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Matthew Bromwich - One of the best experts on this subject based on the ideXlab platform.
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adult validation of a self administered tablet audiometer
Journal of Otolaryngology-head & Neck Surgery, 2019Co-Authors: Mark Bastianelli, Amy E Mark, Arran Mcafee, Renee Lefrancois, David Schramm, Matthew BromwichAbstract:There is evidence to suggest that rates of hearing loss are increasing more rapidly than the capacity of traditional Audiometry resources for screening. A novel innovation in tablet, self-administered portable Audiometry has been proposed as a solution to this discordance. The primary objective of this study was to validate a tablet audiometer with adult patients in a clinical setting. Secondarily, word recognition with a tablet audiometer was compared against conventional Audiometry. Three distinct prospective adult cohorts underwent testing. In group 1 and group 2 testing with the automated tablet audiometer was compared to standard sound booth Audiometry. In Group 1, participants’ pure tone thresholds were measured with an automated tablet audiometer in a quiet clinic exam room. In Group 2, participants completed monosyllabic word recognition testing using the NU-6 word lists. In Group 3, internal reliability was tested by having participants perform two automated tablet audiometric evaluation in sequence. Group 1 included 40 patients mean age was 54.7 ± 18.4 years old and 60% female; Group 2 included 44 participants mean age was 55.2 ± 14.8 years old and 68.2% female; Group 3 included 40 participants with mean age of 39.4 + 15.9 years old and 60.5% female. In Group 1, compared to standard Audiometry, 95.7% (95% CI: 92.6–98.9%) of thresholds were within 10 dB. In Group 2, comparing word recognition results, 96.2% (95% CI: 89.5–98.7%) were clinically equivalent and within a critical difference range. In Group 3, One-way Intraclass Correlation for agreement for the both left- and right-ear pure tone average was 0.98. The mean difference between repeat assessments was 0 (SD = 2.1) in the left ear, and 0.1 (SD = 1.1) in the right ear. Puretone Audiometry and word recognition testing appears valid when performed by non-healthcare experts using a tablet audiometer outside a sound booth in a quiet environment. ClinicalTrials.gov Identifier: NCT02761798. Registered April, 2016
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the new age of play Audiometry prospective validation testing of an ipad based play audiometer
Journal of Otolaryngology-head & Neck Surgery, 2013Co-Authors: Jeffrey Yeung, Sophie Heley, Yves Beauregard, Hedyeh Javidnia, Sandra Champagne, Matthew BromwichAbstract:Objective: The timely diagnosis of hearing loss in the pediatric population has significant implications for a child’s development. However, audiological evaluation in this population poses unique challenges due to difficulties with patient cooperation. Though specialized adaptations exist (such as conditioned play Audiometry), these methods can be time consuming and costly. The objective of this study was to validate an iPad-based play audiometer that addresses the shortcomings of existing Audiometry. Methods: We designed a novel, interactive game for the Apple W iPad W that tests pure tone thresholds. In a prospective, randomized study, the efficacy of this tool was compared to standard play Audiometry. 85 consecutive patients presenting to the Audiology Clinic at the Children’s Hospital of Eastern Ontario (ages 3 and older) were recruited into this study. Their hearing was evaluated using both tablet and traditional play Audiometry. Outcome measure: Warble-tone thresholds obtained by both tablet and traditional Audiometry. Results: The majority of children in this age group were capable of completing an audiologic assessment using the tablet computer. The data demonstrate no statistically significant difference between warble-tone thresholds obtained by tablet and traditional Audiometry (p=0.29). Moreover, the tablet audiometer demonstrates strong sensitivity (93.3%), specificity (94.5%) and negative predictive value (98.1%). Conclusion: The tablet audiometer is a valid and sensitive instrument for screening and assessment of warble-tone thresholds in children.
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evolution of Audiometry clinical testing of a new tablet audiometer
Canadian Acoustics, 2012Co-Authors: Nicolasn Ellaham, Sandra Champagne, Jeff Yeung, Guy-vincent Jourdan, Matthew BromwichAbstract:A clinical study was conducted to determine the accuracy of audiometric thresholds measured using tablet Audiometry. The results were compared to those obtained with accepted conventional conditioned play Audiometry (CPA). The study was conducted on a population of 85 patients with normal or abnormal hearing, aged 3-16, at the Audiology Clinic at the Children's Hospital of Eastern Ontario. All participants completed two audiometric evaluations, one with the tablet audiometer and one with conventional CPA and the order of the test was determined at random. 55 subjects were identified by the conventional CPA test to have normal hearing. Of these, 52 were correctly identified with tablet Audiometry, the remaining 3 children scoring slightly outside the parameters defined for normal hearing. For patients who had separate left-right ear assessments, a repeated measures model for the threshold in each ear at each frequency was fitted using linear mixed effects modeling.
