13% of children and 6% of ears were referred again. Of those that failed the second AABR, 40% had abnormal tympanometry compared with 6% of those that passed. The DPOAE results correlated with AABR findings in all but 1 patient. Acoustic reflex testing was abnormal in 2.6% of patients, which all correlated with referred AABRs. Further statistical analysis is being done to evaluate for significant correlations. Conclusion(s): AABR revealed equivocal results when compared with results of DPOAE, ASR, and tympanometry. This study was limited by the number of patients included, given the current COVID-19 pandemic. Many sites lack AABR capabilities, and given our findings, these alternative auditory tests can be considered in health care settings with limited resources. With further research and greater sample size, these readily available audiologic tests may be considered as simple, reproducible, and sensitive screening alternatives.
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Objective: The COVID-19 pandemic drove the need for remote audiometric testing in the form of mobile applications for hearing assessment. This study sought to determine the accuracy of two smartphone-based hearing assessment applications, Mimi and uHear, against the gold standard of in-clinic audiometric testing. Methods: One hundred patients that presented to clinic for hearing assessment were randomly assigned to take either the Mimi or uHear hearing test alongside standard audiometric testing. Hearing thresholds measured using mobile applications were compared to those from audiometric testing to assess validity. Patient satisfaction was measured using a questionnaire that queried if the app met the user's need, if they would recommend the app to others, and how likely they were to use the app again. Results: Using Mimi, there were no differences in average hearing levels measured at any frequency when compared to standard audiometric testing. uHear overestimated hearing loss at 500 and 1000 Hz (p < .001 for both) by 5-10 Hz, and underestimated hearing loss at 6000 Hz (p < .001) by 5-10 Hz compared to standard audiometric testing. When stratified by level of hearing impairment, uHear overestimated impairment in those with normal hearing (p < .001). Mimi had higher sensitivity (0.971) and specificity (0.912) for hearing loss (defined as a pure tone average for 500, 1000, 2000, and 4000 Hz greater than 25 dB) than uHear (0.914 and 0.780, respectively). However, uHear outranked Mimi on all three questions in the satisfaction questionnaire (p = .01, p = .03, and p = .02, respectively). Conclusion: Mimi appears to be a reasonable substitute for standard audiometric testing when individuals cannot present to clinic for gold standard testing; however, the Mimi user experience can be improved. Level of evidence: Level II.
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Objective: To promote tele-audiology, the smartphone online applications (APP) for assessment of hearing function need to be validated. We present our preliminary report of one such APP that we adapted during the active COVID phase of 2021. Methodology: A total of 44 patients underwent both pure tone audiometry (PTA) and APP-based hearing assessment. The air conduction thresholds at 500 Hz, 1000 Hz, 2000 Hz, 3000 Hz, 4000 Hz, 6000 Hz and 8000 Hz were noted. Results: A significant correlation was seen between the thresholds and paired differences. However, air-conduction (AC) thresholds of either PTA or APP were shown to overshoot each other and right side values were more consistent. Conclusions: While suggestions have been made to overcome these inconsistencies, the APP-based hearing assessment is likely to improve tele-audiology as relevant modifications by the manufacturer are incorporated to improve its efficacy.
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Clinic closures across the United States in response to the coronavirus disease 2019 (COVID-19) pandemic meant that many audiology services were reduced to phone calls, video visits, and modified services (e.g., curbside, mail-ins, drop offs). Audiologists and other providers needed a way to manage hearing- and ear-related complaints via telehealth. A simple pure tone air conduction threshold test performed at home was used to determine which patients needed to come into the clinic for an in-person appointment. This case will review a 56-year-old male who was being treated for an idiopathic sudden sensorineural hearing loss prior to clinic closure. He had on file a comprehensive audiogram at first onset of symptoms and was treated with oral steroids. Virtual hearing testing was then utilized for a variety of other patients from teenagers to adults to triage hearing- and ear-related complaints while clinics were closed for in-person visits.
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INTRODUCTION: Distortion product otoacoustic emission (DPOAE) was measured to investigate the effect of mask use and type on oxygen saturation on cochlear function in health care professionals during the COVID-19 pandemic. MATERIAL AND METHODS: Group 1 participants wore surgical masks; Group 2 participants wore N95 masks. Distortion product otoacoustic emission and oxygen saturation were measured in both groups before and after mask use. RESULTS: Comparison of signal-to-noise ratio (SNR) values before and after surgical mask use in DPOAE measurements of group 1 revealed statistically significant difference in the right and left ears. Comparison of the SNR values in DPOAE measurements of group 2 before and after 8 hours of N95 mask use revealed statistically significant differences in the right ear at 988, 2963, 4444, and 8000 Hz and in the left ear at 8000 Hz. CONCLUSION: We found that prolonged mask use may affect the outer hair cells in the cochlea, causing deterioration in DPOAE values.
ABSTRACT
BACKGROUND/OBJECTIVES: Age-related hearing loss (ARHL) is a widely prevalent yet manageable condition that has been linked to neurocognitive and psychiatric comorbidities. Multiple barriers hinder older individuals from being diagnosed with ARHL through pure-tone audiometry. This is especially true during the COVID-19 pandemic, which has resulted in the closure of many outpatient audiology and otolaryngology offices. Smartphone-based hearing assessment apps may overcome these challenges by enabling patients to remotely self-administer their own hearing examination. The objective of this review is to provide an up-to-date overview of current mobile health applications (apps) that claim to assess hearing. DESIGN: Narrative review. MEASUREMENTS: The Apple App Store and Google Play Store were queried for apps that claim to assess hearing. Relevant apps were downloaded and used to conduct a mock hearing assessment. Names of included apps were searched on four literature databases (PubMed/MEDLINE, EMBASE, Cochrane Library, and CINAHL) to determine which apps had been validated against gold standard methods. RESULTS: App store searches identified 44 unique apps. Apps differed with respect to the type of test offered (e.g., hearing threshold test), cost, strategies to reduce ambient noise, test output (quantitative vs qualitative results), and options to export results. Validation studies were identified for seven apps. CONCLUSION: Given their low cost and relative accessibility, smartphone-based hearing apps may facilitate screening for ARHL, particularly in the setting of limitations on in-person medical care due to COVID-19. However, app features vary widely, few apps have been validated, and user-centered designs for older adults are largely lacking. Further research and validation efforts are necessary to determine whether smartphone-based hearing assessments are a feasible and accurate screening tool for ARHL. Key Points Age-related hearing loss is a prevalent yet undertreated condition among older adults. Why Does this Paper Matter? Smartphone-based hearing test apps may facilitate remote screening for hearing loss, but limitations surrounding app validation, usability, equipment calibration, and data security should be addressed.