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BACKGROUND AND OBJECTIVES: Half of older persons experience serious hearing loss, yet it remains under-assessed in primary care clinics. Providers note time constraints as barriers and patients often minimize or deny their hearing loss. We tested the effectiveness of a simple hearing screen in primary care settings and whether including a brochure describing hearing loss, its consequences, and treatment would increase referrals for formal audiometric assessments. RESEARCH DESIGN AND METHODS: We designed a longitudinal effectiveness study assessing three interventions: Screening alone; Screening plus a brochure handed to the person testing positive; and Screening plus the brochure with a brief review. The screening was accomplished by intake personnel. The results of a positive screen were given to the primary care practitioner. The approach was designed to enable its use across a range of primary care settings. Follow-ups occurred at 4 and 8 months. RESULTS: A total of 111 older adults attending 7 primary care clinics screened positive for having possible hearing loss by intake personnel. A total of 46 received the educational brochure. Physicians discussed test results with two-thirds yet recommended further testing for only half of the participants. Physician recommendations were strongly motivating (OR = 9.12, 95% CI: 3.54-23.52) and those receiving the brochure were still more likely to seek further testing (OR = 2.61, 95% CI: 1.07-6.36) even when physician recommendations were controlled. Additionally, when combined, the 2 options were strongly motivating: all participants receiving both a referral and a brochure sought further testing. DISCUSSION AND IMPLICATIONS: A simple screen and educational brochure on hearing loss improved follow-up for a formal hearing evaluation which may improve hearing health care and minimize negative outcomes. The study also identified barriers to implementation, including how to motivate practitioners and assist intake personnel in integrating hearing screening into their routine intake procedures, supporting further research. Clinical Trials Registration Number: NCT0203713 9.

AbstractObjectivesDesign and study sampleResultsConclusionsThis two-part pilot study investigated the feasibility of using a frequency selectivity measure (TFS) to develop a novel hearing screening test for cooperative adults. Study 1 determined the optimal masker level, while Study 2 assessed the reliability of a self-administered TFS test prototype performed at the selected masker level.Study 1 (normal hearing, n = 20) examined masker-level effects on TFS using a manual threshold determination method from an earlier study. Study 2 (normal hearing, n = 21; hearing loss, n = 5) evaluated the reliability of a self-administered TFS test using a new automated threshold determination procedure.Moderate masker levels (30–40 dB SPL) were suitable for the TFS measurements, with 40 dB SPL being optimal. Lower level (20 dB SPL) led to floor effects, while higher level (50 dB SPL) broadened cochlear tuning and reduced TFS values. The self-administered test demonstrated ±9 dB limit of agreement, with intra-subject absolute mean differences of 1.8–2.7 dB across test frequencies, indicating greater variability compared to the manual method.The self-administered TFS test is a candidate for hearing screening, particularly for mild sensorineural hearing loss. However, further research is needed to reduce measurement variability and optimise testing for real-world use. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy SampleResultsConclusionsThis study developed and validated the Cantonese integrated Digit-in-Noise Test (iDIN) for speech-in-noise measurement and hearing screening.The development of the Cantonese iDIN followed the International Collegium of Rehabilitative Audiology guidelines. Its psychometric properties, including normative data, psychometric function, test-retest reliability, and criterion validity, were established. Additionally, a preliminary comparison of the effectiveness of 2- and 3-digit SRTs in hearing screening was conducted.The sample included 40 young adults with normal hearing and 65 older adults, with and without hearing loss.Mean SRTs for 2-, 3-, and 5-digit with forward recall were −11.5 ± 1.3, −12.0 ± 1.0, and −11.3 ± 0.9 dB SNR in young adults, respectively. The slopes for the psychometric functions of these sequences were 20.26, 18.61, and 19.10 %/dB, respectively, and measurement errors were 0.80, 0.61, and 0.71 dB. The area under the receiver operating characteristic curves for the 2- and 3-digit SRTs were .941 and .974, indicating high discriminative ability in hearing screening.The Cantonese iDIN shows robust psychometric properties. Despite the 3-digit test’s slightly better screening performance, shorter test during associated with the 2-digit suggests its potential for hearing screening. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionThis systematic review addressed two questions: 1) For which audiometric test frequencies or pure tone averages are hearing threshold levels (HTLs) most susceptible to early occupational noise induced hearing loss (NIHL) before significant damage? 2) Which early flag metric best detects early hearing shifts due to noise for occupational NIHL surveillance?Systematic searches were conducted in Ovid MEDLINE(R) and Embase from July 2021 to May 2024. Eligibility was screened by two independent reviewers using Covidence. HTL results were analysed for susceptibility to noise-induced changes, and sensitivity and specificity of early flag metrics were assessed.Of 175 studies retrieved, 18 met the inclusion criteria.Ten studies emphasised the importance of testing at frequencies above 8 kHz, with HTLs at 12, 14, and 16 kHz frequently identified as the most noise susceptible. Conventional frequencies of 3-6 kHz were also noted as susceptible. NIOSH and OSHA metrics had low sensitivity and specificity, but modifications improved their performance to 100% sensitivity and 98% specificity.The review highlights the need to refine current metrics and explore extended high frequencies for NIHL monitoring. Research is required to determine frequencies for warning metrics and sensitive metrics for early occupational NIHL detection. [ABSTRACT FROM AUTHOR]

Background and Objectives: Hearing loss is the largest potentially modifiable risk factor for dementia. Early evaluation and intervention are crucial for older adults with cognitive impairment. However, pure-tone audiometry (PTA), the gold standard, may have limitations. This study reviewed auditory tests for detecting hearing loss in this population, comparing to PTA. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review in PubMed, Scopus, and Embase. Ten studies (1,071 participants) comparing auditory tests and PTA in patients with dementia and mild cognitive impairment were included. Results: Electrophysiological and behavioral tests demonstrated strong correlation and accurate hearing impairment detection compared to PTA. Conversely, self-reported assessment showed weaker correlations when aligned with hearing thresholds. Conclusions: This study highlights the potential of electrophysiological and behavioral auditory tests in detecting hearing impairment in older adults with cognitive impairment, emphasizing the need for further research to develop practical screening protocols for this vulnerable population. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3–18 using a diotic and antiphasic digits‐in‐noise (DIN) tablet‐based test using existing adult cut‐off criteria. Methods: A blinded multi‐institutional prospective cohort of 64 children aged 3–18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same‐day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same‐phased stimuli) and antiphasic (out‐of‐phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over‐the‐ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult "cut off criteria." Results: A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p‐value of.753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p‐value of.373. Otologic pathology and age were not predictive of outcome. Conclusion: This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3–18 when using the adult cut‐off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut‐off values. [ABSTRACT FROM AUTHOR]

