@Article{info:doi/10.2196/51770,
author="Sienko, Anna
and Thirunavukarasu, Arun James
and Kuzmich, Tanya
and Allen, Louise",
title="An Initial Validation of Community-Based Air-Conduction Audiometry in Adults With Simulated Hearing Impairment Using a New Web App, DigiBel: Validation Study",
journal="JMIR Form Res",
year="2024",
month="Jan",
day="25",
volume="8",
pages="e51770",
keywords="audiology; audiometry; hearing test; eHealth; mobile application; automated audiometry; hearing loss; hearing impairment; web-app; web-apps; web-application; digital health; hearing; adult; adults; mobile health; mhealth; community-based; home-based; assistive technology; screening; usability; ears; ear",
abstract="Background: Approximately 80{\%} of primary school children in the United States and Europe experience glue ear, which may impair hearing at a critical time for speech acquisition and social development. A web-based app, DigiBel, has been developed primarily to identify individuals with conductive hearing impairment who may benefit from the temporary use of bone-conduction assistive technology in the community. Objective: This preliminary study aims to determine the screening accuracy and usability of DigiBel self-assessed air-conduction (AC) pure tone audiometry in adult volunteers with simulated hearing impairment prior to formal clinical validation. Methods: Healthy adults, each with 1 ear plugged, underwent automated AC pure tone audiometry (reference test) and DigiBel audiometry in quiet community settings. Threshold measurements were compared across 6 tone frequencies and DigiBel test-retest reliability was calculated. The accuracy of DigiBel for detecting more than 20 dB of hearing impairment was assessed. A total of 30 adults (30 unplugged ears and 30 plugged ears) completed both audiometry tests. Results: DigiBel had 100{\%} sensitivity (95{\%} CI 87.23-100) and 72.73{\%} (95{\%} CI 54.48-86.70) specificity in detecting hearing impairment. Threshold mean bias was insignificant except at 4000 and 8000 Hz where a small but significant overestimation of threshold measurement was identified. All 24 participants completing feedback rated the DigiBel test as good or excellent and 21 (88{\%}) participants agreed or strongly agreed that they would be able to do the test at home without help. Conclusions: This study supports the potential use of DigiBel as a screening tool for hearing impairment. The findings will be used to improve the software further prior to undertaking a formal clinical trial of AC and bone-conduction audiometry in individuals with suspected conductive hearing impairment. ",
issn="2561-326X",
doi="10.2196/51770",
url="https://formative.jmir.org/2024/1/e51770",
url="https://doi.org/10.2196/51770",
url="http://www.ncbi.nlm.nih.gov/pubmed/38271088"
}