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JMIR MHealth and UHealth Sep 2021Hearing loss is one of the most common disabilities worldwide and affects both individual and public health. Pure tone audiometry (PTA) is the gold standard for hearing... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hearing loss is one of the most common disabilities worldwide and affects both individual and public health. Pure tone audiometry (PTA) is the gold standard for hearing assessment, but it is often not available in many settings, given its high cost and demand for human resources. Smartphone-based audiometry may be equally effective and can improve access to adequate hearing evaluations.
OBJECTIVE
The aim of this systematic review is to synthesize the current evidence of the role of smartphone-based audiometry in hearing assessments and further explore the factors that influence its diagnostic accuracy.
METHODS
Five databases-PubMed, Embase, Cochrane Library, Web of Science, and Scopus-were queried to identify original studies that examined the diagnostic accuracy of hearing loss measurement using smartphone-based devices with conventional PTA as a reference test. A bivariate random-effects meta-analysis was performed to estimate the pooled sensitivity and specificity. The factors associated with diagnostic accuracy were identified using a bivariate meta-regression model. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
RESULTS
In all, 25 studies with a total of 4470 patients were included in the meta-analysis. The overall sensitivity, specificity, and area under the receiver operating characteristic curve for smartphone-based audiometry were 89% (95% CI 83%-93%), 93% (95% CI 87%-97%), and 0.96 (95% CI 0.93-0.97), respectively; the corresponding values for the smartphone-based speech recognition test were 91% (95% CI 86%-94%), 88% (95% CI 75%-94%), and 0.93 (95% CI 0.90-0.95), respectively. Meta-regression analysis revealed that patient age, equipment used, and the presence of soundproof booths were significantly related to diagnostic accuracy.
CONCLUSIONS
We have presented comprehensive evidence regarding the effectiveness of smartphone-based tests in diagnosing hearing loss. Smartphone-based audiometry may serve as an accurate and accessible approach to hearing evaluations, especially in settings where conventional PTA is unavailable.
Topics: Audiometry, Pure-Tone; Hearing Loss; Humans; Sensitivity and Specificity; Smartphone; Speech
PubMed: 34515644
DOI: 10.2196/28378 -
Clinical Otolaryngology : Official... Jan 2024Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761)... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy.
DESIGN AND SETTING
A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
PARTICIPANTS
Adults and children, with and without diagnosis of hearing impairment.
MAIN OUTCOME MEASURES
A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL.
RESULTS
Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was Shoebox (6/17) followed by Hearing Test (3/17), then HearTest (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability.
CONCLUSIONS
MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.
Topics: Adult; Child; Humans; Auditory Threshold; Hearing; Hearing Loss; Audiometry; Audiometry, Pure-Tone; Smartphone
PubMed: 37828806
DOI: 10.1111/coa.14107 -
Journal of Clinical Neuroscience :... Jun 2023This study investigates the relationship of superior semicircular canal dehiscence (SSCD) size and location with patient symptomatology and audiometry.
OBJECTIVE
This study investigates the relationship of superior semicircular canal dehiscence (SSCD) size and location with patient symptomatology and audiometry.
METHODS
We retrospectively reviewed SSCD cases presented to a tertiary institution between 2011 and 2022. Dehiscence length and width measured on high-resolution temporal bone computed tomography imaging were used to calculate an approximate dehiscence area (ADA). Dehiscence location was classified employing a six-grade system. Multivariable regression analyses were performed with symptomatology and audiogram metrics as outcome variables and ADA and dehiscence location as the primary covariates of interest.
RESULTS
A total of 402 SSCD were included in the analysis. Controlling for patient age, sex, dehiscence laterality, and location, greater ADA was independently associated higher rates of autophony (aOR 1.39; 95% C.I. 1.14-1.71; P = 0.004) and hyper-amplification (aOR 1.39; 1.14-1.70; P = 0.004). Additionally, dehiscences with greater ADA exhibited significantly lower bone conduction threshold at 500 Hz (adjusted β -1.75, P = 0.006) and 1000 Hz (adjusted β -1.61, P = 0.018) and significantly wider air-bone gap at 500 Hz (adjusted β 2.22, P < 0.001) and 1000 Hz (adjusted β 1.00, P = 0.039). Dehiscence location was not independently associated with any outcome variable examined when accounting for dehiscence size.