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The study aimed to assess the risk of hearing loss in full-term neonates with hyperbilirubinemia, examining the relationship between bilirubin levels, onset age of hyperbilirubinemia, and hearing impairment. Additionally, it investigated whether hearing loss was transient or late-onset, using a cost-effective double-screening method. The study included 160 full-term neonates aged 0-1 month. Following completion of phototherapy for hyperbilirubinemia, all infants underwent initial screening with otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABR). A second screening was administered to all infants within one month. Infants referred during the second screening, regardless of their first screening results, underwent diagnostic evaluation. For analysis, the infants were categorised into 4 groups, based on their bilirubin levels and onset of jaundice. After the initial screening, 37% of infants were referred, which decreased to 9% after subsequent screening, suggesting transient hearing loss in 76% of initially referred infants. Permanent hearing impairment was confirmed in 2.5% of infants following diagnostic evaluation, with 3 infants diagnosed with ANSD and 1 infant with sensorineural hearing loss, all from categories characterized by elevated bilirubin levels. The findings indicated that even bilirubin levels as low as 12 to 15 mg/dl could lead to hearing loss, particularly when jaundice onset occurred early. This study highlights the effectiveness of double-screening for identifying transient hearing losses in infants with hyperbilirubinemia, minimizing the need for diagnostic referrals. It underscores the importance of considering both bilirubin levels and onset timing to assess auditory risk fully. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsTo assess the feasibility of implementing a school entry hearing screening programme in the South-East District, Botswana.A feasibility study design was used. Trained screeners conducted smartphone-based pure tone audiometry screening at 25 dB HL, at 1, 2, and 4 kHz using calibrated headphones. Learners with “refer” results after an immediate rescreen were referred and scheduled for diagnostic hearing assessment at the local hospital. Attendance at diagnostic appointments was encouraged through multiple contacts with the families.The study participants were 403 Grade 1 learners from eight public primary schools.The overall referral rate for diagnostic hearing assessment was 4.7%, with a referral uptake rate of 90%. The sensitivity and specificity of the hearing screening protocol were 93.3% and 86.4%, respectively. The positive and negative predictive values were 82.4% and 95%, respectively. The average cost per learner screened was US$ 10.75.School entry hearing screening programmes can be successfully implemented in the South-East District, Botswana. Lessons learnt from this study can potentially guide phased implementation of school hearing screening programmes in other districts. [ABSTRACT FROM AUTHOR]

Automated pure-tone audiometry is frequently used in teleaudiology and hearing screening. Given the high prevalence of age-related hearing loss, older adults are an important target population. This study aimed to investigate the accuracy of automated audiometry in older adults, and to examine the influence of test frequency, age, sex, hearing and cognitive status. In a population-based study, two age-homogeneous samples of 70-year-olds (n = 238) and 85-year-olds (n = 114) were tested with automated audiometry in an office using circum-aural headphones and, around 4 weeks later, with manual audiometry conducted to clinical standards. The differences were analysed for individual frequencies (range: 0.25–8 kHz) and pure-tone averages. The mean difference varied across test frequencies and age groups, the overall figure being −0.7 dB (SD = 8.8, p < 0.001), and 68% to 94% of automated thresholds corresponded within ±10 dB of manual thresholds. The poorest accuracy was found at 8 kHz. Age, sex, hearing and cognitive status were not associated with the accuracy (ordinal regression analysis). Automated audiometry seems to produce accurate assessments of hearing sensitivity in the majority of older adults, but with larger error margins than in younger populations, and is not affected by relevant patient factors associated with old age. [ABSTRACT FROM AUTHOR]

Identifying auditory impairments early in newborns is essential to prevent developmental delays. Otoacoustic Emissions (OAE) screenings play a critical role in newborn hearing assessments. However, the ideal timing post-birth for these tests remains unclear. This study evaluates the efficacy of OAE screenings within the first five days after birth to determine the most effective timing. An observational study involved 1,013 full-term neonates at a tertiary care centre. These neonates underwent Transient Evoked Otoacoustic Emissions (TEOAE) screenings daily from Day 1 to Day 5, following WHO and JCIH guidelines. The study assessed pass rates, false positives, and false negatives, with follow-up screenings at one and three months for neonates with initial ambiguous results. The study found that screening efficiency significantly increased, with Day 1 pass rates at 8% (81 neonates) and 98% (992 neonates) by Day 5, marking a significant improvement in diagnostic accuracy (p < 0.001). False positive rates dropped from 92% on Day 1 to 2% by Day 5, and false negatives decreased to below 1%. Sensitivity and specificity reached their peak at 98% and 99.5%, respectively, on Day 5. Our study findings advocate for adjusting neonatal hearing screening protocols to include OAE tests on the fifth day post-birth, optimizing clinical efficacy through enhanced diagnostic accuracy and reducing the logistical and emotional burdens on families and healthcare providers. [ABSTRACT FROM AUTHOR]

Hearing loss is an important health care concern. Pure Tone Audiometry (PTA) is considered Gold Standard for audiometric evaluations though, there exist a huge variance between the demand and the actual services available. As smartphones are mobile, applications are upgradable, results are reproducible, the mobile applications may offer a good screening tool, especially in remote areas. There are many smartphone-based hearing applications which are already in use. However, effectiveness of such applications needs to be validated. To evaluate the reliability of 'Hearing Test' a phone application against PTA for assessment of hearing thresholds in adults. We conducted a diagnostic study on a heterogenous group of 250 individuals irrespective of their hearing levels. The hearing thresholds for both ears were measured by PTA and phone app and then compared statistically. The agreement between the methods were statistically significant with respect to diagnosing hearing loss and the degree of hearing loss. Though, PTA remains Gold Standard for hearing evaluation but freely available, highly reproducible & specific 'Hearing Test' application could be used as a screening tool in remote areas and may help bridging the gap between the requirement and availability of diagnostic audiometric services. [ABSTRACT FROM AUTHOR]

