Hearing screening with portable screening pure-tone audiometer and distortion-product otoacoustic emissions.
BACKGROUND
Hearing loss is a prevalent chronic problem among adults of all ages. Early identification and intervention for hearing loss will reduce the magnitude of functional disability. Hearing screening is an important item of physical examination. The purpose of this study is to evaluate the validity of hearing screening by means of the portable screening pure-tone audiometer and distortion-product otoacoustic emissions (DPOAE) measurement.


METHODS
This prospective study recruited 64 subjects visiting Taipei Veterans Hospital for physical examination. They underwent hearing tests performed with screening pure-tone audiometer, DPOAE and conventional pure-tone audiometer. The results of conventional pure-tone audiometry were used for "gold standards" and the normal auditory function was defined as the threshold less than or equal to 20 dB. Compared with the "gold standards," we used kappa statistic to assess the agreement of hearing results measured with screening pure-tone audiometer and DPOAE.


RESULTS
For screening pure-tone audiometry, the kappa values at the 5 tested frequencies (0.5, 1, 2, 4, 8 kHz) ranged from 0.79 to 0.93 and the agreement with the gold standards was classified as "excellent." The sensitivity, specificity and test accuracy values ranged from 91.8-98.5%, 88.0-96.3% and 89.8-96.9%, respectively. For DPOAE measurement, the kappa values at the 3 tested frequencies (1, 2, 4 kHz) ranged from 0.62 to 0.78. The agreement was classified as "good" at 1, 4 kHz and "excellent" at 2 kHz. The sensitivity, specificity and test accuracy values ranged from 91.7-98.5%, 62.3-86.8% and 81.3-89.1%.


CONCLUSIONS
We recommend a hearing screening measured at 0.5, 1, 2, 4, 8 kHz with screening pure-tone audiometer in a simple-type soundproof chamber and performed by a screening assistant. The DPOAE measurement may be used as an auxiliary tool to provide more information for early identification and differential diagnosis of hearing loss in clinical application.
Department of Otolaryngology, Taipei Veterans General Hospital, Taiwan, ROC.
Yi-Fen
YF
Wang
Sun-Sang
SS
Wang
Chun-Ching
CC
Tai
Lih-Ching
LC
Lin
An-Suey
AS
Shiao
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D004311:Double-Blind Method; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D011446:Prospective Studies; D012684:Sensory Thresholds