Accuracy of affordable instruments for hearing screening in adults and the elderly
Acurácia de instrumentos de custo acessível para triagem auditiva de adultos e idosos
Sheila Andreoli Balen; Bianca Stephany Barbosa Vital; Rhadimylla Nágila Pereira; Taise Ferreira de Lima; Daniele Montenegro da Silva Barros; Esteban Alejandro Lopez; Jose Diniz Junior; Ricardo Alexsandro de Medeiros Valentim; Deborah Viviane Ferrari
Abstract
Purpose: To evaluate the accuracy of affordable instruments for hearing screening of adults and the elderly. Methods: This study was carried out with users of a Hearing Health Service of the Unified Health System. All were screened with the MoBASA smartphone application, the Telehealth audiometer (TH) and the electronic version of the Hearing Handicap Inventory for the Elderly - screening version - eHHIE-S. The examiners were blinded to the results of the screening tests and pure tone audiometry (PTA). Hearing impairment was considered for those with a PTA quadritonal mean greater than 40 dB in the best ear. Sensitivity, specificity and positive and negative predictive values (PPV and NPV, respectively) were calculated. The Kappa index was used as an agreement indicator between the PTA and the screening results. Results: The sample consisted of 80 individuals between 18 and 94 years old (55.18 ± 20.21). In the PTA test, 21 individuals (26.25%) had typical hearing and 59 (73.75%) hearing loss. In the hearing screening tests, sensitivity, specificity, PPV and NPV values greater than 75% were observed with the MoBASA as well as in terms of sensitivity and NPV of the TH and the eHHIE-S. The TH and the eHHIE-S specificity and PPV were less than 75%. The Kappa index indicated a substantial agreement (0.6) between the PTA and the MoBASA screening results. The TH and the eHHIE-S showed regular agreement (0.3). Conclusion: MoBASA proved to be an accurate method for hearing screening of adults and the elderly with disabling hearing loss
Keywords
Resumo
Objetivo: Avaliar a acurácia de instrumentos de custo acessível para triagem auditiva de adultos e idosos. Método: Este estudo foi realizado com usuários de um Serviço de Saúde Auditiva do SUS. Todos foram submetidos a triagem com o aplicativo de smartphone MoBASA, o audiômetro Telessaúde (TS) e a versão eletrônica do Questionário de Handicap da Audição para Idosos (Hearing Handicap Inventory for the Elderly – screening version - eHHIE-S). Os examinadores foram cegos quanto aos resultados dos testes de triagem e para os dados de audiometria de tom puro (ATP). Foram considerados com deficiência auditiva aqueles com média quadritonal na ATP maiores que 40 dB na melhor orelha. Sensibilidade, especificidade e valores preditivos positivo (VPP) e negativo (VPN) foram calculados. O índice Kappa foi usado como um indicador de concordância entre ATP e os resultados da triagem. Resultados: A amostra constou de 80 indivíduos entre 18 a 94 anos (55,18 ± 20,21). Na ATP, 21 indivíduos (26,25%) apresentaram audição normal e 59 (73,75%) perda auditiva incapacitante. Nos testes de triagem auditiva observou-se valores de sensibilidade, especificidade, VPP e VPN maiores do que 75% no MoBASA e na sensibilidade e VPN do TS e eHHIE-S. Já a especificidade e VPP do TS e eHHIE-S foram inferiores a 75%. O índice Kappa indicou concordância substancial (0,6) entre o ATP e os resultados do MoBASA. No TS e eHHIE-S foi constatada regular concordância (0,3). Conclusão: O MoBASA demonstrou ser um método acurado para triagem auditiva de adultos e idosos com perda auditiva incapacitante.
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References
1. WHO: World Health Organization. Ear and hearing care: indicators for monitoring provision of services [Internet]. Geneva: WHO; 2019. [citado em 2020 Abr 15]. Disponível em: https://www.who.int/health-topics/ hearing-loss#tab=tab_1
2. Béria JU, Raymann BCDW, Gigante LP, Figueiredo ACL, Jotz G, Roithman R, et al. Hearing impairment and socioeconomic factors: a populationbased survey of an urban locality in southern. Rev Panam Salud Publica. 2007;21(6):381-7. http://dx.doi.org/10.1590/S1020-49892007000500006. PMid:17761050.