Background/Aim: Hearing impairment affects a small but significant percentage of newborns (0.1-0.4%). Newborn hearing screening (NHS) is recommended for early detection and treatment. The implementation of NHS can vary among countries. In this study, we present the methodology, organization, and technical requirements of NHS. This study analyzed results from a tertiary hospital, identified issues, and proposed solutions. Patients and Methods: In the studied region, there are five maternity hospitals and a perinatal intensive care center and in 2020, there were 5,864 live births. Screening is performed at three levels. The first screening is conducted on the 2nd-3rd day of a newborn's life in a maternity hospital, the first rescreening on the 3rd-6th week at a relevant ENT department, and the second rescreening on the 3rd-6th month of life at the regional screening center where the central database is also held. Results: In the studied region, 5,793 out of 5,864 (98.79%) newborns received NHS in 2020. Of these, 120 (2.07%) were tested positive on their first screening. Ninetyfour patients (78.3%) of those attended the ENT department for a first rescreening. Thirty-four patients (0.59% of total) were tested positive again and referred to the regional screening center. Out of the 27 patients who attended the second rescreening, four (0.07% of the total) were ultimately diagnosed with hearing impairment. Conclusion: Our study found that newborn hearing screening (NHS) in our region achieved a high compliance rate of 98.8% for initial screenings in 2020. However, challenges remain in the rescreening process due to data management issues, interregional cooperation, and public awareness. The recent implementation of mandatory screenings, updated guidelines, and a centralized database is expected to enhance the effectiveness of NHS. Further research is needed to evaluate these improvements. [ABSTRACT FROM AUTHOR]

Hearing impairment among adults with intellectual disability (ID) is notably prevalent yet frequently underdiagnosed due, in part, to the challenges associated with traditional hearing screening methods in this population. This study explores the effectiveness of the Digit-in-Noise (DIN) test as a viable alternative for hearing screening within natural settings and with familiar personnel. A total of 16 Hebrew-speaking adults with ID were recruited from supported employment programs, 10 of whom completed the study. The DIN test, which was administered in a daily environment using a simple digital device, evaluated the speech recognition threshold in noise. Results indicated that while some participants performed comparably to typically developing individuals, others showed varying levels of hearing thresholds, suggesting diverse auditory capabilities within the ID population. This pilot study confirms that the DIN test can be feasibly integrated into routine care settings, offering a friendly and accessible method for assessing hearing abilities in adults with ID. The findings advocate for the broader adoption of and potential modifications to the DIN Test to enhance its applicability and inclusiveness, thereby improving diagnostic accuracy and subsequent auditory care for this underserved population. [ABSTRACT FROM AUTHOR]

ObjectivesParental knowledge and satisfaction are critical for evaluating the newborn hearing screening (NHS) program. No studies have assessed both parental knowledge and satisfaction with the NHS program since its launch in Saudi Arabia. The study aimed to evaluate parents' knowledge and satisfaction with the NHS program in Saudi Arabia.MethodsThis study included parents of children aged 3 years or younger who had undergone NHS. A questionnaire with 23 questions in Arabic assessed knowledge and satisfaction. Knowledge-related questions were developed by a focus group, while satisfaction-related questions were derived from the Parent Satisfaction Questionnaire with a Neonatal Hearing Screening Program.ResultsA total of 796 parents participated. Overall, 92.8% reported that their newborns passed the screening, 1.6% reported that their newborns failed, and 5% were unaware of the NHS results. About 0.6% did not return for follow-up appointments due to unawareness of the need for follow-up. Only 29.6% received information about the NHS before the screening, and 44.7% reported receiving sufficient information about the results. Most parents (80.2%) were generally satisfied with the NHS program.ConclusionsParents in this study were generally knowledgeable and satisfied with the NHS program. However, efforts are needed to improve the NHS program's effectiveness by increasing awareness and providing sufficient information on the necessity of NHS, test results, and follow-up appointments.

Abstract Objective The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3–18 using a diotic and antiphasic digits‐in‐noise (DIN) tablet‐based test using existing adult cut‐off criteria. Methods A blinded multi‐institutional prospective cohort of 64 children aged 3–18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same‐day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same‐phased stimuli) and antiphasic (out‐of‐phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over‐the‐ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult “cut off criteria.” Results A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p‐value of .753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p‐value of .373. Otologic pathology and age were not predictive of outcome. Conclusion This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3–18 when using the adult cut‐off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut‐off values.

Background and Objectives Half of older persons experience serious hearing loss, yet it remains under-assessed in primary care clinics. Providers note time constraints as barriers and patients often minimize or deny their hearing loss. We tested the effectiveness of a simple hearing screen in primary care settings and whether including a brochure describing hearing loss, its consequences, and treatment would increase referrals for formal audiometric assessments. Research Design and Methods We designed a longitudinal effectiveness study assessing three interventions: Screening alone; Screening plus a brochure handed to the person testing positive; and Screening plus the brochure with a brief review. The screening was accomplished by intake personnel. The results of a positive screen were given to the primary care practitioner. The approach was designed to enable its use across a range of primary care settings. Follow-ups occurred at 4 and 8 months. Results A total of 111 older adults attending 7 primary care clinics screened positive for having possible hearing loss by intake personnel. A total of 46 received the educational brochure. Physicians discussed test results with two-thirds yet recommended further testing for only half of the participants. Physician recommendations were strongly motivating (OR = 9.12, 95% CI: 3.54–23.52) and those receiving the brochure were still more likely to seek further testing (OR = 2.61, 95% CI: 1.07–6.36) even when physician recommendations were controlled. Additionally, when combined, the 2 options were strongly motivating: all participants receiving both a referral and a brochure sought further testing. Discussion and Implications A simple screen and educational brochure on hearing loss improved follow-up for a formal hearing evaluation which may improve hearing health care and minimize negative outcomes. The study also identified barriers to implementation, including how to motivate practitioners and assist intake personnel in integrating hearing screening into their routine intake procedures, supporting further research. Clinical Trials Registration Number: NCT0203713 9 [ABSTRACT FROM AUTHOR]

Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare. [ABSTRACT FROM AUTHOR]

Appropriate speech-in noise assessment is challenging in multilingual populations. This study aimed to assess whether first preferred language affected performance on an English Digits-in-noise (DIN) test in the local Asian multilingual population, controlling for hearing threshold, age, sex, English fluency and educational status. A secondary aim was to determine the association between DIN test scores and hearing thresholds. English digit-triplets in noise testing and pure-tone audiometry were conducted. Multiple regression analysis was performed with DIN scores and hearing thresholds as dependent variables. Correlation analysis was performed between DIN-SRT and hearing thresholds. 165 subjects from the Singapore Longitudinal Ageing Study, a population-based longitudinal study of community-dwellers over 55 years of age. Mean DIN speech reception threshold (DIN-SRT) was −5.7 dB SNR (SD 3.6; range 6.7 to −11.2). Better ear pure tone average and English fluency were significantly associated with DIN-SRT. DIN performance was independent of first preferred language in a multilingual ageing Singaporean population after adjusting for age, gender and education. Those with poorer English fluency had a significantly lower DIN-SRT score. The DIN test has the potential to provide a quick, uniform method of testing speech in noise in this multilingual population. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsThe aim of this study was to evaluate the efficacy of the Chinese version of Speech, Spatial and Qualities of Hearing Scale (C-SSQ12) in the Chinese Mandarin-speaking population and to determine its screening cut-off value by comparing measured pure-tone average (PTA), the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) scores and C-SSQ12 scores.All participants completed the C-SSQ12 questionnaire and underwent the pure-tone audiometry. Older subjects aged ≧ 60 years completed the HHIE-S questionnaire. The optimal cut-off value for the C-SSQ12 as a hearing screening tool was calculated by comparing different cut-offs and hearing thresholds.A total of 300 subjects were recruited.There was a negative correlation between C-SSQ12 scores and HHIE-S scores (r = −0.749). C-SSQ12 scores were negatively correlated with PTA (r = −0.507; r = −0.542). The best cut-off value for the C-SSQ12 was 6.0, with a sensitivity of 78.2%, specificity of 80.3%, positive predictive value of 63.7% and negative predictive value of 97.0% (PTA > 40dBHL for bilateral ears).Compared to mild hearing loss, the C-SSQ12 is a reliable and validated hearing screening tool with increased sensitivity for detecting moderate-to-severe hearing loss. [ABSTRACT FROM AUTHOR]

This article sets out a proposal for how one might expand hearing screening in school children so as to include testing of speech mastery. From 2008 to 2019, the Institute of Physiology and Pathology of Hearing (IPPH) implemented a program to screen the hearing of Polish children starting school, covering over 1 million children. Its success prompted the development of a screening model to cover the entire process of verbal communication. One result was the "Equal Start in Education", a program implemented from 2019 to 2022 in the Lublin province, otherwise known as the Lublin Program for Early Detection and Therapy of Communication Disorders in Children Starting School. It was conducted by the University Children's Clinical Hospital in Lublin and the Maria Curie-Sklodowska University, in cooperation with IPPH, and was designed to assess hearing, auditory processing, voice, and speech-language. The program was successful in addressing various issues related to the screening of all communication skills. Here we present findings from the program and propose a testing procedure used to evaluate speech. The screening procedure might be applied more widely in the future, and could diagnose those children requiring audiological and speech-language therapy. [ABSTRACT FROM AUTHOR]

Purpose: Newborns who fail the transient evoked otoacoustic emissions (TEOAE) but pass the automatic auditory brainstem response (AABR) in universal newborn hearing screening (UNHS), frequently have no further diagnostic test or follow-up. The present study aimed to investigate whether hearing loss might be missed by ignoring neonatal TEOAE failure in the presence of normal AABR. Methods: A retrospective analysis was conducted in newborns presenting between 2017 and 2021 to a tertiary referral centre due to failure in the initial UNHS. The main focus was on infants who failed TEOAE tests, but passed AABR screening. The clinical characteristics and audiometric outcomes were analysed and compared with those of other neonates. Results: Among 1,095 referred newborns, 253 (23%) failed TEOAE despite passing AABR screening. Of the 253 affected infants, 154 returned for follow-up. At 1-year follow-up, 46 (28%) achieved normal audiometric results. 32 (21%) infants had permanent hearing loss (HL) confirmed by diagnostic ABR, 58 (38%) infants had HL solely due to middle ear effusion (MEE), and for 18 (12%) infants HL was suspected without further differentiation. The majority of permanent HL was mild (78% mild vs. 13% moderate vs. 9% profound). The rate of spontaneous MEE clearance was rather low (29%) leading to early surgical intervention in 36 children. The profile of the risk factors for hearing impairment was similar to that of newborns with failure in both, TEOAE and AABR; however, there was a stronger association between the presence of risk factors and the incidence of HL (relative risk 1.55 vs. 1.06; odds ratio 3.61 vs. 1.80). Conclusion: In newborns, the discordance between a "refer" in TEOAE and a "pass" in AABR screening is associated with a substantial prevalence of hearing impairment at follow-up, especially in the presence of risk factors. [ABSTRACT FROM AUTHOR]

IntroductionThe Newborn Hearing Screening (NHS) program was officially launched in Jordan in 2021. Since its inception, no studies have examined the effectiveness of the program. This study seeks to assess the effectiveness and outcomes of the NHS program in Jordan.MethodsA retrospective cross-sectional study was conducted to investigate the program coverage rate, referral rate, loss to follow-up rate and the hearing status of newborns who successfully completed the necessary diagnostic assessment. Live births in all hospitals administered by the Ministry of Health (MoH) in Jordan from July 2021 to November 2023 were included.ResultsOut of 25,825 newborns delivered, 99.4% (25,682) were screened. A referral rate of 0.7% (189) was recorded. Approximately 61.9% of those referred (n = 117) had normal hearing, while 31.7% (60 infants) were diagnosed with hearing loss. The prevalence of congenital hearing loss was 0.14%, and the mean age for identifying hearing loss was 11 months.DiscussionThe current status of the NHS program in Jordan is promising. The program has achieved most benchmarks recommended by the Joint Committee on Infant Hearing (JCIH), demonstrating encouraging outcomes. There is a need to investigate and address the factors causing delays in the identification of hearing loss in Jordan.

