Empowering Radiographers: A Call for Integrated AI Training in University Curricula.

Background: Artificial intelligence (AI) applications are rapidly advancing in the field of medical imaging. This study is aimed at investigating the perception and knowledge of radiographers towards artificial intelligence. Methods: An online survey employing Google Forms consisting of 20 questions regarding the radiographers' perception of AI. The questionnaire was divided into two parts. The first part consisted of demographic information as well as whether the participants think AI should be part of medical training, their previous knowledge of the technologies used in AI, and whether they prefer to receive training on AI. The second part of the questionnaire consisted of two fields. The first one consisted of 16 questions regarding radiographers' perception of AI applications in radiology. Descriptive analysis and logistic regression analysis were used to evaluate the effect of gender on the items of the questionnaire. Results: Familiarity with AI was low, with only 52 out of 100 respondents (52%) reporting good familiarity with AI. Many participants considered AI useful in the medical field (74%). The findings of the study demonstrate that nearly most of the participants (98%) believed that AI should be integrated into university education, with 87% of the respondents preferring to receive training on AI, with some already having prior knowledge of AI used in technologies. The logistic regression analysis indicated a significant association between male gender and experience within the range of 23-27 years with the degree of familiarity with AI technology, exhibiting respective odds ratios of 1.89 (COR = 1.89) and 1.87 (COR = 1.87). Conclusions: This study suggests that medical practices have a favorable attitude towards AI in the radiology field. Most participants surveyed believed that AI should be part of radiography education. AI training programs for undergraduate and postgraduate radiographers may be necessary to prepare them for AI tools in radiology development.

Knowledge, Attitude, and Practice of Hearing Loss Among Physicians in Jordan.

PURPOSE: The aim of this study is to assess the knowledge, attitude, and practice of physicians regarding hearing loss and its management among children in Jordan as an example of developing countries. METHOD: The cross-sectional survey composed of 18 questions was used to fulfill the aim of the study. The study population consisted of 335 physicians working in Jordan, with different specialties. The data were collected through site visits to a variety of health care facilities, as well as an online version of the survey to facilitate data collection and ensure participants' comfort. RESULTS: The majority of physicians (30.7%) were general practitioners or family doctors, followed by pediatricians (12.8%). Most of the physicians (88.7%) had experience ranging from 1 to 10 years; the majority of physicians (60.3%) were younger than 30 years of age. Most of the physicians identified the importance of newborn hearing screening. Physicians showed limited knowledge about the management and intervention of infants with permanent hearing loss. Only 11.5% of respondents would refer a child with confirmed hearing loss to an audiologist, and 1.9% of them would refer to a speech therapist. Even though the majority of the physicians (69.0%) reported not receiving any training to deal with deaf and hard of hearing children, they felt confident in talking with parents about hearing loss and its management. CONCLUSIONS: This study revealed that physicians have limited knowledge regarding hearing loss in children as well as its management and intervention. Furthermore, this study illustrates the need for more ongoing medical education programs regarding hearing loss in children.

Audiology practice during COVID-19 crisis in Jordan and Arab countries.

OBJECTIVE: This study investigated audiologists' knowledge of COVID-19 characteristics and infection control measures they followed during the COVID-19 pandemic. Moreover, it examined the impact of COVID-19 on audiology practice, and audiologist's knowledge of telehealth as an alternative. DESIGN: A web-based cross-sectional study using a questionnaire consisting of four sections. STUDY SAMPLE: This study engaged 164 audiologists practicing in Jordan and Arab countries. RESULTS: Fever, cough, difficulty in breathing, and fatigue were identified as COVID-19 characteristics by over 80% of the audiologists. Other symptoms were identified by less than half of the audiologists. The audiologists showed limited knowledge regarding measures against COVID-19 transmission. This study revealed the limited availability of infection control measures in many audiologists' workplace. The majority of audiologists stopped working due to the COVID-19 crisis and only 61.6% of the audiologists were familiar with the concepts of tele-audiology and its related aspects. However, most participants were keen to learn more. CONCLUSIONS: This study revealed limited knowledge among audiologists regarding some of the COVID-19 characteristics, and limited compliance with the infection control policies. Limited knowledge in the application of telehealth in audiology practice was also shown.

