Abstract:
OBJECTIVES : A systematic literature review and meta-analysis on the
validity (test–retest reliability and accuracy) of automated threshold
audiometry compared with the gold standard of manual threshold audiometry
was conducted.
DESIGN : A systematic literature review was completed in peer-reviewed
databases on automated compared with manual threshold audiometry.
Subsequently a meta-analysis was conducted on the validity of automated
audiometry.
METHODS : A multifaceted approach, covering several databases and using
different search strategies was used to ensure comprehensive coverage
and to cross-check search findings. Databases included: MEDLINE,
Scopus, and PubMed; a secondary search strategy was the review of
references from identified reports. Reports including within-subject comparisons
of manual and automated threshold audiometry were selected
according to inclusion/exclusion criteria before data were extracted. For
the meta-analysis weighted mean differences (and standard deviations)
on test–retest reliability for automated compared with manual audiometry
were determined to assess the validity of automated threshold audiometry.
RESULTS : In total, 29 reports on automated audiometry (method of limits and
the method of adjustment techniques) met the inclusion criteria and were
included in this review. Most reports included data on adult populations
using air conduction testing with limited data on children, bone conduction
testing and the effects of hearing status on automated audiometry. Metaanalysis
test–retest reliability for automated audiometry was within typical
test–retest variability for manual audiometry. Accuracy results on the
meta-analysis indicated overall average differences between manual and
automated air conduction audiometry (0.4 dB, 6.1 SD) to be comparable
with test–retest differences for manual (1.3 dB, 6.1 SD) and automated (0.3
dB, 6.9 SD) audiometry. No significant differences (p > 0.01; summarized
data analysis of variance) were seen in any of the comparisons between
test–retest reliability of manual and automated audiometry compared with
differences between manual and automated audiometry.
CONCLUSION : Automated audiometry provides an accurate measure of
hearing threshold, but validation data are still limited for (1) automated
bone conduction audiometry; (2) automated audiometry in
children and difficult-to-test populations and; (3) different types and
degrees of hearing loss.