Introduction: Hearing loss is a global issue of hearing disability and early detection and rehabilitation of hearing loss are important for the development of speech and language skills in hearing-impaired infants. There are multiple risk factors that aid in hearing loss but some are potential factors that contribute toward hearing loss in infants. The aim of this study was to assess the burden of hearing loss and its correlation with risk factors among high-risk infants at a teaching institution in Jaipur, Rajasthan. Method: This study was carried out after approval of institutional ethics committee on a total of 320 high-risk infants at RUHS College of medical sciences and associated hospitals. Hearing loss was assessed by brainstem evoked response audiometry (BERA). Statistical analysis of data was done by cross-tabulation analysis with Pearson correlation and quantile regression. Results: Out of 320 high-risk infants, 59.69% of infants had normal hearing, 9.09% Unilaterally hearing impaired, 20.31% were bilaterally mild-moderate hearing loss, and 10.94% had severe-profound deafness. The prevalence of important risk factors viz. hyperbilirubinemia, low birth weight, appearance, pulse, grimace, activity, and respiration score, meconium aspiration, respiratory distress, and ventilation greater than five days were 86%, 58.9%, 40%, 36%, 29%, and 22%, respectively. Conclusion: In high-risk infants, hearing loss is a common hearing disorder. Because of this, early diagnosis of hearing loss gives them the best chance of developing functional speech. Brainstem evoked response audiometry is a simple, reliable, and effective technique for the assessment of auditory functions in infants.

Newborn hearing screening (NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016; however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.

Elevated bilirubin levels in neonates are commonly seen both physiologically and in pathological conditions. There are few articles describing the effects of elevated bilirubin levels on the auditory system. The objectives of this paper was to study the prevalence of hearing impairment in neonates with hyperbilirubinemia and assess outcome/reversibility of hearing impairment in these neonates with follow-up hearing evaluation. This was a prospective single centre, case control study. Cases: neonates, total bilirubin levels >15 mg/dl. Controls: <15 mg/dl. Exclusion criteria included neonates with neonatal hypoxia, intrauterine infections, sepsis or meningitis, infants with a family history of hearing loss, low birth weight, ototoxic medications, external and middle ear pathology. Otoacoustic emission testing (OAE) was done at birth. Neonates who fail OAE were advised follow up with Brainstem Evoked Response Audiometry (BERA) after 2 months. Neonates having abnormal BERA waves were called for follow up at 6 months. Out of 57 cases, 3 had failed OAE and had normal BERA waves on follow up at 2 months. Out of 60 controls, 5 had failed OAE and follow up BERA for 3 patients were normal and 2 babies were lost to follow up. No statistical significance in hearing impairment in hyperbilirubinemia v/s normal babies was noted. Elevated bilirubin levels in the absence of any other risk factors may not show significant changes in the hearing screening. Some effect owing to the p value close to being significant in cases has been noted. The same may not contribute to permanent hearing impairment as first OAE changes may be transient and seem to revert with age. [ABSTRACT FROM AUTHOR]

Background: Genetic disorders ascribe to half of cases of congenital hearing loss. Hearing screening is significant in detecting hearing loss (HL) but weak at diagnosis, which can be complemented by genetic screening. Methods: To find a feasible method to accomplish genetic screening and evaluate its advantage when combined with hearing screening, between 1 January 2022, and 10 December 2023, we performed an observational cohort study based on 2488 neonates from the Han population at three hospitals in Jiangsu province. Genetic screening for 20 variants in four common HL‐associated genes by multicolor melting curve analysis (MMCA) and hearing screening were offered concurrently to all participants. Results: In total, 170 (6.8%) of 2488 eligible neonates were detected at least one variant and among them, the proportion of referral was higher (p < 0.05). Genetic screening combined with hearing screening was associated with a 25.0% increase (2 of 8) in discovering cases of diagnosed hearing loss that were missed by hearing screening. Conclusion: This study suggests that genetic screening combined with hearing screening by MMCA is effective at finding potential HL cases and practical to be validated in other places. [ABSTRACT FROM AUTHOR]

Introduction: Hearing loss is a global issue of hearing disability and early detection and rehabilitation of hearing loss are important for the development of speech and language skills in hearing-impaired infants. There are multiple risk factors that aid in hearing loss but some are potential factors that contribute toward hearing loss in infants. The aim of this study was to assess the burden of hearing loss and its correlation with risk factors among high-risk infants at a teaching institution in Jaipur, Rajasthan. Method: This study was carried out after approval of institutional ethics committee on a total of 320 high-risk infants at RUHS College of medical sciences and associated hospitals. Hearing loss was assessed by brainstem evoked response audiometry (BERA). Statistical analysis of data was done by cross-tabulation analysis with Pearson correlation and quantile regression. Results: Out of 320 high-risk infants, 59.69% of infants had normal hearing, 9.09% Unilaterally hearing impaired, 20.31% were bilaterally mild-moderate hearing loss, and 10.94% had severe-profound deafness. The prevalence of important risk factors viz. hyperbilirubinemia, low birth weight, appearance, pulse, grimace, activity, and respiration score, meconium aspiration, respiratory distress, and ventilation greater than five days were 86%, 58.9%, 40%, 36%, 29%, and 22%, respectively. Conclusion: In high-risk infants, hearing loss is a common hearing disorder. Because of this, early diagnosis of hearing loss gives them the best chance of developing functional speech. Brainstem evoked response audiometry is a simple, reliable, and effective technique for the assessment of auditory functions in infants. [ABSTRACT FROM AUTHOR]