The Effects of Clinical Factors and Neonatal Morbidities on Hearing Screening among Neonatal Admissions.

BACKGROUND: Hearing loss is an important disorder affecting newborns admitted to NICU. A national hearing screening program using otoacoustic emission testing is an essential tool to identify hearing loss early in neonates, enabling early intervention to avoid further challenges of pediatric deafness. On the other hand, a delay of the auditory pathway maturation in preterm babies compared to term newborns has already been suggested in the literature. Taking this information into account, in this paper, we aim to identify the best time to perform NICU infant hearing screening tests. OBJECTIVES: We aim to study the clinical factors and neonatal morbidities that may affect neonatal hearing screening results using otoacoustic emission test in order to decrease the false-positive test results that increase parental anxiety and increase the need for subsequent investigations. METHODS: This is a prospective cross-sectional study that included 204 infants who were admitted to a tertiary referral hospital NICU unit between September 2017 and May 2018. Both transients evoked otoacoustic emissions (TEOAE), and distortion product otoacoustic emission (DPOAE) screening tests were performed in order to screen hearing loss. RESULTS: Our study included 204 infants, 52.9 % of which were males and 47.1 % females. There were correlations between both hyperbilirubinemia and ventilation ≥ 5 days and the failure rate of the first OAE test results among NICU infants where the P-values were (p=0.0133) and (p=0.0456), respectively. Moreover, 165 babies (80.9 %) passed the first OAE with a mean birth weight of 2759 gram and mean maternal age of 30.6 years, while 39 babies (19.1 %) failed the test with a mean birth weight of 2436 gram and a mean maternal age of 32 years. There was no statistically significant relation between both maternal age and birth weight with failure of the first screening test. CONCLUSION: Our study suggests a higher failure rate of the first OAE in NICU infants who had hyperbilirubinemia or ventilation ≥ 5 days. Therefore, our recommendation is to postpone the first phase of hearing screening for those infants until the first scheduled vaccine appointment to achieve high compliance to attendance and decrease distress to the family that can be associated with false-negative results of the test.

Invoking the influence of emotion in central auditory processing to improve the treatment of speech impairments.

OBJECTIVES: To explore the benefits of invoking unconscious sentiment to improve the treatment of stuttering and misarticulation. METHODS: This cross-sectional study of 80 participants with speech issues (44 patients with misarticulation and 36 with stuttering) who underwent comprehensive speech and hearing evaluations to confirm and diagnose speech difficulties. Speech and language pathologists then calculated either the percentage of correctly pronounce sounds in misarticulation cases or stuttering severity index-4 scores in cases of stuttering following the use of therapeutic stimuli recorded with familiar and non-familiar voices of similar linguistic and phonetic complexity. Descriptive and inferential statistics were used to compare the data collected following the use of familiar and unfamiliar stimuli. RESULTS: The analysis showed that the number of dysfluencies in cases of stuttering were significantly fewer when employing familiar voices than unfamiliar voices (3% errors vs 12% errors; Z= -5.16 p<0.001). Additionally, the percentages of correct pronouncing of target sounds in cases of articulation disorders were prominently higher when using familiar voices compared with unfamiliar voices (88% PCC vs 66% PCC; Z= -5.65, p<0.001) CONCLUSION: This study confirms the utility of invoking emotion in improving speech therapy and maximizing therapeutic outcomes. This study also recommends engaging families and friends in providing speech services to the speech-impaired population to improve patient progress.

The effects of mode of delivery, maternal age, birth weight, gender and family history on screening hearing results: A cross sectional study.

