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Petale® behavioral auditory test for infants aged nine months to three years: A diagnostic accuracy pilot study
Bruno Maetz1, Pierre Fayoux2, Christophe Vincent3
1Ramsay Santé, Clinique Saint-Amé, Lambres-Lez-Douai, France. brunomaetz@gmail.com.
Insights
The Petale® behavioral auditory test shows unsatisfactory diagnostic accuracy for infant hearing impairments. Despite this, parents and practitioners report high satisfaction due to its ease of use and cost-effectiveness.
Area of Science:
- Pediatric audiology
- Diagnostic test evaluation
- Infant hearing screening
Background:
- Mandatory infant hearing screenings occur at 9 months and 2 years in France.
- Adherence to hearing screening guidelines is low, with varied and undocumented diagnostic methods.
- The Petale® behavioral auditory test is used for infant hearing impairment screening.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the Petale® test.
- To assess the Petale® test's performance in infants aged 9 months to 3 years.
- To compare Petale® test results against a specialist hearing assessment (COR test).
Main Methods:
- Prospective diagnostic accuracy study conducted in France.
- Infants aged 9 months to 3 years were tested with Petale® (index test).
- Reference standard was a conditioned orientation reflex (COR) test by an ENT specialist.
Main Results:
- 157 infants were included; 119 had both tests.
- Petale® identified hearing impairment in 36.9% of infants.
- Sensitivity: 66.67%, Specificity: 71.29%, Accuracy: 70.59%, Kappa concordance: 0.249 (weak).
Conclusions:
- The diagnostic accuracy of the Petale® test is unsatisfactory.
- High satisfaction reported by practitioners (98.7%) and parents (99.1%).
- Petale® is perceived as easy, quick, and cost-effective where data on audiometry protocols are lacking.
Objectives:
Screening for hearing impairments is part of the mandatory medical visits for infants at nine months and two years in France, however adherence to guidelines is low, diagnostic methods are varied and accuracy is undocumented. The aim of this research was to evaluate the diagnostic accuracy of the Petale® behavioral auditory test for infants aged nine months to three years who were screened for hearing impairments by a general practitioner (GP) or pediatrician.
Methods:
In this prospective diagnostic accuracy study, infants in France aged nine months to three years were tested with Petale® (index test) during a GP or pediatrician consultation and a specialist hearing assessment with a conditioned orientation reflex (COR) test carried out by an Ear-Nose-Throat specialist (reference test).
Results:
Overall, 157 infants were included in the analysis population and 119 had both an index test and a reference test. Median age was 1.5 years (IQR 1.0;2.0). A hearing impairment was identified with Petale® for 58 (36.9%) infants. Sensitivity was 66.67% (95%CI 44.89-88.44), specificity was 71.29% (62.46-80.11), PPV was 29.27% (15.34-43.20), NPV 92.31% (86.39-98.22) and accuracy 70.59% (62.40-78.77). The Kappa index for concordance was 0.249 (95%CI 0.079-0.418) indicating a weak concordance between the two diagnostic tests. Overall, 98.7% of practitioners and 99.1% of parents were satisfied or very satisfied with Petale®.
Conclusions:
The diagnostic accuracy of Petale® is unsatisfactory. Nevertheless, parents' and practitioners' satisfaction with the test is high and the test was shown to be an easy, quick-to-use, cost-effective solution for this population where data on proven audiometry testing protocols are lacking.