Background: To analyze the genotype distribution and frequency of hearing loss genes in newborn population and evaluate the clinical value of genetic screening policy in China. Methods: Genetic screening for hearing loss was offered to 84,029 neonates between March 2019 and December 2021, of whom 77,647 newborns accepted the screening program with one‐year follow‐up. The genotyping of 15 hot spot variants in GJB2, GJB3, SLC26A4, and MT‐RNR1 was performed on microarray platform. Results: A total of 3.05% (2369/77,647) newborns carried at least one genetic hearing loss‐associated variant, indicated for early preventive management. The carrier frequency of GJB2 gene was the highest, at 1.48% (1147/77,647), followed by SLC26A4 gene at 1.07% (831/77,647), and GJB3 gene at 0.23% (181/77,647). GJB2 c.235delC variant and SLC26A4 IVS7‐2A>G variant were the most common allelic variants with allele frequency of 0.6304% (979/155,294) and 0.3992% (620/155,294), respectively. 10 children are identified as homozygous or compound heterozygous for pathogenic variants (4 in GJB2, 6 in SLC26A4), and 7 of these infants had passed the hearing screening. Following up of the genetically screened newborns revealed that genetic screening detected more hearing‐impaired infants than hearing screening alone. Genetic screening helped identify the infants who had passed the initial hearing screening, and reduced time for diagnosis and intervention of hearing aid. In addition, we identified 234 newborns (0.30%, 234/77,647) susceptible to preventable aminoglycoside antibiotic ototoxicity undetectable by hearing screening. Conclusion: We performed the largest‐scale neonatal carrier screening for hearing loss genes in Southeast China. Our results indicated that genetic screening is an important complementation to conventional hearing screening. Our practice and experience may facilitate the application and development of neonatal genetic screening policy in mainland China. [ABSTRACT FROM AUTHOR]

Objectives: To examine general risk propensity in relation to perceptions of noise, risk behaviour, and hearing loss in the general population. Design: Participants completed an online survey using the Amazon Mechanical Turk crowdsourcing platform. Study sample: The sample comprised 1274 adults from the United States. Results: Higher general risk propensity was associated with an increased likelihood to engage in noiserisk behaviours. Lower general risk propensity was associated with increased knowledge of noise risks and an increased perception of noise as risky. The frequency of self-reported exposures to hazardous noise resulted in estimated annual noise doses exceeding standard hazard limits in 40% of the surveyed population. Conclusions: Results revealed limited knowledge of the risks and associated health consequences of noise exposure in the general population Results of this study suggest a high rate of self-exposure to hazardous noise by the general population. Those with higher general risk propensity are more likely to engage in risky noise behaviour. Risky noise behaviour is associated with age, gender, race, ethnicity, and general risk propensity. Intervention programs to modify risky noise behaviour in the general population should focus on both increasing knowledge and establishing accurate perceptions of risk. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is often cited as an important risk factor for hearing loss in the baby. Hearing screening of term and preterm babies was done within 24-48 hours of delivery using otoacoustic emissions. Babies who failed the screening were recalled for further testing. Objective: To study the otoacoustic emission testing results among term and preterm babies. Methods: A prospective institutional based study was conducted between December 2018 and May 2020. All term and preterm babies were screened for hearing impairment using handheld OAE apparatus within 24-48 hours of delivery. Any baby with a “refer” result in the OAE study was recalled for a repeat OAE testing after a month. This was repeated two more times if the baby failed the test every time. In case of failing the test for the third time, the baby was sent for brainstem evoked response audiometry (BERA) for confirmation of hearing loss. Results: Screening was done for 259 babies who were born preterm and 13967 term babies. Among the preterm babies, 92 babies passed the hearing screening the first time. Remaining babies were referred for further follow up. Ultimately, 3 babies had to be referred for BERA and 1 baby had confirmed hearing loss. Conclusions: Preterm babies are often quoted to have a higher risk of developing hearing loss when compared to term babies. Early screening for hearing loss among such babies will help in early recognition and intervention that will help the baby to deal with the handicap.

Abstract Background Pure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing. Methods The digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss. Results The Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p

Hearing impairment among adults with intellectual disability (ID) is notably prevalent yet frequently underdiagnosed due, in part, to the challenges associated with traditional hearing screening methods in this population. This study explores the effectiveness of the Digit-in-Noise (DIN) test as a viable alternative for hearing screening within natural settings and with familiar personnel. A total of 16 Hebrew-speaking adults with ID were recruited from supported employment programs, 10 of whom completed the study. The DIN test, which was administered in a daily environment using a simple digital device, evaluated the speech recognition threshold in noise. Results indicated that while some participants performed comparably to typically developing individuals, others showed varying levels of hearing thresholds, suggesting diverse auditory capabilities within the ID population. This pilot study confirms that the DIN test can be feasibly integrated into routine care settings, offering a friendly and accessible method for assessing hearing abilities in adults with ID. The findings advocate for the broader adoption of and potential modifications to the DIN Test to enhance its applicability and inclusiveness, thereby improving diagnostic accuracy and subsequent auditory care for this underserved population.

Abstract Background Genetic disorders ascribe to half of cases of congenital hearing loss. Hearing screening is significant in detecting hearing loss (HL) but weak at diagnosis, which can be complemented by genetic screening. Methods To find a feasible method to accomplish genetic screening and evaluate its advantage when combined with hearing screening, between 1 January 2022, and 10 December 2023, we performed an observational cohort study based on 2488 neonates from the Han population at three hospitals in Jiangsu province. Genetic screening for 20 variants in four common HL‐associated genes by multicolor melting curve analysis (MMCA) and hearing screening were offered concurrently to all participants. Results In total, 170 (6.8%) of 2488 eligible neonates were detected at least one variant and among them, the proportion of referral was higher (p