INTRODUCTION: Congenital hearing impairment is one of the principal issues that make distress to families especially those with a family history of hearing problems. Early detection of hearing impairment can make a difference regarding cognitive, attention, learning, speech, and social and emotional development of babies. Otoacoustic test emission is a very common screening test that can be used to pick up early cases and relieve family stress. We tried to evaluate the factors that may disrupt our results regarding the OAE test. METHODS: A cross-sectional study included infants who were admitted to the nursery unit alone. Infants who were admitted to the NICU unit, infants with craniofacial anomalies, infants with vernix in the external auditory canal, and Infants with Stigmata associated with a syndrome known to include a sensorineural hearing loss were excluded from the study. Both transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) Screening tests were performed by the same professional audiologist experienced in neonatal screening. RESULTS: A total of 1413 newborns (733 males and 680 females) were included in the study. Among them, 1368 babies (96.8%) passed the first OAE in both ears, while 45 babies (3.2%) didn't pass the first OAE in one or both ears.Significant correlations between the female gender and family history of congenital hearing loss with failure of the first OAE test results. Moreover, vaginal delivery (VD) infants had a 1.5-fold higher failure rates of first OAE test screening results in comparison to caesarian delivery (CD) infants. CONCLUSION: Our study demonstrated higher failure rates of the first OAE in female infants, vaginal delivery infants, and infants with a family history of hearing impairment. It is recommended to postpone the first phase of hearing screening for those infants until the first scheduled vaccine appointment to achieve higher compliance attendance, and decrease family stress associated with false-negative results of the test.

Knowledge and Practice of Hearing Screening and Hearing Loss Management among Ear, Nose, and Throat Physicians in Jordan.

Introduction One of the main factors that affect the early diagnosis and intervention of hearing loss is inadequate knowledge by the health care workers. Ear, nose, and throat (ENT) specialists are the main source of information about hearing loss and its management in most developing countries, such as Jordan. Objective The purpose of the present study is to explore the level of knowledge and the practice of hearing screening and hearing loss management for children among ENT physicians in Jordan as an example of health care providers in developing countries of the Middle East. Methods This was a cross-sectional study, adapting a questionnaire of knowledge and the practice of hearing screening and hearing loss management for children. The questionnaire consisted of 2 sections with 20 questions. A total of 40 ENT physicians completed the questionnaire. Results The majority of the respondents acknowledged the importance of hearing screening for children; however, there was limited knowledge regarding hearing loss management and testing. Only 10 of the ENT physicians believed that a referral to an audiologist is warranted, and the majority of the respondents were not aware that a child with a confirmed permanent hearing loss should be referred to a speech pathologist or to a rehabilitation center. Managing unilateral and mild sensorineural hearing loss (SNHL) was another area about which ENT physicians have limited knowledge. Conclusion There is a strong need for professional intervention programs, providing the latest updates and standardizations in the field of audiology and pediatric rehabilitation for ENT physicians.

Challenges facing users of hearing aids during the COVID-19 pandemic.

OBJECTIVES: To explore the difficulties and obstacles of hearing-technology users during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: Descriptive, cross-sectional study. STUDY SAMPLE: Individuals with permanent hearing loss (n = 278) answered a questionnaire designed to identify potential obstacles caused by using hearing aids during the COVID-19 pandemic, along with the reasons and deleterious effects associated with the devices. Each category reflected challenges in communicating, learning, and working during the pandemic. Different response categories were compared using descriptive and inferential statistics. RESULTS: The duration of daily device usage before the imposed lockdown was significantly higher than that during (Z = -2.01, p < 0.05), potentially attributable to the pandemic-induced difficulties faced by hearing-technology users. Such challenges include the shortage of batteries for hearing devices, limited access to repair or programming services of said devices and accessories, termination of speech therapy sessions, and obstacles to employment and education. CONCLUSIONS: Among audiologists, efficiency and professionalism are required to educate the public and private health sectors regarding the prevalent challenges and their harmful impact on hearing-technology users during the COVID-19 pandemic. To overcome these issues, awareness of telepractice and its importance in providing audiological services to hard of hearing individuals should be raised.

