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An Open-Source Smartphone Otoacoustic Emissions Test for Infants
Nada Ali1, Justin Chan2, Anna Meehan3,4
1Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington.
Insights
A novel smartphone device effectively screens infant hearing loss using otoacoustic emissions (OAEs). This low-cost technology offers a scalable solution for universal newborn hearing screening in underserved regions.
Area of Science:
- Biomedical Engineering
- Otoacoustic Emissions
- Infant Hearing Screening
Background:
- Universal infant hearing screening is critical for early detection of hearing loss.
- Existing equipment is often costly and not suitable for resource-limited settings.
- There is a need for accessible and scalable hearing screening tools.
Purpose of the Study:
- To evaluate a low-cost, smartphone-based device for infant hearing screening.
- To compare the performance of the smartphone device against a conventional otoacoustic emission (OAE) device.
Main Methods:
- Infants aged 0-6 months from high-prevalence clinics were recruited.
- A low-cost, open-source distortion product otoacoustic emission (DPOAE) probe and smartphone app were tested.
- Results were compared to a commercial OAE device, with hearing status confirmed by diagnostic testing.
Main Results:
- The smartphone device showed 100% sensitivity and 88% specificity.
- Negative predictive value was 100% for the smartphone device.
- Referral rates were comparable between the smartphone (24%) and conventional (26%) devices.
Conclusions:
- Smartphone-based DPOAE detection is an effective method for infant hearing screening.
- This technology presents a promising, low-cost solution for scalable newborn and infant hearing programs, particularly in resource-constrained environments.
Objective:
Universal hearing screening is essential for early identification of infants with hearing loss, yet there is a lack of low-cost, scalable equipment suitable for resource-constrained settings. Here we test a low-cost smartphone device for infant hearing screening.
Methods:
Infants aged 0 to 6 months were recruited from 3 ambulatory clinics at Seattle Children's Hospital with a high prevalence of hearing loss. We compared results from a low-cost open-source distortion product otoacoustic emission (OAE) probe and smartphone app with results from a commercially available OAE device. Hearing status was confirmed using newborn hearing screening, diagnostic testing, or both. Primary outcomes were referral rate as well as sensitivity, specificity, positive predictive value, and negative predictive value compared with known hearing status.
Results:
Among N = 76 infants, the mean age at screening was 3.1 ± 1.9 months and 13% had hearing loss. Referral rates were 24% and 26% for the smartphone and conventional devices, respectively. Both devices demonstrated 100% sensitivity (95% CI, 0.69-1.00) and negative predictive value (95% CI, 0.94-1.00). Specificity was 88% (95% CI, 0.78-0.95) and 85% (95% CI, 0.74-0.92) for the smartphone and conventional devices, respectively. Positive predictive value was 56% (95% CI, 0.31-0.78) for the smartphone and 50% (95% CI, 0.27-0.73) for the conventional device.
Conclusion:
The smartphone-based OAE device effectively screened hearing in high-prevalence infants. Thus, smartphone-based OAE detection may be a promising low-cost solution to the challenge of building scalable universal newborn and infant hearing screening programs in resource-constrained settings.
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