Can schools detect mild hearing loss? Evaluating screening accuracy and feasibility

Area of Science:

• Pediatric Audiology
• Public Health
• Diagnostic Accuracy Studies

Background:

• Mild hearing loss affects a significant portion of children.
• Early detection is crucial for academic and social development.
• Rural Alaskan schools present unique challenges for hearing screening.

Purpose of the Study:

• To assess the feasibility and accuracy of lower-level pure-tone hearing screening.
• To compare 15 dB and 20 dB screening levels against World Health Organization (WHO) definitions.
• To identify optimal screening parameters for detecting mild hearing loss in school children.

Main Methods:

• Prospective, observational diagnostic accuracy study.
• Compared 15 dB and 20 dB pure-tone screening levels.
• Used benchmark audiometric evaluation with former (PTA >25 dB) and updated (PTA ≥20 dB) WHO definitions.

Main Results:

• 15 dB screening identified more children with potential hearing loss (18.6%) than 20 dB (13.8%).
• 15 dB screening showed higher sensitivity (85.0%) but lower specificity (90.8%) compared to 20 dB (75.0% vs 94.3%).
• The updated WHO definition (PTA ≥20 dB) identified more cases of mild hearing loss.

Conclusions:

• Screening at 15 dB increases sensitivity for detecting mild hearing loss, aligning with the updated WHO definition.
• While improving detection, 15 dB screening results in more false positives.
• Affordable, reliable screening technologies are needed for noisy school environments to effectively identify children at risk.