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Science Translational Medicine  24 Jun 2015:
Vol. 7, Issue 293, pp. 293ec103
DOI: 10.1126/scitranslmed.aac7158

While child development experts debate the impact of tablet use by children, one team, Yeung et al., set out to ask a simple question: Could a tablet-based audiometer differentiate normal from abnormal hearing in children? Specifically, the goal was to test hearing ability in the presence of ambient noise, using standard ear bud headphones, and without a professional administering the test. A total of 79 children ranging in age from 5 to 17 years each used an iPad Air2 running an app called “ShoeBOX Audiometry” to complete a hearing test—without direct input from a clinician. The app was designed around a forced-choice algorithm to find the point at which the child could hear a sound (the threshold) over a fixed set of frequencies, from 500 to 4000 Hz, which is a relevant range for speech. For comparison, each child also completed a standard hearing test in a soundbooth that blocked out all environmental noise. Yeung and colleagues reported that, although a direct comparison between the soundbooth and the tablet tests cannot be made owing to the uncalibrated nature of the headphones and uncontrollable noise, the tablet test did have a strong negative predictive value (89.7%) as well as high sensitivity (91.2%) for diagnosing hearing loss. In summary, ShoeBOX Audiometry could flag children at risk for future hearing loss that occurs in 15% of children.

The authors acknowledge that low-frequency hearing assessment is adversely affected by environmental noise that would not be present in a standard sound booth. Nevertheless, the capability for self-assessment of hearing screening outside the clinic has a broad, global health impact. Given the desire to detect hearing impairment early in children, such a low-cost, portable screening tool could identify children with or at risk for hearing loss and prompt them to seek clinical help.

J. C. Yeung et al., Self-administered hearing loss screening using an interactive, tablet play audiometer with ear bud headphones. Int. J. Pediatr. Otorhinolaryngol. 10.1016/j.ijporl.2015.05.021 (2015). [Abstract]

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