title: Automated hearing tests: applying the otogram to patients who are difficult to test.
abstract: OBJECTIVE
  The Otogram is an automated audiometer capable of determining air and bone conduction thresholds with masking when appropriate. The manufacturer claims that testing can be done in a quiet physician's consultation room without a sound-treated booth. We aimed to test the validity of the Otogram on "difficult-to-test" patients, all of whom require masking.
  
  
  METHODS
  Twenty-eight difficult-to-test patients underwent three audiograms: two by an audiologist and one by the Otogram. First, audiograms performed by the audiologists were compared, establishing test-retest reliability. Second, audiograms performed by the Otogram were compared to those of the audiologists. We calculated the percentage of pure-tone thresholds that were in agreement by 10 dB. Weighted kappa statistical analyses demonstrated levels of agreement.
  
  
  RESULTS
  Comparisons between audiologists demonstrated a very high degree of agreement. More than 90% of air and bone conduction thresholds fell within 10 dB of each other. Comparisons between audiologists and the Otogram also demonstrated a high degree of agreement.
  
  
  CONCLUSIONS
  The Otogram has the capability to accurately ascertain air and bone conduction thresholds. It appropriately used masking when indicated. The Otogram has great potential as a diagnostic tool to improve access to health care, especially where hearing test facilities are limited or unavailable.
authors.affiliation: Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB. jwyu@ualberta.ca
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yu
authors.forename: Amberley
authors.initials: A
authors.lastname: Ostevik
authors.forename: Bill
authors.initials: B
authors.lastname: Hodgetts
authors.forename: Allan
authors.initials: A
authors.lastname: Ho
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone / Q000295:instrumentation*; D001309:Auditory Threshold; D001844:Bone Conduction; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D004867:Equipment Design; D006310:Hearing Aids; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000534:rehabilitation; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000175:diagnosis* / Q000534:rehabilitation; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000534:rehabilitation; D006801:Humans; D015588:Observer Variation; D010470:Perceptual Masking; D015203:Reproducibility of Results; D053441:Suture Anchors