Ambient noise limits efficacy of smartphone-based screening for hearing loss in children at risk
Regan C Manayan1, Olivia H Ladd-Luthringshauser2, Alison Packer3
1Tufts University School of Medicine, Boston, MA, United States of America.
Insights
The hearScreen® smartphone app shows promise as an accessible tool for identifying hearing loss in at-risk children. While sensitive for conductive hearing loss, ambient noise may affect accuracy, particularly at 500 Hz.
Area of Science:
- Pediatric Audiology
- Mobile Health Technology
- Hearing Screening
Background:
- Hearing loss in children poses significant developmental risks.
- Children with chronic otitis media and craniofacial anomalies are at higher risk.
- Effective and accessible screening methods are crucial for early detection.
Purpose of the Study:
- To evaluate the efficacy of hearScreen®, a smartphone-based audiometric screening tool.
- To determine if hearScreen® can effectively identify hearing loss in pediatric patients at risk.
- To assess the performance of hearScreen® compared to conventional audiometry.
Main Methods:
- A prospective, cross-sectional study involving 208 pediatric ears at risk.
- Comparison of hearScreen® results with conventional pure tone audiometry.
- Evaluation of sensitivity, specificity, and predictive values.
Main Results:
- HearScreen® demonstrated 85% sensitivity and 87% negative predictive value.
- Specificity was 41% and positive predictive value was 36%.
- The tool showed increased sensitivity for detecting conductive hearing loss.
Conclusions:
- HearScreen® offers a potentially accessible and low-cost hearing screening option for at-risk children.
- The method is particularly sensitive for conductive hearing loss.
- Ambient noise, especially at 500 Hz, may lead to false positives, warranting further investigation.
Objective:
To determine if hearScreen®, a smartphone-based pure tone audiometric screen, serves as an effective hearing screen for identifying hearing loss in children at risk, such as those with chronic otitis media and/or craniofacial anomalies.
Methods:
A cross-sectional, single-center, prospective study at an urban tertiary care hospital was completed. From June to October 2019, a total of 208 pediatric ears at risk for hearing loss were evaluated by both hearScreen® and conventional pure tone audiometry. The efficacy of hearScreen® for detecting hearing loss in a pediatric population at risk was determined.
Results:
A total of 208 pediatric ears at risk for hearing loss were screened. HearScreen® demonstrated a sensitivity of 85%, a specificity of 41%, a positive predictive value of 36%, and a negative predictive value of 87%. Subgroup analysis stratified by hearing loss type showed that hearScreen® screens for conductive hearing loss with increased sensitivity.
Conclusions:
This investigation suggests that hearScreen® may serve as a an accessible, low-cost, and sensitive pure tone audiometric screen for hearing loss in children at risk, particularly those with conductive hearing loss, with the caveat that it may generate a high proportion of false positives due to the influence of ambient noise, especially when screening at 500 Hz. Future investigations should weigh the utility of including 500 Hz in the screening protocol as well as assess methods that may mitigate the influence of ambient noise during a pure-tone audiometric screen.