Knowledge and Practice of Hearing Screening and Hearing Loss Management among Ear, Nose, and Throat Physicians in Jordan

Abstract Introduction One of the main factors that affect the early diagnosis and intervention of hearing loss is inadequate knowledge by the health care workers. Ear, nose, and throat (ENT) specialists are the main source of information about hearing loss and its management in most developing countries, such as Jordan. Objective The purpose of the present study is to explore the level of knowledge and the practice of hearing screening and hearing loss management for children among ENT physicians in Jordan as an example of health care providers in developing countries of the Middle East. Methods This was a cross-sectional study, adapting a questionnaire of knowledge and the practice of hearing screening and hearing loss management for children. The questionnaire consisted of 2 sections with 20 questions. A total of 40 ENT physicians completed the questionnaire. Results The majority of the respondents acknowledged the importance of hearing screening for children; however, there was limited knowledge regarding hearing loss management and testing. Only 10 of the ENT physicians believed that a referral to an audiologist is warranted, and the majority of the respondents were not aware that a child with a confirmed permanent hearing loss should be referred to a speech pathologist or to a rehabilitation center. Managing unilateral and mild sensorineural hearing loss (SNHL) was another area about which ENT physicians have limited knowledge. Conclusion There is a strong need for professional intervention programs, providing the latest updates and standardizations in the field of audiology and pediatric rehabilitation for ENT physicians.

Neonatal Screening for Congenital Hearing Loss in the North of Jordan; Findings and Implications.

BACKGROUND: Congenital hearing loss is one of the important illnesses that affect newborns. Early diagnosis and treatment are a challenge for medical authorities in developing countries to improve children's functional, intellectual, emotional, and social abilities. We aimed to study the prevalence of congenital hearing loss in northern Jordan community and identify factors that could affect hearing screening protocol. METHODS: Prospective cross-sectional study of 1595 infants born in our hospital underwent hearing screening tests. Totally, 104 were tested in NICU and the rest examined in the nursery room using Otoacoustic emission (OAE) test as a primary testing tool. The patients were followed in the three hearing screening phases. Factors affecting screening results were studied and analyzed. RESULTS: The total number of newborns who didn't pass the first OAE test in one or both ears were 90 (5.6%); 69 from the nursery group and 21 from the NICU group. In the 2nd screening phase 21 (23.3%) didn't attend the appointment. Sixty-four passed the second screening OAE test. Five newborns (5.6%) had a second refer result in one or both ears and referred for a diagnostic ABR test. Three infants passed the test and two found to have bilateral hearing loss. CONCLUSIONS: Hearing screening test is conducted via a 3-phases-protocol. OAE is used in the first two phases and ABR in the third phase. Hearing results is significantly affected for infants admitted to NICU. The following factors increase OAE fail response: mechanical ventilation for more than 5 days, Hyperbilirubinemia, associated congenital anomalies. Mode of delivery doesn't have statistical significance on hearing screening results.

Adaptation of the Arabic versions of the Hearing Handicap Inventory for adults and elderly with permanent sensorineural hearing loss.

Objective: To translate the Hearing Handicap Inventory for Adults (HHIA) and Hearing Handicap Inventory for the Elderly (HHIE) into Arabic while ensuring that the reliability and validity are the same as those of the original English versions.Design: Descriptive, cross-sectional study.Study sample: In total, 115 individuals with hearing impairment and 114 controls with normal hearing completed the Arabic versions of HHIA/HHIE. Each subject underwent a complete audiological evaluation before answering the questionnaires. The construct and discriminant validities were determined in addition to the reliability, which was investigated by calculating the internal and test-retest consistencies.Results: Internal consistency between the total and subscale scores were excellent for the Arabic versions of HHIA and HHIE (Cronbach's alpha: ∼0.90). With regard to the test-retest reproducibility, the Spearman's correlation coefficient for consistency between total scores obtained at baseline and those obtained at 6 weeks was acceptable (r = 0.761, p < 0.0001). The total scores were statistically proportional to the degree of hearing loss. Moreover, the questionnaire successfully differentiated between individuals with hearing impairment and those with normal hearing.Conclusions: Our findings clarified that the Arabic versions of HHIA and HHIE are acceptable tools for evaluating the psychological influences of hearing loss in Arabic populations.