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active noise reduction Audiometry a prospective analysis of a new approach to noise management in audiometric testing
Laryngoscope, 2008Co-Authors: Matthew Bromwich, Vijay Parsa, Nicole Lanthier, John Yoo, Lorne S ParnesAbstract:Objectives: To develop a new method of screening Audiometry that reduces the adverse effects of low frequency background noise by using active noise reduction (ANR) headphone technology. Design: Prospective testing within an anechoic chamber evaluated the physical properties of ANR headphones. A prospective clinical crossover study compared standard Audiometry with ANR headphone Audiometry. Methods: Bose Aviation X circum-aural ANR headphones were tested for both active and passive attenuation properties in a hemi-anechoic chamber using a head and torso simulator. Thirty-seven otology clinic patients then underwent standard Audiometry and ANR Audiometry, which was performed in a 30- and/or 40-dB sound field. Results: Objective ANR headphone attenuation levels of up to 12 dB were achieved at frequencies below 2,000 Hz. In standard audiometric testing, 40 dB of narrow-band background noise decreased patient pure tone thresholds by 24 dB at 250 Hz. The use of ANR technology provided 12 dB of additional attenuation. This resulted in a significant improvement in test results despite the 40 dB of background noise (P = <0.001). In a 30-dB sound field, standard audiometric thresholds were shifted down by an average of 12 dB. The use of ANR technology completely attenuated this effect and resulted in a significant improvement in results (P = <0.01). These results were identical to those obtained in a quiet sound booth. Conclusions: Despite a 30-dB sound field, ANR Audiometry can produce an audiogram identical to that obtained in a double-walled sound booth. ANR headphone Audiometry improves the sensitivity of audiometric screening for mild low-frequency hearing loss. This technology may have important applications for screening in schools, industry, and community practices.
De Wet Swanepoel - One of the best experts on this subject based on the ideXlab platform.
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automated smartphone threshold Audiometry validity and time efficiency
Journal of The American Academy of Audiology, 2017Co-Authors: Jessica Van Tonder, De Wet Swanepoel, Robert H Eikelboom, Faheema Mahomedasmail, Hermanus Carel MyburghAbstract:Smartphone-based threshold Audiometry with automated testing has the potential to provide affordable access to Audiometry in underserved contexts. To validate the threshold version (hearTest) of the validated hearScreen™ smartphone-based application using inexpensive smartphones (Android operating system) and calibrated supra-aural headphones. A repeated measures within-participant study design was employed to compare air-conduction thresholds (0.5–8 kHz) obtained through automated smartphone Audiometry to thresholds obtained through conventional Audiometry. A total of 95 participants were included in the study. Of these, 30 were adults, who had known bilateral hearing losses of varying degrees (mean age = 59 yr, standard deviation [SD] = 21.8; 56.7% female), and 65 were adolescents (mean age = 16.5 yr, SD = 1.2; 70.8% female), of which 61 had normal hearing and the remaining 4 had mild hearing losses. Threshold comparisons were made between the two test procedures. The Wilcoxon signed-ranked test was used for comparison of threshold correspondence between manual and smartphone thresholds and the paired samples t test was used to compare test time. Within the adult sample, 94.4% of thresholds obtained through smartphone and conventional Audiometry corresponded within 10 dB or less. There was no significant difference between smartphone (6.75-min average, SD = 1.5) and conventional Audiometry test duration (6.65-min average, SD = 2.5). Within the adolescent sample, 84.7% of thresholds obtained at 0.5, 2, and 4 kHz with hearTest and conventional Audiometry corresponded within ≤5 dB. At 1 kHz, 79.3% of the thresholds differed by ≤10 dB. There was a significant difference (p The hearTest application with calibrated supra-aural headphones provides a cost-effective option to determine valid air-conduction hearing thresholds.