CONCLUSION
The size of dehiscence is more independently related to clinical presentations than the anatomical location of the dehiscence in the superior semicircular canal. Greater dehiscence size is associated with symptomatology and audiometry consistent with more severe bone conduction hyperacusis.
Topics: Humans; Semicircular Canal Dehiscence; Retrospective Studies; Tomography, X-Ray Computed; Audiometry; Semicircular Canals
PubMed: 37037168
DOI: 10.1016/j.jocn.2023.04.002 -
The Relationship between Psychoacoustic and Electrophysiological Assessments of Temporal Resolution.Journal of the American Academy of... Mar 2021Temporal resolution is essential to speech acoustic perception. However, it may alter in individuals with auditory disorders, impairing the development of spoken and...
BACKGROUND
Temporal resolution is essential to speech acoustic perception. However, it may alter in individuals with auditory disorders, impairing the development of spoken and written language. The envelope of speech signals contains amplitude modulation (AM) that has critical information. Any problem reducing the listener's sensitivity to these amplitude variations (auditory temporal acuity) is likely to cause speech comprehension problems. The modulation detection threshold (MDT) test is a measure for evaluating temporal resolution. However, this test cannot be used for patients with poor cooperation; therefore, objective evaluation of MDT is essential.
PURPOSE
The main aim of this study is to find the association between the auditory steady-state response (ASSR) and psychoacoustic measurement of MDT at different intensity levels and to assess the amplitude and phase of ASSR as a function of modulation depth.
DESIGN
This was a correlational research.
STUDY SAMPLE
Eighteen individuals (nine males and nine females) with normal hearing sensitivity, aged between 18 and 23 years, participated in this study.
DATA COLLECTION AND ANALYSIS
ASSR was recorded at fixed AM rates and variable AM depths for carrier frequencies of 1,000 and 2,000 Hz with varying intensities. The least AM depth, efficient to evoke an ASSR response, was interpreted as the physiological detection threshold of AM. The ASSR amplitude and phase, as a function of AM depth, were also evaluated at an intensity level of 60 dB hearing level (HL) with modulation rates of 40 and 100 Hz. Moreover, the Natus instrument (Biologic Systems) was used for the electrophysiological measurements. An AC40 clinical audiometer (Intra-acoustic, Denmark) was also used for the psychoacoustic measurement of MDT in a similar setting to ASSR, using the two-alternative forced choice method. Pearson's correlation test and linear regression model and paired -test were used for statistical analyses.
RESULTS
A significant positive correlation was found between psychoacoustic and electrophysiological measurements at a carrier frequency of 1000 Hz, with a modulation rate of 40 Hz at intensity levels of 60 dB HL ( = 0.63, = 0.004), 50 dB HL ( = 0.52, = 0.02). A significant positive correlation was also found at a carrier frequency of 2000 Hz, with a modulation rate of 47 Hz at 60 dB HL ( = 0.55, = 0.01) and 50 dB HL ( = 0.67, = 0.002) and a modulation rate of 97 Hz at 60 dB HL ( = 0.65, = 0.003). Moreover, a significant association was found between the modulation depth and ASSR amplitude and phase increment at carrier frequencies of 1,000 and 2000 Hz, with modulation rates of 40 and 100 Hz.
CONCLUSION
There was a significant correlation between ASSR and behavioral measurement of MDT, even at low intensities with low modulation rates of 40 and 47 Hz. The ASSR amplitude and phase increment was a function of modulation depth increase. The findings of this study can be used as a basis for evaluating the relationship between two approaches in the clinical population.