3. American Academy of Audiology. Accessibility and Affordability of Hearing Care for Adult Consumers [Internet]. Reston: American Academy of Audiology; 2017 [citado em 2020 Abr 15]. Disponível em: https://www. audiology.org/publications/accessibility-and-affordability-hearing-careadult-consumers
4. Brasil. Ministério da Saúde. Portaria nº 2.528, de 19 de outubro de 2006. Aprova a Política Nacional de Saúde de Pessoa Idosa [Internet]. Diário Oficial da União; Brasília; 2006 [citado em 2020 Abr 15]. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2006/prt2528_19_10_2006. html
5. Ferrari DV, Lopez EA, Lopes AC, Aiello CP, Jokura PR. Results obtained with a low cost software-based audiometer for hearing screening. Int Arch Otorhinolaryngol. 2013;17(3):257-64. http://dx.doi.org/10.7162/S1809- 97772013000300005. PMid:27053951.
6. Ventry IM, Weinstein BE. Identification of elderly people with hearing problems. ASHA. 1983;25(7):37-42. PMid:6626295.
7. Rosis ACA, Souza MRF, Iório MCM. Questionário Hearing Handicap Inventory for the Elderly - Screening version (HHIE-S): estudo da sensibilidade e especificidade. Rev Soc Bras Fonoaudiol. 2009;14(3):339- 45. http://dx.doi.org/10.1590/S1516-80342009000300009.
8. Swanepoel DW, Myburgh HC, Howe DM, Mahomed F, Eikelboom RH. Smartphone hearing screening with integrated quality control and data management. Int J Audiol. 2014;53(12):841-9. http://dx.doi.org/10.3109/ 14992027.2014.920965. PMid:24998412.
9. Abu-Ghanem S, Handzel O, Ness L, Ben-Artzi-Blima M, Fait-Ghelbendorf K, Himmelfarb M. Smartphone-based audiometric test for screening hearing loss in the elderly. Eur Arch Otorhinolaryngol. 2016;273(2):333-9. http:// dx.doi.org/10.1007/s00405-015-3533-9. PMid:25655259. Balen et al. CoDAS 2021;33(5):e20200100 DOI: 10.1590/2317-1782/20202020100 8/8
10. Potgieter JM, Swanepoel DW, Myburgh HC, Hopper TC, Smits C. Development and validation of a smartphone-based digits-in-noise hearing test in South African English. Int J Audiol. 2015;55(7):405-11. http://dx.doi. org/10.3109/14992027.2016.1172269. PMid:27121117.
11. Swanepoel DW. Smartphone-based National Hearing Test Launched in South Africa. Hear J. 2017;70(1):14-6. http://dx.doi.org/10.1097/01. HJ.0000511726.41335.83.
12. van Tonder J, Swanepoel W, Mahomed-Asmail F, Myburgh H, Eikelboom RH. Automated smartphone threshold audiometry: validity and time efficiency. J Am Acad Audiol. 2017;28(3):200-8. http://dx.doi.org/10.3766/ jaaa.16002. PMid:28277211.
13. Barczik J, Serpanos YC. Accuracy of smartphone self-hearing test applications across frequencies and earphone styles in adults. Am J Audiol. 2018;27(4):570-80. http://dx.doi.org/10.1044/2018_AJA-17-0070. PMid:30242342.
14. Potgieter JM, Swanepoel W, Myburgh HC, Smits C. The south african english smartphone digits-in-noise hearing test: effect of age, hearing loss an speaking competence. Ear Hear. 2018;39(4):656-63. http://dx.doi. org/10.1097/AUD.0000000000000522. PMid:29189432.
15. Kelly EA, Stadler ME, Nelson S, Runge CL, Friedland DR. Tabletbased screening for hearing loss: feasibility of testing in nonspecialty locations. Otol Neurotol. 2018;39(4):410-6. http://dx.doi.org/10.1097/ MAO.0000000000001752. PMid:29494473.