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clinical validation of automated Audiometry with continuous noise monitoring in a clinically heterogeneous population outside a sound treated environment
International Journal of Audiology, 2016Co-Authors: Christopher G Brennanjones, De Wet Swanepoel, Robert H Eikelboom, Peter L Friedland, Marcus D AtlasAbstract:AbstractObjective: Examine the accuracy of automated Audiometry in a clinically heterogeneous population of adults using the KUDUwave automated audiometer. Design: Prospective accuracy study. Manual Audiometry was performed in a sound-treated room and automated Audiometry was not conducted in a sound-treated environment. Study sample: 42 consecutively recruited participants from a tertiary otolaryngology department in Western Australia. Results: Absolute mean differences ranged between 5.12–9.68 dB (air-conduction) and 8.26–15 dB (bone-conduction). A total of 86.5% of manual and automated 4FAs were within 10 dB (i.e. ±5 dB); 94.8% were within 15 dB. However, there were significant (p 0.05; R2 = 0.11). The presence of a hearing loss (better ear ≥26 dB) did not si...
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diagnostic hearing assessment in schools validity and time efficiency of automated Audiometry
Journal of The American Academy of Audiology, 2016Co-Authors: Faheema Mahomedasmail, De Wet Swanepoel, Robert H EikelboomAbstract:Background Poor follow-up compliance from school-based hearing screening typically undermines the efficacy of school-based hearing screening programs. Onsite diagnostic Audiometry with automation may reduce false positives and ensure directed referrals. Purpose To investigate the validity and time efficiency of automated diagnostic air- and bone-conduction Audiometry for children in a natural school environment following hearing screening. Research design A within-subject repeated measures design was employed to compare air- and bone-conduction pure-tone thresholds (0.5-4 kHz), measured by manual and automated pure-tone Audiometry. Study sample Sixty-two children, 25 males and 37 females, with an average age of 8 yr (standard deviation [SD] = 0.92; range = 6-10 yr) were recruited for this study. The participants included 30 children who failed on a hearing screening and 32 children who passed a hearing screening. Data analysis Threshold comparisons were made for air- and bone-conduction thresholds across ears tested with manual and automated Audiometry. To avoid a floor effect thresholds of 15 dB HL were excluded in analyses. The Wilcoxon signed ranked test was used to compare threshold correspondence for manual and automated thresholds and the paired samples t-test was used to compare test time. Statistical significance was set as p ≤ 0.05. Results 85.7% of air-conduction thresholds and 44.6% of bone-conduction thresholds corresponded within the normal range (15 dB HL) for manual and automated Audiometry. Both manual and automated Audiometry air- and bone-conduction thresholds exceeded 15 dB HL in 9.9% and 34.0% of thresholds, respectively. For these thresholds, average absolute differences for air- and bone-conduction thresholds were 6.3 (SD = 8.3) and 2.2 dB (SD = 3.6) and they corresponded within 10 dB across frequencies in 87.7% and 100.0%, respectively. There was no significant difference between manual and automated air- and bone-conduction across frequencies for these thresholds. Conclusion Using onsite automated diagnostic Audiometry for children who fail hearing screening may improve the efficacy of school-based screening programs by reducing false positives and ensuring directed referrals for audiological or medical intervention or both.
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validity of automated threshold Audiometry a systematic review and meta analysis
Ear and Hearing, 2013Co-Authors: Faheema Mahomed, De Wet Swanepoel, Robert H Eikelboom, Maggi E SoerAbstract:Objectives A systematic literature review and meta-analysis on the validity (test-retest reliability and accuracy) of automated threshold Audiometry compared with the gold standard of manual threshold Audiometry was conducted. Design A systematic literature review was completed in peer-reviewed databases on automated compared with manual threshold Audiometry. Subsequently a meta-analysis was conducted on the validity of automated Audiometry. Methods A multifaceted approach, covering several databases and using different search strategies was used to ensure comprehensive coverage and to cross-check search findings. Databases included: MEDLINE, Scopus, and PubMed; a secondary search strategy was the review of references from identified reports. Reports including within-subject comparisons of manual and automated threshold Audiometry were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) on test-retest reliability for automated compared with manual Audiometry were determined to assess the validity of automated threshold Audiometry. Results In total, 29 reports on automated Audiometry (method of limits and the method of adjustment techniques) met the inclusion criteria and were included in this review. Most reports included data on adult populations using air conduction testing with limited data on children, bone conduction testing and the effects of hearing status on automated Audiometry. Meta-analysis test-retest reliability for automated Audiometry was within typical test-retest variability for manual Audiometry. Accuracy results on the meta-analysis indicated overall average differences between manual and automated air conduction Audiometry (0.4 dB, 6.1 SD) to be comparable with test-retest differences for manual (1.3 dB, 6.1 SD) and automated (0.3 dB, 6.9 SD) Audiometry. No significant differences (p > 0.01; summarized data analysis of variance) were seen in any of the comparisons between test-retest reliability of manual and automated Audiometry compared with differences between manual and automated Audiometry. Conclusion Automated Audiometry provides an accurate measure of hearing threshold, but validation data are still limited for (1) automated bone conduction Audiometry; (2) automated Audiometry in children and difficult-to-test populations and; (3) different types and degrees of hearing loss.
