Accuracy of affordable instruments for hearing screening in adults and the elderly

Balen, Sheila Andreoli; Vital, Bianca Stephany Barbosa; Pereira, Rhadimylla Nágila; Lima, Taise Ferreira de; Barros, Daniele Montenegro da Silva; Lopez, Esteban Alejandro; Diniz Junior, Jose; Valentim, Ricardo Alexsandro de Medeiros; Ferrari, Deborah Viviane

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Original Article • CoDAS 33 (5) • 2021 • https://doi.org/10.1590/2317-1782/20202020100 copy

Accuracy of affordable instruments for hearing screening in adults and the elderly

Authorship SCIMAGO INSTITUTIONS RANKINGS

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
Hearing; Hearing Loss; Hearing Tests; Audiology; Adults; Health Policy; Presbycusis; Health of the Elderly

Type	Degree*	Right ear	Left ear	Total

n	%	n		n	%

Normal	Normal	23	14.375	24	15	47	29.375
	Total	23	14.375	24	15	47	29.375
Sensorineural	Mild	08	5.00	10	6.25	18	11.25
	Moderate	18	11.25	14	8.75	32	20.00
	Severe	09	5.625	13	8.125	22	13.75
	Profound	09	5.625	09	5.625	18	11.25
	Total	44	27.5	46	28.75	90	56.25
Mixed	Mild	02	1.25	0	0	02	1.26
	Moderate	05	3.125	0	0	05	3.13
	Severe	06	3.75	07	4.375	13	8.08
	Profound	0	0	03	1.875	03	1.87
	Total	13	8.125	10	6.25	23	14.375

		Pure-tone audiometry – Quadritonal mean ^* * Average hearing thresholds at frequencies of 500, 1000, 2000, and 4000 Hz
		≤ 40 dB NA		≥ 41 dB NA		Total
		≤ 40 dB NA		(hearing loss)		Total
		n	%	n	%	n	%
MoBASA	Pass	28	35.00	5	6.25	33	41.25
	Fail	9	11.25	38	47.50	47	58.75
	Total	37	46.25	43	53.75	80	100
					“
Telehealth	Pass	11	13.75	0	0	11	13.75
	Fail	26	32.50	43	53.75	69	86.25
	Total	37	46.25	43	53.75	80	100

HHIE-S	Pass	17	21.25	4	5.00	21	26.25
	Fail	20	25.00	39	48.75	59	73.75
	Total	37	46.25	43	53.75	80	100

Trials	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
Trials	(95% IC)	(95% IC)	(95% CI)	(95% CI)
MoBASA	88.30 (0.75;0.94)	75.68 (0.60;0.86)	80.85(2.03;6.48)	84.85 (0.06;0.35)
Telehealth audiometer	100.00 (0.92;1)	29.73 (0.17;0.45)	62.32 (1.15;1.75)	100.00 (-)
HHIE-S	90.70 (0.78;0.96)	45.95 (0.31;0.61)	66.10 (1.23;2.29)	80.95 (0.07;0.54)

Tests	Crude concordance rate	Kappa concordance	CI 95%	p value
MoBASA	75.7%	0.645	0.427-0.863	<0.001
Telehealth audiometer	29.7%	0.313	0.153-0.472	<0.001
HHIE-S	45.9%	0.378	0.178-0.577	<0.001

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[1] Conflict of interests: nothing to declare.