Topics: Acoustic Stimulation; Adolescent; Adult; Audiometry; Auditory Perception; Auditory Threshold; Female; Hearing Tests; Humans; Male; Psychoacoustics; Young Adult
PubMed: 33873218
DOI: 10.1055/s-0041-1722983 -
European Archives of... Mar 2020The use of standardized outcome parameters is essential for the comparability of clinical studies. Pure-tone audiometry and speech audiometry are widely used, but there... (Review)
Review
OBJECTIVES
The use of standardized outcome parameters is essential for the comparability of clinical studies. Pure-tone audiometry and speech audiometry are widely used, but there is no systematic evaluation of the outcome parameters in clinical application. Nevertheless, there is presumably a great heterogeneity especially in the field of speech audiometry. This study presents a snapshot of the current situation of documentation and usage of outcome parameters in otologic research.
STUDY DESIGN
Retrospective study of existing literature analyzing common speech audiometric test material and procedure MAIN OUTCOME MEASURES: Intervention Studies from 2012 to 2016 concerning hearing ability were eligible for evaluation. Studies were analyzed with regard to study design, pathology and intervention, speech audiometric parameters, pure-tone audiometry, implementation of reporting standards and journal related data.
RESULTS
279 studies were included. Over 50% of the analyzed studies lacked proper documentation. In the remaining studies, there was a broad variance concerning the documented speech audiometric parameters, most often with a fixed presentation level of 65 dB SPL.
CONCLUSION
The lack of generally used standards for reporting hearing outcomes makes it difficult to compare results of different clinical studies. An adequate description of the methods would be a first and important step in improving reports on audiological outcomes.
Topics: Audiometry, Pure-Tone; Audiometry, Speech; Clinical Studies as Topic; Hearing Loss; Humans; Outcome Assessment, Health Care; Quality of Health Care; Retrospective Studies
PubMed: 31758308
DOI: 10.1007/s00405-019-05734-9 -
Irish Journal of Medical Science Feb 2024Subjective tinnitus is an unpleasant perception of sound without any external acoustic stimulus. It can be manifested in the form of various phantom sounds, which most...
BACKGROUND
Subjective tinnitus is an unpleasant perception of sound without any external acoustic stimulus. It can be manifested in the form of various phantom sounds, which most often resemble ringing, whistling, squeaking, noise, chirping, or buzzing. The sounds are heard solely by the sufferer and can occur in the middle of the head, but also in the ears-on one or both sides.
AIM
The aim of the study was to evaluate the hearing capacity based on audiometric threshold measurements in the frequency range of 0.125-16 kHz in patients with tinnitus. In addition, we investigated the following questions: Can high-frequency audiometry be useful in the diagnosis of tinnitus? Does hearing loss occur in an increasingly wide frequency range with age compared to the control group? Can tinnitus be considered the first symptom of the onset of high-frequency hearing loss?
METHODS
The study included 99 patients, all of whom underwent pure-tone audiometry (PTA) and extended high-frequency audiometry (HFA) in the ranges of 0.125-8 kHz and 8-16 kHz, respectively. In each patient (excluding the control group), tinnitus was characterized in terms of its frequency and intensity.
RESULTS AND CONCLUSION
The study concluded that tinnitus may be a symptom indicating the presence of high-frequency hearing loss as hearing loss occurs in an increasingly wider frequency range with age, so HFA should be a routine audiological test in patients with tinnitus.
Topics: Humans; Tinnitus; Audiometry, Pure-Tone; Hearing Loss, High-Frequency; Auditory Threshold
PubMed: 37518821
DOI: 10.1007/s11845-023-03462-y -
Modern Rheumatology Oct 2022The aim of the present study was to evaluate hearing loss in patients diagnosed with systemic sclerosis (SSc) and to investigate the relation between hearing loss,...
OBJECTIVES
The aim of the present study was to evaluate hearing loss in patients diagnosed with systemic sclerosis (SSc) and to investigate the relation between hearing loss, subtypes of the disease, its duration and clinical findings, and antibody positivity.
