Article Figures & Data
Figures
- Figure 1.
Population Characteristics (N = 516)
Population distribution by sex (A), type of location (B), and age grouped into 10 year blocks (C) are shown. Of the 516 patients with consultations, 219 performed the hearing screening tests.
- Figure 2.
Duration and Results of Audiometry Screening By Age Group and Location (N = 219)
Duration of stages of the screening tests (A) are shown with each dot representing a patient and the median duration of each stage provided. Screening test results as a function of age groups of 10 years (B) and location type (C) are further broken down to normal (negative) or hearing loss detected (positive) by which tests.
- Figure 3.
Patient Flowchart and Hearing Screening Outcomes (N = 516)
ENT = ear, nose, and throat; PTA = pure-tone average.
The patient flowchart (A) illustrates the progression of patients from the initial inclusion criteria (total population) to the final stage of confirmed hearing impairment by the ENT doctor. The number and the percentage (according to the whole population) of patients at each stage is indicated. Cumulative ENT-confirmed hearing loss as the function of age in 10 year blocks (B). Note that SoTone alone predict almost all confirmed PTA-based hearing loss. The small inserted tables are the confusion matrix for SoTone and SoNoise, presenting the number of true positives, true negatives, false positives, and false negatives when predicting ENT diagnostics.
Tables
Overall reason (%) Specific reason No. (%) Permanent incapacity (25.6%) Categorical refusal 40 (13.5) Language barrier 26 (8.8) Behavioral difficulties 10 (3.4) Time constraints (54.6%) GP’s busy schedule 130 (43.8) Patient’s busy schedule 17 (5.7) SoTone only 15 (5.0) Temporary incapacity (10.1%) Tough diagnosis 16 (5.4) Noisy environment 9 (3.0) Otalgia 4 (1.6) COVID-19 1 (0.3) Already done (9.8%) Recent ENT consultation 29 (9.8) GP = general practitioner; ENT = ear, nose, and throat
- Table 2.
Performance of SoTone and SoNoise to Independently Predict ENT Diagnostic Results
Test type Sensitivity, %a Specificity, %b PPV, %c NPV, %d Accuracy, %e SoTone 2 50 92 50 88 SoNoise 42 50 85 11 50 ENT = ear, nose, and throat; NPV = negative predictive value; PPV = positive predictive value.
Note: Patients consulting ENT specialists were positive on at least 1 test which affects the pertinence of metrics based on negative predictions.
↵a Sensitivity = number of true positive results divided by total number of positive results.
↵b Specificity = number of true negative results divided by total number of negative results.
↵c PPV = number of true positive results divided by the number predicted positive.
↵d NPV = number of true negative results divided by number predicted negative.
↵e Accuracy = number of good predictions divided by the total number of predictions.
PLAIN-LANGUAGE SUMMARY
Original Research
App-Based Hearing Screenings May Improve Diagnosis of Hearing Disorders in Family Practice
Background and Goal:Hearing loss is a common deficit that remains underdiagnosed. Pure-tone audiometry, the gold standard for assessing hearing impairment, is costly and time-consuming. This study evaluated the acceptability and feasibility of hearing screening in the routine practice of private family medicine using two self-tests.
Study Approach: 516 consecutive patients aged older than 10 years attending three private French family-practice clinics were invited to undergo hearing screening. After a brief explanation, patients wore calibrated Bluetooth headphones and completed two tablet-based hearing tests: SoTone, which measures pure-tone thresholds, and SoNoise, which assesses speech recognition in noise. Any positive result led the general practitioner to recommend an ear-nose-throat (ENT) consultation. Adherence was checked by phone 1–3 months later.
Main Results:
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Of 516 patients eligible for screening, 219 (42%) completed the screening.
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On average, it took six minutes and eight seconds for consent, instruction, and completion of testing.
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Of the 219 people screened, 59 (27%) screened positive for some hearing impairment and were referred to an ENT specialist. Only 16 patients ultimately followed up, 14 of whom had confirmed hearing loss, and 8 received a prescription for hearing aids.
Why It Matters:Hearing problems are common, but often go undiagnosed in primary care. Even when hearing problems are identified, many patients don’t follow up with specialists. The findings from this study show that tablet-based hearing tests may help general practitioners improve the diagnosis of hearing disorders.
Hearing Screening in Private Family Practice Medicine Using Tablet Applications
Jean-Charles Ceccato, et al
Montpellier Neuroscience Institute, University of Montpellier, Montpellier, France
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