Telehealth in audiology: an integrative review

Lima, Thales Rafael Correia de Melo; Santos, Larissa Menezes; Muniz, Marcella Cristina Halliday; Araújo, Brenda Carla Lima; Santos, Mario Adriano dos; de Oliveira, Adicinéia Aparecida; Simões, Silvia de Magalhães

doi:10.1590/1806-9282.20200800

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REVIEW ARTICLE • Rev. Assoc. Med. Bras. 67 (3) • Mar 2021 • https://doi.org/10.1590/1806-9282.20200800 copy

Telehealth in audiology: an integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

We performed an integrative review on the scientific literature about the use of telehealth in audiology care. Through high criteria search of published studies on the “Biblioteca Virtual em Saúde” – Virtual Health Library, PubMed, and Scientific Electronic Library Online databases, nine articles were selected. It was possible to verify that the use of telehealth in audiology is feasible and efficient, because it could promote audiological care for patients from away places. This process reaches more patients and communities by breaking down geographic barriers, and it offers a specific service not available with less cost and more quickly when compared with traditional speech therapy care.

KEYWORDS:
Telehealth; Healthcare; Telemedicine; Audiology; eHealth

Author/Year/Country	Study Design	Objective	Conclusion
Hattonet al.¹⁰10. Hatton JL, Rowlandson J, Beers A, Small S. Telehealth-enabled auditory brainstem response testing for infants living in rural communities: the British Columbia Early Hearing Program experience. Int J Audiol. 2019;58(7):381-92.https://doi.org/10.1080/14992027.2019.1584681 https://doi.org/10.1080/14992027.2019.15... , 2019, Canada	Cross-sectional	To describe the design/implementation of a telehealth-enabled auditory brain stem response (TH-ABR) program; summarize equipment/procedures; report the results of the TH-ABR program.	TH-ABR is efficient, accurate, valued by parents, optimizes the availability of audiology resources, creates local servicecapacity, and reduces costs for communities in Northern British Columbia.
Schepers et al.¹¹11. Schepers K, Steinhoff HJ, Ebenhoch H, Böck K, Bauer K, Rupprecht L, et al. Remote programming of cochlear implants in users of all ages. Acta Otolaryngol. 2019;139(3):251-7.https://doi.org/10.1080/00016489.2018.1554264 https://doi.org/10.1080/00016489.2018.15... , 2019, Germany	Cross-sectional	To evaluate the safety and feasibility of remote programming in cochlear implant (CI) users for all ages.	Remote tracking adjustment is safe, feasible, and effective for local adjustment for CI users. A more extensive adoption of remote adjustment can allow many CI users greater acces to clinics and greater benefits from the use of CI
Samelli et al.¹⁸18. Samelli AG, Rabelo CM, Sanches SGG, Martinho AC, Matas CG. Tablet-based tele-audiometry: automated hearing screening for schoolchildren. J Telemed Telecare. 2020;26(3):140-9. https://doi.org/10.1 177/1357633X18800856 https://doi.org/10.1 177/1357633X1880085... , 2018, Brazil	Accuracy study	To evaluate the performance of a tablet-based teleaudiometry method for automated hearing screening of schoolchildren by comparing the results of various hearing screening approaches	The highest diagnostic values were generally obtained by the automated method of hearing screening (including 500 Hz). The application, developed for the tablet, proved to be a valuable hearing screening tool for use in schoolchildren. Therefore, we suggest that this hearing screening protocol has the potential to improve the provision of asynchronous teleaudiology services.
Monica et al.¹²12. Monica SD, Ramkumar V, Krumm M, Raman N, Nagarajan R, Venkatesh L. School entry level tele-hearing screening in a town in South India - Lessons learnt. Int J Pediatr Otorhinolaryngol. 2017;92:130-5.https://doi.org/10.1016/j.ijporl.2016.11.021 https://doi.org/10.1016/j.ijporl.2016.11... , 2016, India	Cross-sectional	To evaluate the feasibility of school hearing screening using telehealth technology operated by a professional located in a hospital 400 km away.	Synchronous hearing screening can be provided in schools using mobile device hotspots or dongle connectivity in places where Internet bandwidth is restricted.
