Audiometry in general practice: validation of a pragmatic pure-tone audiometry method

Area of Science:

• Audiology
• Otolaryngology
• Diagnostic Testing

Background:

• Pure-tone audiometry is a standard hearing test.
• Validating diagnostic accuracy in general practice is crucial for efficient healthcare.
• ISO standards provide a benchmark for audiological assessments.

Purpose of the Study:

• To validate pure-tone audiometry results from general practice against standardized audiological settings.
• To assess the diagnostic accuracy of practice-based audiometry for hearing impairment.
• To determine the utility of general practice audiometry in patient selection for further audiological evaluation.

Main Methods:

• Single-blinded crossover design involving 119 participants.
• Comparison of pure-tone audiometry (0.25-8 kHz) in a general practice setting versus a standardized audiological setting.
• Calculation of mean deviations, sensitivity, specificity, positive predictive values, and negative predictive values.

Main Results:

• Mean frequency-dependent deviations were generally below 4 dB, with practice settings showing poorer thresholds.
• High diagnostic validity was observed for hearing impairment criteria (0.5-4 kHz): sensitivity (82-100%), specificity (95-99%).
• Excellent positive (75-90%) and negative (98-100%) predictive values were reported for the better ear.

Conclusions:

• Pure-tone audiometry performed in general practice demonstrates appropriate validity for hearing assessment.
• Practice-based audiometry is effective in identifying patients who do not require further audiological examination.
• Standardized guidelines for pure-tone audiometry in general practice are recommended.