Acurácia de testes de triagem auditiva baseados em smartphone: uma revisão sistemática

Correspondence address: Sheila Andreoli Balen Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte – UFRN
Rua Gen Gustavo Cordeiro de Faria, 601, Ribeira, Natal, RN - 59012-570. E-mail:
sheila@sheilabalen.com.br

groupsAuthor contributions

IMMM was responsible for writing, collecting and analyzing the data; ARXS was responsible for collecting and analyzing the data; RC was responsible for the translation of the manuscript; HCG was responsible for revising the manuscript; DVF was responsible for revising the manuscript; KVMT was responsible for the study design, data analysis and manuscript review; SAB was responsible for writing, study design, data analysis and review of the manuscript.

Figuras (2)
Tabelas (2)

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Figure 1 Flow Diagram of Literature Search and Selection Criteria⁽¹⁾

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Figure 2 Quality assessment through the Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2)

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Table 1 Summary of studies included in the systematic review (n=17)

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Database Search (JULY 10th 2018 updated on July 20th, 2020) LILACS audiology OR audiometria OR “audiometria de fala” OR “audiometria de tonos puros” OR “audiometria de habla” [Palavras] and smartphone OR teléfono inteligente OR telefone [Palavras] and Hearing loss OR Pérdida Auditiva OR perda auditiva [Palavras] PubMed (((“audiology” OR “audiometry” OR “speech audiometries” OR “speech audiometry” OR “pure-tone audiometry” OR “speech intelligibility” OR “speech intelligibilities” OR “speech reception threshold test” OR “speech discrimination tests” OR “speech discrimination test” OR “hearing test” OR “hearing tests” OR “screening test” OR “screening tests”)) AND (“hearing loss” OR “hearing impairment” OR hypoacusis OR hypoacuses OR “hearing disorder” OR “hearing disorders”)) AND (“cellular telephones” OR “mobile phone” OR “mobiles phones” OR “mobile telephone” OR mobile telephones” OR “mobile application” OR “mobile applications” OR “mobile app”) Scopus (TITLE-ABS-KEY (audiology OR audiometry) AND TITLE-ABS-KEY (“hearing loss” OR “hearing impairment”) AND TITLE-ABS-KEY (“mobile application” OR “mobile applications”)) Web of Science (audiology OR audiometry OR “speech audiometries” OR “speech audiometry” OR “speech intelligibility” OR “speech intelligibilities” OR “speech discrimination tests” OR “speech discrimination test” OR “hearing test” OR “hearing tests” OR “screening test” OR “screening tests”) AND TÓPICO: (“hearing loss” OR “hearing impairment” OR hypoacusis OR hypoacuses OR “hearing disorder” OR “hearing disorders”) AND TÓPICO: (“cellular telephones” OR “mobile phone” OR “mobiles phones” OR “mobile application” OR “mobile applications” OR “mobile app”) Google Scholar audiometry AND hearing loss AND smartphone Open Grey hearing loss AND application ProQuest noft(audiology OR audiometry OR “speech audiometry” AND “hearing loss” OR “hearing impairment”) AND noft(“mobile application” OR “mobile applications” OR smartphone)

