title: Development and analysis of a low-cost screening tool to identify and classify hearing loss in children: a proposal for developing countries.
abstract: OBJECTIVE
  A lack of attention has been given to hearing health in primary care in developing countries. A strategy involving low-cost screening tools may fill the current gap in hearing health care provided to children. Therefore, it is necessary to establish and adopt lower-cost procedures that are accessible to underserved areas that lack other physical or human resources that would enable the identification of groups at risk for hearing loss. The aim of this study was to develop and analyze the efficacy of a low-cost screening tool to identify and classify hearing loss in children.
  
  
  METHODS
  A total of 214 2-to-10 year-old children participated in this study. The study was conducted by providing a questionnaire to the parents and comparing the answers with the results of a complete audiological assessment. Receiver operating characteristic (ROC) curves were constructed, and discriminant analysis techniques were used to classify each child based on the total score.
  
  
  RESULTS
  We found conductive hearing loss in 39.3% of children, sensorineural hearing loss in 7.4% and normal hearing in 53.3%. The discriminant analysis technique provided the following classification rule for the total score on the questionnaire: 0 to 4 points - normal hearing; 5 to 7 points - conductive hearing loss; over 7 points - sensorineural hearing loss.
  
  
  CONCLUSIONS
  Our results suggest that the questionnaire could be used as a screening tool to classify children with normal hearing or hearing loss and according to the type of hearing loss based on the total questionnaire score.
authors.affiliation: Centro de Docência e Pesquisa em Fonoaudiologia, Fisioterapia e Terapia Ocupacional, Universidade de São Paulo, São Paulo, Brazil. alesamelli@usp.br
authors.forename: Alessandra Giannella
authors.initials: AG
authors.lastname: Samelli
authors.forename: Camila Maia
authors.initials: CM
authors.lastname: Rabelo
authors.forename: Ana Paula Chaparin
authors.initials: AP
authors.lastname: Vespasiano
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005192:Family Health; D005260:Female; D006078:Government Programs / Q000379:methods / Q000592:standards; D034381:Hearing Loss / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D010290:Parents; D011795:Surveys and Questionnaires / Q000592:standards*
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