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Comparison of screening methods for conductive hearing loss identification in children: low-cost proposal
A G Samelli1, C M Rabelo, M B Pereira
1Department of Physical Therapy, Speech-language Pathology and Audiology, and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil. alesamelli@usp.br
Insights
Combining a questionnaire with imitanciometry screening significantly improves the accuracy of identifying children at risk for conductive hearing loss, offering a more reliable diagnostic tool.
Area of Science:
- Pediatric Audiology
- Screening Methodologies
- Conductive Hearing Loss
Background:
- Conductive hearing loss in children can impede development.
- Early identification is crucial for timely intervention.
- Existing screening methods require optimization for accuracy.
Purpose of the Study:
- To assess the efficacy of imitanciometry screening and a risk factor questionnaire.
- To compare these methods against a comprehensive audiologic evaluation.
- To determine the optimal combination for identifying children at risk.
Main Methods:
- A cohort of 507 children (3-6 years) was screened.
- Imitanciometry screening and a hearing loss risk questionnaire were administered.
- Results were compared to a gold standard complete audiologic evaluation.
Main Results:
- The combined approach (questionnaire followed by imitanciometry) demonstrated a higher odds ratio.
- Sequential testing showed improved sensitivity and a better false-positive rate (ROC curve analysis).
Conclusions:
- A combined screening strategy enhances accuracy in identifying at-risk children.
- The sequential application of questionnaire and imitanciometry is the most effective tool.
- This integrated method improves early detection of conductive hearing loss.
Objective:
To evaluate the effectiveness of two screening methods (imitanciometry screening and questionnaire) to identify children at risk for conductive hearing loss, comparing this data with complete audiologic evaluation.
Methods:
Of 507 children aged between three and six, 111 completed all procedures. The observational methods used were: imitanciometry screening, a questionnaire to identify risk factors for hearing loss and complete audiologic evaluation. Results obtained in the first two instruments were compared with results from complete audiologic evaluation (gold standard). From these comparisons, sensitivity and specificity, accuracy, positive and negative predictive values, and odds ratio were determined for the two screening methods and for the combination of both methods.
Results:
The two methods applied in series (questionnaire and after imitanciometry screening) showed a greater odds ratio and better correlation between sensitivity and proportion of false-positives (ROC curve).
Conclusion:
Combining the two tests in series improved screening accuracy. This combination was the best tool for identifying children at risk for conductive hearing loss.