Authors/ Year/Country	Sample/Age group (mean ± SD)	App	Type of Stimulus	Gold standard test	Gold standard test pass-fail criteria	Sensitivity	Specificity	PPV/NPV	Prevalence/Accuracy
Abu-Ghanem, et al. (2015)⁽²³⁾ Israel	26 individuals/ 65-94 years old (84.4 ± 6.73)	uHear	Pure tone	Pure-tone threshold audiometry from 250 to 6000 Hz	Mean of 500, 1000, and 2000 Hz at 40 dB as the cut-off point.	100%	60%	33.3% 100%	4.1% 91.6%
Armstrong et al. (2020)⁽³²⁾ Netherlands	3422 individuals/ 51-98 years old	Digits-in-Noise (DIN) test	Digits-in-noise	Pure-tone threshold audiometry from 250 to 8000 Hz.	Mean of 500, 1000, 2000 and 4000 Hz at 25 dB as the cut-off point.	For mild hearing loss = 69% For moderate hearing loss = 94%	For mild hearing loss = 75% For moderate hearing loss = 95%	*	*
Barczik and Serpanos (2018)⁽²⁵⁾ United States	22 individuals/ 18-84 years old (48.7)	uHear uHearing Test	Pure tone Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Mean of 500, 1000, and 2000 Hz at 25 dB as the cut-off point.	UHear Earbud earphones = 90-100% Supra-aural headphones=100% Circumaural headphones = 88,9-100% uHearing Test Earbud earphones = 10,5-75% Supra-aural headphones=85,7-90,5% Circumaural headphones = 10,5-70%	uHear Earbud earphones = 85,5-100% Supra-aural headphones=6,5-25% Circumaural headphones = 33-96,3% uHearing Test Earbud earphones = 91,7-100% Supra-aural headphones=87-86,7% Circumaural headphones = 100%	uHear Earbud earphones = 81,3-100%/ 92,3-100% Supra-aural headphones=31-52,6% Circumaural headphones = 55,6-86,7% uHearing Test Earbud earphones = 88,2-100%/ 59,5-81,5% Supra-aural headphones=90,9-93,6% Circumaural headphones = 100%/ 59,5-93,3%	*
Chu et al. (2019)⁽²⁶⁾ Taiwan	85 individuals/ 11-12 years old (11 ±0,5)	EarScale app	Pure tone	Pure-tone threshold audiometry from 500 to 4000Hz	Mean of 500, 1000, 2000 Hz and 4000 Hz more than 25 dB in the sound-treated booth were designated as hearing impairment.	95,2-100%	100%	*	*
Corona et al. (2020)⁽³⁶⁾ Brazil	300 adults/ 15-92 years old (53±) 40 children/ 5-14 years old (9±)	hearTest	Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Mean of 500, 1000, 2000 and 4000 Hz at 25 dB as the cut-off point.	Adults = 98% Children = 100%	Adults = 100% Children = 98%	Adults = 86,7% 99,2% Children = 83,3% 100%	*
Durgut et al. (2020)⁽³⁰⁾ Turkey	50 individuals/ 5-15 years old (8.18±2.58)	HearingTest	Pure tone	Pure-tone threshold audiometry from 500 to 4000 Hz	Mean of 500, 1000, and 2000 Hz at 20 dB as the cut-off point.	93,6%	26,4%	53% 33%	47% 58%
Louw et al. (2017)⁽²⁸⁾ South Africa	1236 individuals Above 16 years olds (37.8±17.9)	HearScreen	Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Mean of 500, 1000, 2000 Hz and 4000 Hz was greater than 25 dB for children or greater than 35 dB for adults.	81.7%	83.1%	86.6% 99.4%	*
Mahomed-Asmail et al. (2016)⁽²⁷⁾ South Africa	1070 individuals/ 5–12 years old (8 ± 1.1)	HearScreen	Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Gold standard test results revealed hearing loss when a threshold is higher than 25 dB HL at 0.5, 1, 2, or 4 kHz.	75%	98.5%	52.9% 99.4%	*
Masalski et al. (2018)⁽²⁹⁾ Poland	70 individuals/ 18–71 years old (36±11)	HearingTest	Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Hearing loss was diagnosed when the threshold exceeded 30 dB at one of the following frequencies: 500Hz, 1 kHz, 2 kHz, or 25 dB at more than one, or when the hearing threshold exceeded 50 dB at 4 kHz.	98%	79%	*	*
Peer and Fagan (2015)⁽²⁴⁾ South Africa	25 individuals/ 15–80 years old (*)	uHear	Pure tone	Pure-tone threshold audiometry from 250 to 6000Hz	For the auditory screening, presence or absence of moderate or worse hearing loss (pure-tone average >40 dB) in each ear was determined via formal audiometry, considering 40 dB as the critical auditory threshold for disabling hearing loss.	100%	Waiting room = 64% Quiet room = 74% Acoustically treated room = 88%	100% in all environments Waiting room = 32% Quiet room = 72.7% Acoustically treated room = 100%	84% Waiting room = 50% Quiet room = 78% Acoustically treated room = 90%
Potgieter et al. (2018)⁽¹⁰⁾ South Africa	458 individuals/ 16-90 years old (27±16)	Digits-in-Noise (DIN) test	Digits-in-noise	Pure-tone threshold audiometry from 250 to 8000 Hz.	Mean of 500, 1000, 2000 and 4000 Hz at 25 dB as the cut-off point.	94%	77%	*	*
Potgieter et al. (2018)⁽³¹⁾ South Africa	109 individuals/ 16–89 years old (72±7.2)	Digits-in-Noise (DIN) test	Digits-in-noise	Pure-tone threshold audiometry from 250 to 8000 Hz	Mean of 500, 1000, 2000 and 4000 Hz at 25 dB as the cut-off point.	88%	88%	98.3% 75.5%	*
Sandström et al. (2020)⁽³⁵⁾ South Africa	63 individuals/ 20-88 years old (52±*)	hearTest	Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Mean of 500, 1000, 2000 and 4000 Hz at 20 dB as the cut-off point.	90,6%	94,2%	*	38,1% *
Sousa et al. (2019)⁽³³⁾ South Africa	145 individuals/ 18-84 years old (*)	Digits-in-Noise (DIN) test	Digits-in-noise	Pure-tone threshold audiometry from 250 to 8000 Hz.	Mean of 500, 1000, 2000 and 4000 Hz at 25 dB as the cut-off point.	Antiphasic DIN = 85% Diotic DIN = 83%	Antiphasic DIN = 67% Diotic DIN = 80%	*	*
Sousa et al. (2020)⁽³⁴⁾ South Africa	158 individuals/ 18-92 years old (61±17)	Digits-in-Noise (DIN) test	Digits-in-noise	Pure-tone threshold audiometry from 250 to 8000 Hz.	Mean of 500, 1000, 2000 and 4000 Hz at 25 dB as the cut-off point.	97,2%	93,4%	*	*
Swami et al. (2017)⁽³⁷⁾ India	200 individuals/ 17-65 years old (*)	Free field hearing (FFH) Free Hearing Test (“freehearingtestsoftware.com”)	Words Pure tone	Pure-tone threshold audiometry from 250 to 8000 Hz	Mean air conduction thresholds at a 500 Hz, 1000 Hz, 2000 Hz, 3000 Hz higher than 20 dB were considered normal.	FFH: 73% Free Hearing Test: 98%	FFH: 99% Free Hearing Test: 95%	Free Hearing Test = 95.1% Free Hearing Test = 97.9%	50% 96.5%
Szudek et al. (2012)⁽²²⁾ Canada	100 individuals/ 20-91 years old (46±*)	uHear	Pure tone	Pure-tone threshold audiometry from 250 to 6000Hz	Mean of 500, 1000, 2000 and 4000 Hz at 40 dB as the cut-off point.	100%	90%	*	*

[1] Authors did not provide the values in the manuscript or did not forward absolute values so the researchers of this review could perform calculations

[2] Caption: VPP: positive predictive value; VPN: negative predictive value