This study established a normative range of resonance frequency (RF) values as estimated using Wideband Tympanometry (WBT) and determined the ability of WBT-estimated RF to predict the presence of middle ear dysfunction in school-aged children. Cross-sectional data were collected using a hearing screening test battery consisting of WBT, Pure Tone Screening (PTS), 226- kHz tympanometry, and ipsilateral Acoustic Stapedial Reflexes (ASR). About 1590 children aged 4–13 years. RF significantly decreased from 4 to 13 years of age (4–6 years, 928.95 kHz; 7–9 years, 872.80 kHz; 10–13 years, 863.68 kHz). RF had area under the receiver operating characteristic curve (AROC) values between 0.589 and 0.626 to predict ears that failed PTS or 226- kHz tympanometry. RF below 627 kHz accurately predicted the presence of a Type B tympanogram (AROC 0.945). RF had high test-retest reliability with Intra-Class Coefficient value of 0.817 and good agreement according to Bland-Altman plot analysis. WBT-estimated RF had fair diagnostic accuracy for predicting PTS and tympanometry results, but had excellent accuracy for predicting the presence of middle ear dysfunction, indicated by a Type B tympanogram. WBT-estimated RF does not require age-, gender-, ear- or ethnicity-specific normative data for clinical use with children. [ABSTRACT FROM AUTHOR]

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Background:Hearing loss is one of the most prevalent chronic health conditions. Traditional pure tone audiometry (PTA) is the gold standard for hearing loss screening, but is not widely available outside specialized clinical centers. Mobile health (mHealth)-based audiometry could improve access and cost-effectiveness, but its diagnostic accuracy varies widely between studies. Therefore, we aimed to evaluate the diagnostic accuracy of mHealth-based audiometry for hearing loss screening in adults compared with traditional PTA. Methods:Ten English and Chinese databases were searched from inception until April 30, 2022. Two researchers independently selected studies, extracted data, and appraised methodological quality. The bivariate random-effects model was adopted to estimate the pooled sensitivity and specificity for each common threshold (i.e., the threshold to define mild or moderate hearing loss). The hierarchical summary receiver operating characteristic model was used to assess the area under the receiver operating characteristic curve (AUC) across all thresholds. Results:Twenty cohort studies were included. Only one study (n = 109) used the mHealth-based speech recognition test (SRT) as the index test. Nineteen studies (n = 1,656) used mHealth-based PTA as the index test, and all of them were included in the meta-analysis. For detecting mild hearing loss, the pooled sensitivity and specificity were 0.91 (95% confidence interval [CI] 0.80–0.96) and 0.90 (95% CI 0.82–0.94), respectively. For detecting moderate hearing loss, the pooled sensitivity and specificity were 0.94 (95% CI 0.87–0.98) and 0.87 (95% CI 0.79–0.93), respectively. For all PTA thresholds, the AUC was 0.96 (95% CI 0.40–1.00). Conclusions:mHealth-based audiometry provided good diagnostic accuracy for screening both mild and moderate hearing loss in adults. Given its high diagnostic accuracy, accessibility, convenience, and cost-effectiveness, it shows enormous potential for hearing loss screening, particularly in primary care sites, low-income regions, and settings with in-person visit limitations. Further work should evaluate the diagnostic accuracy of the mHealth-based SRT tests. [ABSTRACT FROM AUTHOR]

Aim: More studies exploring referral rates and false-positive rates are needed to make hearing screening programs in newborns better and cost-effective. Our aim was to study the referral and false-positivity rates among high-risk newborns in our hearing screening program and to analyze the factors potentially associated with false-positive hearing screening test results. Methods: A retrospective cohort study was done among the newborns hospitalized at a university hospital from January 2009 to December 2014 that underwent hearing screening with a two-staged AABR screening protocol. Referral rates and false-positivity rates were calculated and possible risk factors for false-positivity were analyzed. Results: 4512 newborns were screened for hearing loss in the neonatology department. The referral rate for the two-staged AABR-only screening was 3.8% with false-positivity being 2.9%. Our study showed that the higher the birthweight or gestational age of the newborn, the lower the odds of the hearing screening results being false-positive, and the higher the chronological age of the infant at the time of screening, the higher the odds of the results being false-positive. Our study did not show a clear association between the mode of delivery or gender and false-positivity. Conclusion: Among high-risk infants, prematurity and low-birthweight increased the rate of false-positivity in the hearing screening, and the chronological age at the time of the test seems to be significantly associated with false-positivity. [ABSTRACT FROM AUTHOR]

Purpose: Pure-tone audiometry (PTA) is the gold standard for screening and diagnosis of hearing loss but is not always accessible. This study evaluated a simplified cochlear frequency selectivity (FS) measure as an alternative option to screen for early frequency-specific sensorineural hearing loss (SNHL). Methods: FS measures at 1 and 4 kHz center frequencies were obtained using a custom-made software in normal-hearing (NH), slight SNHL and mild-to-moderate SNHL subjects. For comparison, subjects were also assessed with the Malay Digit Triplet Test (DTT) and the shortened Malay Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. Results: Compared to DTT and SSQ, the FS measure at 4 kHz was able to distinguish NH from slight and mild-to-moderate SNHL subjects, and was strongly correlated with their thresholds in quiet determined separately in 1-dB step sizes at the similar test frequency. Further analysis with receiver operating characteristic (ROC) curves indicated area under the curve (AUC) of 0.77 and 0.83 for the FS measure at 4 kHz when PTA thresholds of NH subjects were taken as ≤ 15 dB HL and ≤ 20 dB HL, respectively. At the optimal FS cut-off point for 4 kHz, the FS measure had 77.8% sensitivity and 86.7% specificity to detect 20 dB HL hearing loss. Conclusion: FS measure was superior to DTT and SSQ questionnaire in detecting early frequency-specific threshold shifts in SNHL subjects, particularly at 4 kHz. This method could be used for screening subjects at risk of noise-induced hearing loss. [ABSTRACT FROM AUTHOR]