Parents' satisfaction with a trial of a newborn hearing screening programme in Jordan.

OBJECTIVE: This study examines parents' satisfaction level toward a trial of a newborn hearing screening programme (NHSP) that was applied in King Abdullah II University Hospital (KAUH) in Jordan over one year. This is the first study that investigated parents' satisfaction toward a hearing screening programme in the Arab countries, and the results will improve any future screening programmes in the Arabian region. METHOD: The main tool for this study was a questionnaire that was translated and modified from the original version of the Parental Satisfaction with the Newborn Hearing Screening Programme (PSQ-NHSPs1). The questionnaire consisted of 19 items covering five main aspects of the NHSP. The parents' responses were not anonymously given where the parents whose children had undergone the hearing screening were contacted by phone using the data record of the hospital. RESULTS: The majority of the parents were very satisfied with the programme overall and showed great support and appreciation for the effort in testing their babies and increasing their awareness. The satisfaction levels varied among the specific aspects of the programme. Good portion of the parents did not receive the brochure containing information about the screening, and almost half of them did not know the results of the hearing screening. CONCLUSION: Parents were overall satisfied with neonatal hearing screening programme that was conducted at KAUH. However, parents were less satisfied with information related to the test procedure and results. Parents' responses in this study could be used to improve any future hearing screening program in Jordan or in the Arab countries.

Diagnostic reference levels for paediatric CT in Jordan.

This study aimed to investigate the current status of Diagnostic Reference Levels (DRLs) in paediatric CT across Jordan. The dose data for four main CT examinations (brain, chest, abdominopelvic, and chest, abdomen and pelvis (CAP)) in hospitals and imaging centres (n = 4) were measured. The volume CT dose index (CTDIvol) and Dose Length Product (DLP) values were compared within the different hospitals and age groups (<1 year, 1-4 years, 5-10 years and 11-18 years). DRLs in Jordan were compared to international DRLs. The paediatric population consisted of 1818 children; 61.4% of them were male. There were significant variations between the DRLs for each CT scanner with an up to four-fold difference in dose between hospitals. There were apparent significant differences between Jordan and other countries with the DLPs in Jordan being relatively high. However, for CTDIvol, the values in Jordan were close to those of other countries. This study confirmed variations in the CTDIvol and DLP values of paediatric CT scans in Jordan. These variations were attributed to the different protocols and equipment used. There is a need to optimise paediatric CT examinations doses in Jordan.

Establishment of diagnostic reference levels in cardiac computed tomography.

The aim of this study was to determine diagnostic reference levels (DRLs) for cardiac computed tomography (CCT) in Jordan. Volume computed tomography dose index (CTDIvol ) and dose-length product (DLP) were collected from 228 CCTs performed at seven Jordanian hospitals specialized in cardiac CT. DRLs for cardiac CT were defined at the 75th percentile of CTDIvol and DLP. CTDIvol and DLP were collected from 30 successive cardiac CT in each center except for one center (18 scans). The 75th percentile of the CTDIvol and the DLP of the centers calculated from mixed retrospective and prospective gated modes were 47.74 milligray (mGy) and 1035 mGy/cm, respectively. This study demonstrated wide dose variations among the surveyed hospitals for cardiac CT scans; there was a 5.1-fold difference between the highest and lowest median DLP with a range of 223.2-1146.7 mGy/cm. Differences were associated with variations in the mAs and kVp. This study confirmed large variability in CTDIvol and DLP for cardiac CT scans; variation was associated with acquisition protocols and highlights the need for dose optimization. DRLs are proposed for CCT; there remains substantial potential for optimization of cardiac CT examinations for adults in Jordan.

Knowledge and practice of computed tomography exposure parameters amongst radiographers in Jordan.

