Accuracy of affordable instruments for hearing screening in adults and the elderly. / Acurácia de instrumentos de custo acessível para triagem auditiva de adultos e idosos.

PURPOSE: To evaluate the accuracy of affordable instruments for hearing screening of adults and the elderly. METHODS: This study was carried out with users of a Hearing Health Service of the Unified Health System. All were screened with the MoBASA smartphone application, the Telehealth audiometer (TH) and the electronic version of the Hearing Handicap Inventory for the Elderly - screening version - eHHIE-S. The examiners were blinded to the results of the screening tests and pure tone audiometry (PTA). Hearing impairment was considered for those with a PTA quadritonal mean greater than 40 dB in the best ear. Sensitivity, specificity and positive and negative predictive values (PPV and NPV, respectively) were calculated. The Kappa index was used as an agreement indicator between the PTA and the screening results. RESULTS: The sample consisted of 80 individuals between 18 and 94 years old (55.18 ± 20.21). In the PTA test, 21 individuals (26.25%) had typical hearing and 59 (73.75%) hearing loss. In the hearing screening tests, sensitivity, specificity, PPV and NPV values greater than 75% were observed with the MoBASA as well as in terms of sensitivity and NPV of the TH and the eHHIE-S. The TH and the eHHIE-S specificity and PPV were less than 75%. The Kappa index indicated a substantial agreement (0.6) between the PTA and the MoBASA screening results. The TH and the eHHIE-S showed regular agreement (0.3). CONCLUSION: MoBASA proved to be an accurate method for hearing screening of adults and the elderly with disabling hearing loss.

OBJETIVO: Avaliar a acurácia de instrumentos de custo acessível para triagem auditiva de adultos e idosos. MÉTODO: Este estudo foi realizado com usuários de um Serviço de Saúde Auditiva do SUS. Todos foram submetidos a triagem com o aplicativo de smartphone MoBASA, o audiômetro Telessaúde (TS) e a versão eletrônica do Questionário de Handicap da Audição para Idosos (Hearing Handicap Inventory for the Elderly ­ screening version - eHHIE-S). Os examinadores foram cegos quanto aos resultados dos testes de triagem e para os dados de audiometria de tom puro (ATP). Foram considerados com deficiência auditiva aqueles com média quadritonal na ATP maiores que 40 dB na melhor orelha. Sensibilidade, especificidade e valores preditivos positivo (VPP) e negativo (VPN) foram calculados. O índice Kappa foi usado como um indicador de concordância entre ATP e os resultados da triagem. RESULTADOS: A amostra constou de 80 indivíduos entre 18 a 94 anos (55,18 ± 20,21). Na ATP, 21 indivíduos (26,25%) apresentaram audição normal e 59 (73,75%) perda auditiva incapacitante. Nos testes de triagem auditiva observou-se valores de sensibilidade, especificidade, VPP e VPN maiores do que 75% no MoBASA e na sensibilidade e VPN do TS e eHHIE-S. Já a especificidade e VPP do TS e eHHIE-S foram inferiores a 75%. O índice Kappa indicou concordância substancial (0,6) entre o ATP e os resultados do MoBASA. No TS e eHHIE-S foi constatada regular concordância (0,3). CONCLUSÃO: O MoBASA demonstrou ser um método acurado para triagem auditiva de adultos e idosos com perda auditiva incapacitante.

Sensitivity and specificity of three hearing screening protocols in the school setting

ABSTRACT Objective: to evaluate the sensitivity and specificity of three hearing screening protocols: audiometry, tympanometry, and transient evoked otoacoustic emissions (TEOAE). Methods: a cross-sectional study comprising 70 schoolchildren aged 6-14 years old (9.9 ± 2). All participants underwent a complete audiological evaluation and screening procedures. Procedures were compared regarding sensitivity, specificity, and positive and negative predictive values. Results: sensitivity and specificity were, respectively, 64.71% and 66.04% for audiometry, 64.71% and 73.58% for tympanometry, and 66.67% and 78.85% for TEOAE. The positive and negative predictive values were 37.93% and 14.63% for audiometry, 44% and 13.33% for tympanometry, and 52.17% and 12.77% for TEOAE. Conclusions: in the school setting, TEOAE stands out from the two other screening protocols, in all measures regarding sensitivity, accuracy, and predictive values.