Diagnosis of hearing loss using automated audiometry in an asynchronous telehealth model : a pilot accuracy study

Abstract

INTRODUCTION : Standard criteria exist for diagnosing different types of hearing loss, yet audiologists interpret audiograms manually. This pilot study examined the feasibility of standardised interpretations of audiometry in a telehealth model of care. The aim of this study was to examine diagnostic accuracy of automated audiometry in adults with hearing loss in an asynchronous telehealth model using pre-defined diagnostic protocols. MATERIALS AND METHODS : We recruited 42 study participants from a public audiology and otolaryngology clinic in Perth, Western Australia. Manual audiometry was performed by an audiologist either before or after automated audiometry. Diagnostic protocols were applied asynchronously for normal hearing, disabling hearing loss, conductive hearing loss and unilateral hearing loss. Sensitivity and specificity analyses were conducted using a two-by-two matrix and Cohen’s kappa was used to measure agreement. RESULTS : The overall sensitivity for the diagnostic criteria was 0.88 (range: 0.86 – 1) and overall specificity was 0.93 (range: 0.86 – 0.97). Overall Kappa (k) agreement was “substantial” k = 0.80 [95%CI 0.70, 0.89] and significant at p<0.001. DISCUSSION : Pre-defined diagnostic protocols applied asynchronously to automated audiometry provide accurate identification of disabling, conductive and unilateral hearing loss. This method has the potential to improve synchronous and asynchronous tele-audiology service delivery.