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clinical validation of the amtas automated audiometer
International Journal of Audiology, 2013Co-Authors: Robert H Eikelboom, De Wet Swanepoel, Shahpar Motakef, Gemma UpsonAbstract:AbstractObjective: To validate the air- and bone-conduction AMTAS automated Audiometry system. Design: Prospective study. Test-retest reliability was determined by assessing adults with AMTAS air- and bone-conduction Audiometry. Accuracy was determined by comparing AMTAS and manual Audiometry conducted on adults. AMTAS testing was conducted in a quiet room and manual Audiometry in a sound booth. Study sample: Ten participants for test-retest reliability tests and 44 participants to determine accuracy were included. Participants had varying degrees of hearing loss. Results: For test-retest reliability the overall difference in air-conduction hearing thresholds (n = 119) was 0.5 dB. The spread of differences (standard deviation of absolute differences) was 4.9 dB. For bone-conduction thresholds (n = 99) the overall difference was − 0.2 dB, and the spread of differences 4.5 dB. For accuracy the overall difference in air-conduction hearing thresholds (n = 509) between the two techniques was 0.1 dB. The spread...
Donald P Forster - One of the best experts on this subject based on the ideXlab platform.
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pure tone Audiometry and impedance screening of school entrant children by nurses evaluation in a practical setting
Journal of Epidemiology and Community Health, 1997Co-Authors: Ian Holtby, Donald P Forster, Udhaya KumarAbstract:BACKGROUND: Screening for hearing loss in English children at entry to school (age 5-6 years) is usually by pure tone Audiometry sweep undertaken by school nurses. This study aimed to compare the validity and screening rates of pure tone Audiometry with impedance screening in these children. METHODS: Two stage pure tone Audiometry and impedance methods of screening were compared in 610 school entry children from 19 infant schools in north east England. Both procedures were completed by school nurses. The results of screening were validated against subsequent clinical assessment, including otological examination and actions taken by an independent assessor. RESULTS: Both methods produced broadly similar validation indices after two stages of screening: sensitivity was 74.4% for both methods; specificity was 92.1% and 90.0%; and predicted values of a positive test 43.2% and 37.6% respectively for pure tone Audiometry and impedance methods. Single stage screening in both methods produced higher sensitivity but lower specificity and predictive values of a positive test than two stage screening. Screening rates were appreciably higher with impedance methods than with pure tone Audiometry. CONCLUSIONS: In choosing the method to be used, it must be borne in mind that the impedance method is technically more efficient but takes longer than pure tone Audiometry screening. However, the latter method allows opportunity for other health inquiries in these children.
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evaluation of pure tone Audiometry and impedance screening in infant schoolchildren
Journal of Epidemiology and Community Health, 1992Co-Authors: Ian Holtby, Donald P ForsterAbstract:STUDY OBJECTIVE--The aims were (1) to evaluate impedance measurements against pure tone Audiometry as a screening method for the detection of middle ear changes associated with hearing loss in infant school children; (2) to estimate the costs of the health authority of each method. DESIGN--The study involved two stage screening in which both methods were offered, pure tone Audiometry being carried out by school nurses and impedance screening by a doctor. SETTING--18 infant or primary schools in Langbaurgh, Cleveland, UK. PARTICIPANTS--610 previously unscreened infant school children took part in the study. MEASUREMENTS AND MAIN RESULTS--Main outcome measures were the sensitivity, specificity, and predictive value of each screening method, using clinical assessment and action as the validating technique. The sensitivity and the predictive value of a positive test in two stage impedance screening was markedly superior to that of pure tone Audiometry. The specificity was similar using the two methods. In addition the impedance methods was more rapid and estimated to consume less resource as a screening procedure than pure tone Audiometry. CONCLUSIONS--The superiority of the use of impedance screening established in this study should be confirmed in a subsequent audit carried out purely by school nurses.