METHODS
The study included 47 patients with SSc and 44 healthy controls. Audiometric, tympanometric, and otoacoustic emission measurements were applied to both groups.
RESULTS
The evaluation of the participants medical history showed that among the patients with SSc, 19.1% experienced ear fullness, 27.7% experienced vertigo, and 36.2% experienced tinnitus. Hearing loss was detected in 23.4% of the patients with SSc. The corresponding result was 4.3% in the control group with a statistically significant difference (p = 0.001). Transient-evoked otoacoustic emission amplitude values were significantly lower in the patients' both ears with SSc than the control group (p < 0.005). Duration of disease was significantly longer, and diffusing capacity of the lungs for carbon monoxide values were significantly higher in the patients with SSc and sensorineural hearing loss.
CONCLUSIONS
The present study found that the incidence of hearing loss was significantly higher in the study group than in the healthy control group. In addition to other organ involvements, cochlear involvement occurs in these patients, and further studies are required.
Topics: Audiometry; Carbon Monoxide; Hearing Loss; Humans; Otoacoustic Emissions, Spontaneous; Scleroderma, Systemic
PubMed: 34850918
DOI: 10.1093/mr/roab107 -
European Archives of... Feb 2023This study aimed to determine hearing thresholds in an otologically normal population without occupational noise exposure aged 18 to 64 years using extended...
PURPOSE
This study aimed to determine hearing thresholds in an otologically normal population without occupational noise exposure aged 18 to 64 years using extended high-frequency audiometry (EHFA).
METHODS
Individuals from the general population who have never had hearing problems and whose job was not associated with noise exposure were included in the study and classified by age into 5 categories: 18-24 and, further, by 10 years of age. Each of these groups was further divided according to gender. All subjects underwent tympanometry, conventional pure-tone audiometry within the 0.125-8 kHz range, and extended high-frequency audiometry within the 9-16 kHz range, performed according to the standards. The significance level for statistical testing was set at 5%.
RESULTS
Here, we established hearing thresholds in an otologically healthy population within the extended high-frequency (EHF) range (9-16 kHz). We found the EHFA to be a highly sensitive method for early detection of hearing loss, with hearing thresholds decreasing as soon as 35 years of age. In males, the hearing thresholds grew with age more rapidly than in women. The ability to respond at EHF gradually decreased with age and increasing frequency.
CONCLUSION
Our results can help improve the knowledge of EHF hearing thresholds for individual sexes and age groups. So far, the standard 7029:2017 is not binding and, moreover, it only reaches up to the frequency of 12.5 kHz. EHFA is a highly sensitive method for the evaluation of hearing loss depending on age and sex.
Topics: Male; Adult; Humans; Female; Child; Audiometry, Pure-Tone; Hearing; Hearing Loss; Acoustic Impedance Tests; Deafness; Auditory Threshold; Audiometry; Hearing Loss, Noise-Induced
PubMed: 35763083
DOI: 10.1007/s00405-022-07498-1 -
Radiation and Environmental Biophysics Nov 2021Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of... (Review)
Review
Numerous studies have documented the adverse effects of high-dose radiation on hearing in patients. On the other hand, radiographers are exposed to a low dose of ionizing radiation, and the effect of a low dose of radiation on hearing is quite abstruse. Therefore, the present systematic review aimed to elucidate the effect of low-dose ionizing radiation on hearing. Two authors independently carried out a comprehensive data search in three electronic databases, including PUBMED/MEDLINE, CINAHL, and SCOPUS. Eligible articles were independently assessed for quality by two authors. Cochrane Risk of Bias tool was used assess quality of the included studies. Two articles met the low-dose radiation exposure criteria given by Atomic Energy Regulatory Board (AERB) and National Council on Radiation Protection (NCRP) guidelines. Both studies observed the behavioral symptoms, pure-tone hearing sensitivity at the standard, extended high frequencies, and the middle ear functioning in low-dose radiation-exposed individuals and compared with age and gender-matched controls. One study assessed the cochlear function using transient-evoked otoacoustic emissions (TEOAE). Both studies reported that behavioral symptoms of auditory dysfunction and hearing thresholds at extended high frequencies were higher in radiation-exposed individuals than in the controls. The current systematic review concludes that the low-dose ionizing radiation may affect the hearing adversely. Nevertheless, further studies with robust research design are required to explicate the cause and effect relationship between the occupational low-dose ionizing radiation exposure and hearing.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Hearing; Humans; Otoacoustic Emissions, Spontaneous
PubMed: 34302524
DOI: 10.1007/s00411-021-00926-6 -
Test-retest reliability of distortion-product thresholds compared to behavioral auditory thresholds.Hearing Research Jul 2021When referred to baseline measures, serial monitoring of pure-tone behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) can be used to detect the...
