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Evaluating the feasibility of a tele-diagnostic auditory brainstem response service in a rural context
Divhanani Sithi1, Samantha M Govender, Thembelihle S Ntuli
1Department of Speech-Language Pathology and Audiology, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria. divhananisithi@gmail.com.
Insights
Tele-diagnostic Auditory Brainstem Response (ABR) testing in mobile clinics is comparable to traditional ABR assessments for infants. This approach can improve hearing healthcare access in rural South Africa.
Area of Science:
- Audiology and Hearing Healthcare
- Telehealth and Mobile Health Technologies
- Pediatric Health Services
Background:
- Significant disparities exist in audiology service access in South Africa, particularly in rural regions.
- Primary healthcare facilities face challenges with audiologist-to-patient ratios.
- Telehealth offers a potential solution to expand hearing healthcare services.
Purpose of the Study:
- To compare tele-diagnostic Auditory Brainstem Response (ABR) results from a mobile clinic van with face-to-face ABR assessments in rural South Africa.
- To evaluate the feasibility of mobile tele-diagnostic ABR for infant hearing assessments.
Main Methods:
- A quantitative, prospective, cross-sectional, within-subject design was employed.
- Infants underwent both face-to-face and mobile tele-diagnostic ABR tests.
- Student's t-test and Bland-Altman plots were used for statistical comparison and agreement analysis.
Main Results:
- A strong correlation was observed between face-to-face and mobile tele-diagnostic ABR results (p < 0.001).
- No statistically significant differences were found between the two ABR testing methods.
- Results from both methods were within clinically acceptable and normative ranges.
Conclusions:
- Tele-diagnostic ABR delivered via mobile clinic van is a feasible method for infant hearing assessment.
- This approach yields results comparable to traditional methods and is clinically acceptable.
- Mobile tele-diagnostic ABR shows promise for accelerating hearing healthcare delivery to infants in underserved rural communities.
Background:
There is a noticeable gap in access to audiology services in South Africa, and the gap is intensified in rural areas. Often, primary healthcare (PHC) facilities have an unequal ratio of audiologists to patients in need. Telehealth can expand the range of hearing healthcare services.
Objectives:
This study aimed to determine whether, for infants, tele-diagnostic Auditory Brainstem Response (ABR) assessment results conducted within a mobile clinic van are comparable to face-to-face diagnostic ABR results in rural Winterveldt, Pretoria North, South Africa.
Method:
The study utilised a quantitative, prospective cross-sectional comparative within-subject design. Each participant received both face-to-face and mobile tele-diagnostic ABR tests, which were then compared to evaluate the feasibility of mobile tele-diagnostic ABR testing. The Student's t-test was used to determine whether there was a difference between face-to-face and tele-diagnostic tests, and Bland -Altman plots were used to assess the level of agreement between the ABR testing results.
Results:
There was a strong correlation (p 0.001) between face-to-face and mobile tele-diagnostic ABR test results for both neurological and audiological ABR tests. The study found that there was no statistical significance between face-to-face and tele-diagnostic ABR measures; additionally, the results were within clinically acceptable and normative measures.
Conclusion:
Tele-diagnostic ABR offered within a mobile clinic van is feasible as it produces similar and clinically acceptable results when compared to the traditional assessment method.Contribution: This feasibility study is a positive indicator that tele-diagnostic ABR testing through a mobile clinic van may be considered to accelerate the delivery of hearing healthcare services to the infant population in rural communities.