Edward A Neuwelt - One of the best experts on this subject based on the ideXlab platform.
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early changes in auditory function as a result of platinum chemotherapy use of extended high frequency Audiometry and evoked distortion product otoacoustic emissions
Journal of Clinical Oncology, 2007Co-Authors: Kristin Knight, Dale F Kraemer, Christiane Winter, Edward A NeuweltAbstract:Purpose The objective is to describe progressive changes in hearing and cochlear function in children and adolescents treated with platinum-based chemotherapy and to begin preliminary evaluation of the feasibility of extended high-frequency Audiometry and distortion product otoacoustic emissions for ototoxicity monitoring in children. Patients and Methods Baseline and serial measurement of conventional pure-tone Audiometry (0.5 to 8 kHz) and evoked distortion product otoacoustic emissions (DPOAEs) were conducted for 32 patients age 8 months to 20 years who were treated with cisplatin and/or carboplatin chemotherapy. Seventeen children also had baseline and serial measurement of extended high-frequency (EHF) Audiometry (9 to 16 kHz). Audiologic data were analyzed to determine the incidence of ototoxicity using the American Speech-Language-Hearing Association criteria, and the relationships between the different measures of ototoxicity. Results Of the 32 children, 20 (62.5%) acquired bilateral ototoxicity i...
Ian Holtby - One of the best experts on this subject based on the ideXlab platform.
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pure tone Audiometry and impedance screening of school entrant children by nurses evaluation in a practical setting
Journal of Epidemiology and Community Health, 1997Co-Authors: Ian Holtby, Donald P Forster, Udhaya KumarAbstract:BACKGROUND: Screening for hearing loss in English children at entry to school (age 5-6 years) is usually by pure tone Audiometry sweep undertaken by school nurses. This study aimed to compare the validity and screening rates of pure tone Audiometry with impedance screening in these children. METHODS: Two stage pure tone Audiometry and impedance methods of screening were compared in 610 school entry children from 19 infant schools in north east England. Both procedures were completed by school nurses. The results of screening were validated against subsequent clinical assessment, including otological examination and actions taken by an independent assessor. RESULTS: Both methods produced broadly similar validation indices after two stages of screening: sensitivity was 74.4% for both methods; specificity was 92.1% and 90.0%; and predicted values of a positive test 43.2% and 37.6% respectively for pure tone Audiometry and impedance methods. Single stage screening in both methods produced higher sensitivity but lower specificity and predictive values of a positive test than two stage screening. Screening rates were appreciably higher with impedance methods than with pure tone Audiometry. CONCLUSIONS: In choosing the method to be used, it must be borne in mind that the impedance method is technically more efficient but takes longer than pure tone Audiometry screening. However, the latter method allows opportunity for other health inquiries in these children.
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evaluation of pure tone Audiometry and impedance screening in infant schoolchildren
Journal of Epidemiology and Community Health, 1992Co-Authors: Ian Holtby, Donald P ForsterAbstract:STUDY OBJECTIVE--The aims were (1) to evaluate impedance measurements against pure tone Audiometry as a screening method for the detection of middle ear changes associated with hearing loss in infant school children; (2) to estimate the costs of the health authority of each method. DESIGN--The study involved two stage screening in which both methods were offered, pure tone Audiometry being carried out by school nurses and impedance screening by a doctor. SETTING--18 infant or primary schools in Langbaurgh, Cleveland, UK. PARTICIPANTS--610 previously unscreened infant school children took part in the study. MEASUREMENTS AND MAIN RESULTS--Main outcome measures were the sensitivity, specificity, and predictive value of each screening method, using clinical assessment and action as the validating technique. The sensitivity and the predictive value of a positive test in two stage impedance screening was markedly superior to that of pure tone Audiometry. The specificity was similar using the two methods. In addition the impedance methods was more rapid and estimated to consume less resource as a screening procedure than pure tone Audiometry. CONCLUSIONS--The superiority of the use of impedance screening established in this study should be confirmed in a subsequent audit carried out purely by school nurses.