16. Samelli AG, Rabelo CM, Sanches SGG, Aquino CP, Gonzaga D. Tabletbased hearing screening test. Telemed J E Health. 2017;23(9):747-52. http://dx.doi.org/10.1089/tmj.2016.0253. PMid:28328389.
17. Watson HA, Tribe RM, Shennan AH. The role of medical smartphone apps in clinical decision-support: A literature review. Artif Intell Med. 2019;100:101707. http://dx.doi.org/10.1016/j.artmed.2019.101707. PMid:31607347.
18. Bright T, Pallawela D. Validated smartphone-based apps for ear and hearing assessments: a review. JMIR Rehabil Assist Technol. 2016;3(2):e13. http:// dx.doi.org/10.2196/rehab.6074. PMid:28582261.
19. Bush ML, Sprang R. Management of hearing lossa through telemedicine. JAMA Otolaryngol Head Neck. 2019;145(3):204-5. http://dx.doi.org/10.1001/ jamaoto.2018.3885.
20. Silva LSG, Gonçalves CG, Soares VMN. National Policy on Health Care Hearing: an evaluative study from covering services and diagnostic procedures. CoDAS. 2014;26(3):241-7. http://dx.doi.org/10.1590/2317- 1782/201420140440. PMid:25118922.
21. Ventry IM, Weinstein BE. The hearing handicap inventory for the elderly: a new tool. Ear Hear. 1982;3(3):128-34. http://dx.doi.org/10.1097/00003446- 198205000-00006. PMid:7095321.
22. Landis JR, Koch GG. An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics. 1977;33(2):363-74. http://dx.doi.org/10.2307/2529786. PMid:884196.
23. Tomioka K, Ikeda H, Hanaie K, Morikawa M, Iwamoto J, Okamoto N, et al. The Hearing Handicap Inventory for Elderly-Screening (HHIE-S) versus a single question: reliability, validity, and relations with quality of life measures in the elderly community. Qual Life Res. 2013;22(5):1151-9. http://dx.doi.org/10.1007/s11136-012-0235-2. PMid:22833152.
24. Diao M, Sun J, Jiang T, Tian F, Jia Z, Liu Y, et al. Comparison between self-reported hearing and measured hearing thresholds of the elderly in China. Ear Hear. 2014;35(5):e228-32. http://dx.doi.org/10.1097/ AUD.0000000000000050. PMid:24979248.
25. Menegotto IH, Soldera CLC, Anderle P, Anhaia TC. Correlação entre perda auditiva e resultados dos questionários Hearing Handicap Inventory for the Adults - Screening Version HHIA-S e Hearing Handicap Inventory for the Elderly - Screening Version - HHIE-S. Int Arch Otorhinolaryngol. 2011;15(3):319-26. http://dx.doi.org/10.1590/ S1809-48722011000300009.
26. Servidoni AB, Conterno LO. Hearing loss in the elderly: is the hearing handicap inventory for the elderly - screening version effective in diagnosis when compared to the audiometric test? Int Arch Otorhinolaryngol. 2018;22(1):1-8. http://dx.doi.org/10.1055/s-0037-1601427. PMid:29371892.
27. Brennan-Jones CG, Taljaard DS, Brennan-Jones SE, Bennett RJ, Swanepoel W, Eikelboom RH. Self-reported hearing loss and manual audiometry: a rural versus urban comparison. Aust J Rural Health. 2016;24(2):130-5. http://dx.doi.org/10.1111/ajr.12227. PMid:26311193.
28. Jayawardena A, Waller B, Edwards B, Larsen-Reindorf R, Esinam Anomah J, Frimpong B, et al. Portable audiometric screening platforms used in low-resource settings: a review. J Laryngol Otol. 2019;133(2):74-9. http://dx.doi.org/10.1017/S0022215118001925. PMid:30392484.
Submitted date:
04/15/2020
Accepted date:
09/30/2020
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