Assessing the efficacy of asynchronous telehealth-based hearing screening and diagnostic services using automated audiometry in a rural South African school

Abstract

BackgroundAsynchronous automated telehealth-based hearing screening and diagnostic testing can be used within the rural school context to identify and confirm hearing loss.ObjectiveThe aims of the study were to evaluate the efficacy of an asynchronous telehealth-based service delivery model using automated technology for screening and diagnostic testing as well as to describe the prevalence, type and degree of hearing loss.MethodA comparative within-subject design was used. Frequency distributions, sensitivity, specificity scores as well as the positive and negative predictive values were calculated. Testing was conducted in a non-sound-treated classroom within a school environment on 73 participants (146 ears). The sensitivity and specificity rates were 65.2% and 100%, respectively. Diagnostic accuracy was 91.7% and the negative predictive values (NPV) and positive predictive values (PPV) were 93.8% and 100%, respectively.ResultsResults revealed that 23 ears of 20 participants (16%) presented with hearing loss. Twelve per cent of ears presented with unilateral hearing impairment and 4% with bilateral hearing loss. Mild hearing loss was identified as most prevalent (8% of ears). Eight ears obtained false-negative results and presented with mild low- to mid-frequency hearing loss. The sensitivity rate for the study was low and was attributed to plausible reasons relating to test accuracy, child-related variables and mild low-frequency sensory-neural hearing loss.ConclusionThe study demonstrates that asynchronous telehealth-based automated hearing testing within the school context can be used to facilitate early identification of hearing loss; however, further research and development into protocol formulation, ongoing device monitoring and facilitator training is required to improve test sensitivity and ensure accuracy of results.

Results of hearing screening of school-age children in Bishkek, Kyrgyzstan

“…Feder et al (2017) found that 7.7% of Canadian children aged 6-19 had HL at one or more pure-tone frequencies. Govender and Mars (2018) assessed 146 ears and found that 23 ears of 20 children (16%) presented with hearing loss. In rural areas of Poland, the rate of positive results of hearing screening was 16.4% (Skarżyński et al, 2020).…”

An evidence‐based synthesis of instructional reading and spelling procedures using telepractice: A rapid review in the context of COVID‐19

“…The benefits of telepractice are well-documented across both education and allied health (Keck andDoarn 2014, Valentine et al 2021). These benefits include increased service availability, convenience, improved caseload management resulting in more costeffective service delivery, improved access to services for people living in rural and remote areas (Fairweather et al 2016); and removal of travel and geographical barriers (Govender andMars 2018, Yoo et al 2020). Telepractice has facilitated access to education for students who are unable to attend full-time classes (Burdina et al 2019) and has a long history through Distance Learning programs (Cavanaugh et al 2004).…”

“…These benefits include increased service availability, convenience, improved caseload management resulting in more cost‐effective service delivery, improved access to services for people living in rural and remote areas (Fairweather et al . 2016); and removal of travel and geographical barriers (Govender and Mars 2018, Yoo et al . 2020).…”

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