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Kids are not just small adults: An attempt to validate pediatric tablet-based digits in noise testing
Allyson Dunlap1, Morgan McBride1, Alison Tuominen1
1Department of Otolaryngology - Head and Neck Surgery University of Minnesota Medical School Minneapolis Minnesota USA.
Insights
This study found that a tablet-based digits-in-noise test using adult criteria cannot reliably differentiate conductive hearing loss from sensorineural hearing loss in children. Further research is needed to establish pediatric-specific criteria for accurate hearing loss diagnosis.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Hearing Diagnostics
Background:
- Conductive hearing loss (CHL) and sensorineural hearing loss (SNHL) require accurate differentiation for appropriate pediatric treatment.
- Tablet-based hearing tests offer potential for accessible audiological assessments.
Purpose of the Study:
- To evaluate if a tablet-based digits-in-noise (DIN) test, using adult cut-off criteria, can distinguish CHL from SNHL in children aged 3-18.
- To compare DIN test results with traditional soundbooth audiometry.
Main Methods:
- A prospective cohort of 64 children (3-18 years) underwent soundbooth audiometry and a tablet-based diotic/antiphasic DIN test.
- DIN test results were compared to soundbooth audiometry using established adult cut-off criteria for CHL.
- Logistic regression analysis adjusted for age, sex, and race was performed.
Main Results:
- There was 50% agreement between DIN testing and soundbooth audiometry for CHL determination (p=.753).
- Combined DIN test results showed only 33% agreement (p=.373).
- Otologic pathology and age did not predict test outcomes.
Conclusions:
- The current adult cut-off criteria for the tablet-based DIN test are not predictive of soundbooth audiometry results in children.
- This preliminary analysis suggests the need for pediatric-specific cut-off values for accurate hearing loss differentiation in children.
- Further research is essential to validate and refine tablet-based hearing diagnostic tools for pediatric populations.
Objective:
The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3-18 using a diotic and antiphasic digits-in-noise (DIN) tablet-based test using existing adult cut-off criteria.
Methods:
A blinded multi-institutional prospective cohort of 64 children aged 3-18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same-day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same-phased stimuli) and antiphasic (out-of-phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over-the-ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult "cut off criteria."
Results:
A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p-value of .753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p-value of .373. Otologic pathology and age were not predictive of outcome.
Conclusion:
This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3-18 when using the adult cut-off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut-off values.
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