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Evaluation of pure tone audiometry and impedance screening in infant schoolchildren
1South Tees Health Authority, Poole Hospital, Middlesbrough, Cleveland, United Kingdom.
Insights
Impedance screening is a superior method for detecting middle ear changes in children compared to pure tone audiometry. This cost-effective approach offers higher sensitivity and predictive value for identifying hearing loss.
Area of Science:
- Audiology
- Pediatric Health
- Public Health Screening
Background:
- Middle ear changes in children can lead to hearing loss, impacting development.
- Early detection is crucial for timely intervention and management.
- Current screening methods require evaluation for optimal efficacy.
Purpose of the Study:
- To compare impedance measurements with pure tone audiometry for detecting middle ear changes in school children.
- To assess the cost-effectiveness of each screening method for health authorities.
Main Methods:
- A two-stage screening process was employed, offering both pure tone audiometry and impedance screening.
- Pure tone audiometry was conducted by school nurses, while impedance screening was performed by a doctor.
- The study included 610 previously unscreened infant school children across 18 schools.
Main Results:
- Impedance screening demonstrated significantly higher sensitivity and predictive value than pure tone audiometry.
- The specificity of both methods was comparable.
- Impedance screening was found to be faster and more resource-efficient.
Conclusions:
- Impedance screening is a more effective method for identifying middle ear issues associated with hearing loss in school children.
- Further validation through an audit conducted by school nurses is recommended to confirm these findings.
Study Objective:
The aims were (1) to evaluate impedance measurements against pure tone audiometry as a screening method for the detection of middle ear changes associated with hearing loss in infant school children; (2) to estimate the costs of the health authority of each method.
Design:
The study involved two stage screening in which both methods were offered, pure tone audiometry being carried out by school nurses and impedance screening by a doctor.
Setting:
18 infant or primary schools in Langbaurgh, Cleveland, UK.
Participants:
610 previously unscreened infant school children took part in the study.
Measurements And Main Results:
Main outcome measures were the sensitivity, specificity, and predictive value of each screening method, using clinical assessment and action as the validating technique. The sensitivity and the predictive value of a positive test in two stage impedance screening was markedly superior to that of pure tone audiometry. The specificity was similar using the two methods. In addition the impedance methods was more rapid and estimated to consume less resource as a screening procedure than pure tone audiometry.
Conclusions:
The superiority of the use of impedance screening established in this study should be confirmed in a subsequent audit carried out purely by school nurses.
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