When referred to baseline measures, serial monitoring of pure-tone behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) can be used to detect the progression of cochlear damage. Semi-logarithmic DPOAE input-output (I/O) functions enable the computation of estimated distortion-product thresholds (EDPTs) by means of linear regression, a metric that provides a quantitative estimate of hearing loss due to cochlear-amplifier degradation. DPOAE wave interference and a suboptimal choice of stimulus levels limit the accuracy of EDPTs. This work identifies the test-retest reliability of EDPTs derived from short-pulse DPOAE level maps (EDPT), a method that circumvents limitations associated with both wave interference and suboptimal choice of stimulus levels. The test-retest reliability was compared to that of EDPTs derived from semi-logarithmic I/O functions (EDPT) and that of behavioral thresholds acquired with pure-tone audiometry (PTA) and modified Békésy tracking audiometry (TA) to provide a foundation for identifying and interpreting significant threshold shifts. The DPOAE-based auditory thresholds (EDPT and EDPT) and behavioral thresholds (PTA and TA) were recorded seven times within three months at 14 frequencies with f = 1-14 kHz in 20 ears from ten subjects with normal hearing (4PTA < 20 dB HL). To obtain EDPT, short-pulse DPOAEs were recorded using 21 L,L pairs. Reconstruction of DPOAE growth behavior as a function of L and L using nonlinear curve fitting enabled the derivation of EDPT for each frequency. Test-retest reliability was determined using three different approaches: 1) centered thresholds, 2) average threshold differences, and 3) average absolute threshold differences, between each possible test session (N = 21). Test-retest reliability based on centered thresholds and average threshold differences showed no statistically significant difference between EDPT, EDPT, PTA, and TA for the pooled analysis incorporating all stimulus frequencies. Average absolute threshold differences presented small but significant differences in test-retest reliability with median values of 3.00 dB for PTA, 3.20 dB for TA, 3.34 dB for EDPT, and 3.51 dB for EDPT. A considerable frequency dependence of test-retest reliability was found; namely, the highest test-retest reliability was for EDPT at f = 11 - 14 kHz. Otherwise, at lower frequencies, the highest test-retest reliability was for TA at f =1 - 2 kHz. Overall, the test-retest reliability of EDPT was better than that of EDPT and was similar to that for behavioral thresholds. Hence, deriving EDPT from individual level maps is a promising and sensitive method for objectively monitoring the state of the cochlea. Furthermore, the detection of an equidirectional threshold change at a single frequency in both EDPT and TA might allow reducing the threshold shift as indication of a follow-up examination from the clinical standard of 10 dB down to 5 dB. This stricter indicator might be beneficial when monitoring cochlear damage, for example ototoxicity, in the presence of (remnant) cochlear amplification at baseline.
Topics: Audiometry, Pure-Tone; Auditory Threshold; Cochlea; Humans; Otoacoustic Emissions, Spontaneous; Reproducibility of Results
PubMed: 33984603
DOI: 10.1016/j.heares.2021.108232