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Hearing screening with portable screening pure-tone audiometer and distortion-product otoacoustic emissions
Yi-Fen Wang1, Sun-Sang Wang, Chun-Ching Tai
1Department of Otolaryngology, Taipei Veterans General Hospital, Taiwan, ROC.
Background:
Hearing loss is a prevalent chronic problem among adults of all ages. Early identification and intervention for hearing loss will reduce the magnitude of functional disability. Hearing screening is an important item of physical examination. The purpose of this study is to evaluate the validity of hearing screening by means of the portable screening pure-tone audiometer and distortion-product otoacoustic emissions (DPOAE) measurement.
Methods:
This prospective study recruited 64 subjects visiting Taipei Veterans Hospital for physical examination. They underwent hearing tests performed with screening pure-tone audiometer, DPOAE and conventional pure-tone audiometer. The results of conventional pure-tone audiometry were used for "gold standards" and the normal auditory function was defined as the threshold less than or equal to 20 dB. Compared with the "gold standards," we used kappa statistic to assess the agreement of hearing results measured with screening pure-tone audiometer and DPOAE.
Results:
For screening pure-tone audiometry, the kappa values at the 5 tested frequencies (0.5, 1, 2, 4, 8 kHz) ranged from 0.79 to 0.93 and the agreement with the gold standards was classified as "excellent." The sensitivity, specificity and test accuracy values ranged from 91.8-98.5%, 88.0-96.3% and 89.8-96.9%, respectively. For DPOAE measurement, the kappa values at the 3 tested frequencies (1, 2, 4 kHz) ranged from 0.62 to 0.78. The agreement was classified as "good" at 1, 4 kHz and "excellent" at 2 kHz. The sensitivity, specificity and test accuracy values ranged from 91.7-98.5%, 62.3-86.8% and 81.3-89.1%.
Conclusions:
We recommend a hearing screening measured at 0.5, 1, 2, 4, 8 kHz with screening pure-tone audiometer in a simple-type soundproof chamber and performed by a screening assistant. The DPOAE measurement may be used as an auxiliary tool to provide more information for early identification and differential diagnosis of hearing loss in clinical application.