App-Based Hearing Screenings in Preschool Children With Different Types of Headphones: Diagnostic Study
Pornsek Tananuchittikul1,2, Kwanchanok Yimtae2, Nichtima Chayaopas2
1Department of Otolaryngology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Insights
A mobile app called PASS-Pro effectively screens preschool children for hearing loss using generic headphones. This innovative tool offers high sensitivity and specificity, making hearing tests more accessible.
Area of Science:
- Audiology
- Pediatric Health
- Mobile Health Technology
Background:
- Hearing disability in preschoolers impacts communication and social skills.
- Traditional audiometry is challenging in low-resource settings due to a lack of specialists and equipment.
- Mobile apps offer an accessible and inexpensive alternative for hearing screenings.
Purpose of the Study:
- To evaluate the PASS-Pro app's sensitivity, specificity, and time efficiency.
- To compare the app's performance with TDH39, Beyerdynamic DT 770 PRO, and generic earmuff headphones against standard audiometry.
Main Methods:
- 44 preschool children (4-5 years) participated.
- Children underwent PASS-Pro screenings with three headphone types and standard audiometry.
- Data analyzed for agreement, sensitivity, specificity, and test duration.
Main Results:
- PASS-Pro demonstrated high sensitivity (50% mild, 100% moderate loss) and specificity (>88% mild, >92% moderate loss) across all headphone types.
- No significant differences in performance between reference and generic headphones.
- PASS-Pro screenings were significantly faster than traditional audiometry.
Conclusions:
- The PASS-Pro app, particularly with generic headphones, is a viable tool for preschool hearing screenings.
- This approach enhances accessibility in resource-limited areas.
- Generic headphones are effective alternatives to specialized audiometric headphones for screening.
Background:
Hearing disability in preschool children can delay or impact oral communication and social skills. Provision of hearing screening tests by standard audiometry in low- to middle-income countries is problematic due to a lack of pediatric audiologists, standard hearing equipment, and standard soundproof rooms. Therefore, an innovative hearing screening tool that is easily accessible and inexpensive such as a mobile app should be considered. Headphones have been a crucial part of hearing screenings. Audiometric headphones, which serve as the reference standard, have been used in most studies. However, since audiometric headphones are not accessible in rural areas, we hypothesized that generic headphones can also be used in hearing screenings.
Objective:
This study aimed to determine the sensitivity, specificity, κ coefficiency, and time consumption of the PASS-Pro (Preschool Audiometry Screening System-Pro) app when using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones compared to standard conditioned play audiometry.
Methods:
We recruited preschool children aged 4 to 5 years to participate in this study. The children received 3 PASS-Pro screening tests using different types of headphones in a quiet room and 1 standard conditioned play audiometry in a soundproof room. All tests were administered in random order. The agreement coefficient, sensitivity, specificity, and mean test duration were determined.
Results:
A total of 44 children participated in this study. For mild hearing loss screening, the κ coefficients between standard conditioned play audiometry and the PASS-Pro app using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones were 0.195, 0.290, and 0.261 (P=.02, P=.002, and P=.004), respectively. The sensitivity for all headphones was 50% and the specificity was more than 88%. For moderate hearing loss screening, the κ coefficients were 0.206, 0.272, and 0.235 (all Ps=.001), respectively. The sensitivity for all headphones was 100% and the specificity was more than 92%. There were no statistical differences in sensitivity and specificity between the reference headphone (TDH39), Beyerdynamic DT 770 PRO headphone, and generic earmuff headphones (all Ps >.05). The PASS-Pro app used significantly less time to carry out hearing tests than conditioned play audiometry (P<.001).
Conclusions:
The PASS-Pro app, used with generic headphones, is effective for conducting hearing screening tests in preschool children with high sensitivity and specificity.