OBJECTIVE: To investigate the knowledge and practice of computed tomography (CT) radiographers working in Jordan. MATERIALS AND METHODS: This Institutional Review Board (IRB) approved study disseminated a questionnaire via social media and recruited 54 Jordanian CT radiographers. The questionnaire comprised 36 questions divided into four sections: demographics; an evaluation of knowledge regarding CT exposure; modifications to CT exposure for paediatric patients; dose units and diagnostic reference levels (DRLs). Descriptive and inferential statistics including Chi-square tests, Mann-Whitney U tests, independent samples t-tests and Kruskal-Wallis H tests were employed. Statistical significance was considered below p < 0.05. RESULTS: The 54 participants had various qualifications, with the majority holding a Bachelor's degree (n = 35, 64.8%) and the rest holding a Diploma (n = 19, 35.2%). In order to pass the questionnaire, participants needed to score 13 correct answers. The overall number of radiographers who correctly passed the questionnaire was 48 (88.9%). None of the participants correctly stated all the DRL values for chest, abdomen and brain CT. However, four out of 54 respondents (7.4%) knew the chest DRL value, three (5.6%) participants correctly estimated the abdominal DRL value but only two (3.7%) knew the DRL for the brain. CONCLUSION: Good general knowledge was found amongst radiographers regarding the relationship of each exposure parameter to the image quality and patient dose. However, there was poor knowledge of diagnostic reference levels and the order of the organ radiation sensitivity. The need for CT radiographers to undertake further education that focuses on radiation exposure in CT is highlighted.

Breast lesion shape and margin evaluation: BI-RADS based metrics understate radiologists' actual levels of agreement.

BACKGROUND: While there is much literature describing the radiologic detection of breast cancer, there are limited data available on the agreement between experts when delineating and classifying breast lesions. The aim of this work is to measure the level of agreement between expert radiologists when delineating and classifying breast lesions as demonstrated through Breast Imaging Reporting and Data System (BI-RADS) and quantitative shape metrics. METHODS: Forty mammographic images, each containing a single lesion, were presented to nine expert breast radiologists using a high specification interactive digital drawing tablet with stylus. Each reader was asked to manually delineate the breast masses using the tablet and stylus and then visually classify the lesion according to the American College of Radiology (ACR) BI-RADS lexicon. The delineated lesion compactness and elongation were computed using Matlab software. Intraclass Correlation Coefficient (ICC) and Cohen's kappa were used to assess inter-observer agreement for delineation and classification outcomes, respectively. RESULTS: Inter-observer agreement was fair for BI-RADS shape (kappa = 0.37) and moderate for margin (kappa = 0.58) assessments. Agreement for quantitative shape metrics was good for lesion elongation (ICC = 0.82) and excellent for compactness (ICC = 0.93). CONCLUSIONS: Fair to moderate levels of agreement was shown by radiologists for shape and margin classifications of cancers using the BI-RADS lexicon. When quantitative shape metrics were used to evaluate radiologists' delineation of lesions, good to excellent inter-observer agreement was found. The results suggest that qualitative descriptors such as BI-RADS lesion shape and margin understate the actual level of expert radiologist agreement.

The Impact of Clinical History on the Threshold Estimation of Auditory Brainstem Response Results for Infants.

Purpose: This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results. Method: Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st occasion, ABR traces were presented to the audiologists with no clinical information except for the age of the child. On the 2nd occasion, audiologists were given a full clinical history for the ABR cases. Results: The addition of clinical history information had no statistically significant impact on sensitivity, specificity, or accuracy of diagnosis. Although the mean numbers of true-negative and true-positive diagnoses were higher when audiologists were given clinical information, the difference was again not statistically significant. Conclusion: This study suggests that if there are circumstances in which case material is incomplete or unavailable, audiologists have no cause for concern regarding the accuracy of their interpretation of ABR traces. In a clinical manner, this may help audiologists with large caseloads or audiologists who need to provide a diagnosis of hearing loss in a short time by allowing them to focus on conducting ABR without the need for case history information.