title: Hearing assessment-reliability, accuracy, and efficiency of automated audiometry.
abstract: OBJECTIVE
  This study investigated the reliability, accuracy, and time efficiency of automated hearing assessment using a computer-based telemedicine-compliant audiometer.
  
  
  METHODS
  Thirty normal-hearing subjects and eight hearing-impaired subjects were tested with pure-tone air conduction audiometry (125-8,000 Hz) in a manual and automated configuration in a counterbalanced manner. For the normal-hearing group each test was repeated to determine test-retest reliability and recording time, and preference for threshold-seeking method (manual vs. automated) was documented.
  
  
  RESULTS
  Test-retest thresholds were not significantly different for manual and automated testing. Manual audiometry test-retest correspondence was 5 dB or less in 88% of thresholds compared to 91% for automated audiometry. Thresholds for automated audiometry did not differ significantly from manual audiometry with 87% of thresholds in the normal-hearing group and 97% in the hearing-impaired group, corresponding within 5 dB or less of each other. The largest overall average absolute difference across frequencies was 3.6 +/- 3.9 dB for the normal-hearing group and 3.3 +/- 2.4 for the hearing-impaired group. Both techniques were equally time efficient in the normal-hearing population, and 63% of subjects preferred the automated threshold-seeking method.
  
  
  CONCLUSIONS
  Automated audiometry provides reliable, accurate, and time-efficient hearing assessments for normal-hearing and hearing-impaired adults. Combined with an asynchronous telehealth model it holds significant potential for reaching underserved areas where hearing health professionals are unavailable.
authors.affiliation: Department of Communication Pathology, University of Pretoria, Pretoria, South Africa. dewet.swanepoel@up.ac.za
authors.forename: De Wet
authors.initials: de W
authors.lastname: Swanepoel
authors.forename: Shadrack
authors.initials: S
authors.lastname: Mngemane
authors.forename: Silindile
authors.initials: S
authors.lastname: Molemong
authors.forename: Hilda
authors.initials: H
authors.lastname: Mkwanazi
authors.forename: Sizwe
authors.initials: S
authors.lastname: Tutshini
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone / Q000295:instrumentation / Q000379:methods*; D001309:Auditory Threshold; D016022:Case-Control Studies; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D017598:Efficiency, Organizational; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008507:Medically Underserved Area; D008875:Middle Aged; D012984:Software; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*; D013996:Time and Motion Studies