Pross et al.¹⁴14. Pross SE, Bourne AL, Cheung SW. TeleAudiology in the veterans health administration. Otol Neurotol. 2016;37(7):847-50. https://doi.org/10.1097/MAO.0000000000001058 https://doi.org/10.1097/MAO.000000000000... , 2016, United States	Case–control, retrospective	To evaluate the effectiveness of teleaudiology (TA) for hearing aid services.	Assistance through TA and conventional care to provide hearing aid services to veterans is comparable, as both are highly effective based on the results of the International Outcome Inventory for Hearing Aids (IOI-HA) results. The non-inferiority of TA suggests that its adoption by non-veterans can improve access and preserve high satisfaction. The financial impact of migration on TA will require future econometric analysis.
Rourke et al.¹³13. Rourke R, Kong DC, Bromwich M. Tablet audiometry in Canada’s north: a portable and efficient method for hearing screening. Otolaryngol Head Neck Surg. 2016;155(3):473-8. https://doi.org/10.1177/0194599816644407 https://doi.org/10.1177/0194599816644407... , 2016, Canada	Cross-sectional and prospective	To determine the prevalence of hearing loss in children aged 4–11 years; test and demonstrate the use of the tablet audiometer as a portable hearing test device in children in a remote location.	A total of 14.8% children tested positive for hearing loss basedon our interactive audiometer for tablets. The audiometer for tablets was time-efficient and largely language-independent. This test is valuable for providing the necessary hearing health care for high-risk populations in rural andremote areas where audiology services are not available.
Blamey et al.¹⁷17. Blamey PJ, Blamey JK, Saunders E. Effectiveness of a teleaudiology approach to hearing aid fitting. J Telemed Telecare. 2015;21(8):474-8. https://doi.org/10.1177/1357633X15611568 https://doi.org/10.1177/1357633X15611568... , 2015, Australia	Accuracy study	To evaluate the effectiveness of an online speech perception test (SPT) for measuring hearing and adjusting the hearing aid in comparison with conventional methods.	SPT isan effective tool for the detection and measurement of hearing loss and the adaptation of hearing aids. The use of SPT reduces costs and increases the effectiveness of adjusting the hearing aid, enabling a sustainable teleaudiology business model.
Penteado et al.¹⁵15. Penteado SP, Lima Ramos S, Battistella LR, Marone SAM, Bento RF. Adaptação à distância de próteses auditivas acústicas: a teleaudiologia aplicada na melhoria da condução das Políticas Públicas no Brasil. Int. Arch. Otorhinolaryngol. 2012;16(3):371-81.https://doi.org/10.7162/S1809-97772012000300012 https://doi.org/10.7162/S1809-9777201200... , 2013, Brazil	Case study	To describe a case of remote adaptation between two cities, with a literature review.	Remoteadjustment of hearing aids is possible over the Internet, in addition to providing additional technical training for a remote center on assembly procedures. This technological approach can help the government to promote public policies in hearing rehabilitation, as patients can be motivated to keep using hearing aids with the option of asking for help in the comfort of their own homes.
Swanepoel et al.¹⁶16. Swanepoel W, Koekemoer D, Clark J. Intercontinental hearing assessment - a study in tele-audiology. J Telemed Telecare. 2010;16(5):248-52. https://doi.org/10.1258/jtt.2010.090906 https://doi.org/10.1258/jtt.2010.090906... , 2010, South Africa	Validation study	To validate remote pure tone audiometric tests performed in North America on individuals from South Africa.	It may be possible to expand the reach of hearing services in remote and underserved regions of the world.

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[1] * Corresponding author: brendaaraujo@yahoo.com.br