Background: Pure-tone audiometry is the traditional gold standard for assessment and screening of hearing impairment, but it requires the use of calibrated devices and soundproof booth. Mobile apps can offer a good alternative to traditional methods in limited circumstances and in some emergency situations, especially when traditional methods are not available. The aim of the study was to develop an easily accessible mobile-based Turkish Digit in Noise Test screening test for the assessment of hearing. Methods: The digits were read by a male speaker whose native language is Turkish. A mobile application was developed in accordance with the Android operating system. Twenty-five individuals with normal hearing, 25 individuals with bilateral mild sensorineural hearing loss, 25 with bilateral mild mixed hearing loss, and 25 with bilateral mild conductive hearing loss total of 100 participated in the study. All participants were between the ages of 18–60. The Turkish Digit in Noise Test mobile application was applied to the participants and the test scores were compared among the types of hearing loss. Results: The Turkish Digit in Noise Test scores of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with normal hearing (39.68 ± 6.82) (p <.01). In addition, the results of participants with bilateral mild sensorineural hearing loss (19.4 ± 5.39) and mixed hearing loss (22.96 ± 4.52) were lower than those of participants with conductive hearing loss (36.88 ± 6.31) (p <.01). Conclusion: An easy and accessible Turkish Digit in Noise Test mobile application has been developed using which one can assess his/her hearing. [ABSTRACT FROM AUTHOR]

Copyright of Praxis of Otorhinolaryngology / Kulak Burun Boğaz Uygulamaları is the property of Official Journal of ENT-HNS Society of Istanbul and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Maintaining good hearing health is crucial for effective communication and awareness of one’s surroundings. However, if not adequately addressed, various factors such as lifestyle, illness, genetic disorders, age, and leisure activities can contribute to hearing loss. This study seeks to culturally adapt, administer, and evaluate public awareness of hearing loss and hearing health in Karnataka. It is essential to prioritize hearing health and take proactive measures to prevent and treat hearing loss. Methods: The design used in this study was a cross-sectional survey design. The sampling method used in this study was Quota sampling. In total, 720 participants aged 20–60 completed a culturally adapted questionnaire. The questionnaire consisted of 22 questions targeting the awareness of hearing loss and hearing health, focusing on four domains: (1) Knowledge about infant hearing loss, (2) Cleaning and treatment, (3) The effect of overexposure to noise and loud sounds, (4) Diagnostic delay. Results: Approximately 70% of the correct responses were given to almost all the statements. However, specific essential Knowledge on the impact of tinnitus on hearing and the use of ear protective devices during noise exposure was lacking. Only 56% and 50.23% knew about specialized tests available for a hearing evaluation and the recommended standards on the duration of noise exposure. Conclusions: It is essential to increase public awareness of the impact of ringing sensation on a person’s daily activities. Many people need to be aware of the guidelines for reducing exposure to high-intensity noises, which underscores the need for informative initiatives on noise reduction. The audiological questionnaire used was simple, practical, and reliable, and the results showed the need for ongoing development of hearing conservation programs. To ensure continued progress, these programs should focus on hearing aid management, early detection of infant hearing loss, and noise exposure prevention.

Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare.

Background: Hearing loss is a neglected global health priority affecting 1.5 billion persons. Global access to hearing care is severely limited with management options, like hearing aids, inaccessible to most. The cost and centralised nature of traditional service-delivery approaches in hearing care have undermined equitable access alongside poor awareness. Summary: Recent innovations in digital and mHealth hearing technologies used by health workers through task shifting are enabling novel community-based services across the continuum of care. This narrative review explores technology-enabled hearing care in communities. We provide examples focused on our work over the past decade to explore more equitable hearing care across primary, secondary, and tertiary levels of prevention. Key Messages: Hearing health innovations have the potential to increase access to care, improve the quality of life for those affected by hearing loss, and reduce global costs associated with untreated hearing loss. More equitable hearing care is a global health priority that requires scalable service-delivery models enabled by innovative technologies within communities and integrated into public health initiatives including hearing health promotion. [ABSTRACT FROM AUTHOR]

Background and Objectives: Indonesians encounter several barriers to regular functional hearing assessment. Hearing loss screening is only provided by tertiary-care hospitals that are not reachable by people in remote regions. This study aimed to develop a website-based hearing screening application that is accessible and inexpensive. Subjects and Methods: This comparative study was conducted between July and August 2022 in the Otolaryngology Clinic of Muhammadiyah Bandung Hospital with noise levels below 50 dB. The hearing screening was conducted using a website-based application (www.Screenout.id) and audiogram as the gold standard method. On ScreenOut, patients heard sounds with frequencies at 500, 1,000, 2,000, 4,000, and 8,000 Hz and sound intensity of each frequency at 35, 55, and 75 dB using earphones. Results: A total of 133 participants were enrolled in our study. ScreenOut showed high sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (90.9%, 98.9%, 93.6%, 99.4%, and 84.8%, respectively). Regarding hearing threshold, a very strong correlation was found between ScreenOut and audiogram, ranging between r=0.843 and r=0.899. Aside from that, there was no significant difference in hearing threshold values between ScreenOut and audiogram. Conclusions: Many advantages of the ScreenOut were found, including low-cost, accessibility, and easy-to-use interface, making it favorably used in low-middle-income countries such as Indonesia. [ABSTRACT FROM AUTHOR]

The WHISPER (Widespread Hearing Impairment Screening and PrEvention of Risk) platform was recently developed for screening for hearing loss (HL) and cognitive decline in adults. It includes a battery of tests (a risk factors (RF) questionnaire, a language-independent speech-in-noise test, and cognitive tests) and provides a pass/fail outcome based on the analysis of several features. Earlier studies demonstrated high accuracy of the speech-in-noise test for predicting HL in 350 participants. In this study, preliminary results from the RF questionnaire (137 participants) and from the visual digit span test (DST) (78 participants) are presented. Despite the relatively small sample size, these findings indicate that the RF and DST may provide additional features that could be useful to characterize the overall individual profile, providing additional knowledge related to short-term memory performance and overall risk of HL and cognitive decline. Future research is needed to expand number of subjects tested, number of features analyzed, and the range of algorithms (including supervised and unsupervised machine learning) used to identify novel measures able to predict the individual hearing and cognitive abilities, also including components related to the individual risk. [ABSTRACT FROM AUTHOR]

(1) Background: An important part of any neonatal hearing screening program is monitoring diagnostic visits to confirm or exclude the presence of hearing loss. In addition, time plays an important role in the diagnosis. We identified the number of children who came for a diagnostic visit and analyzed the time of the first audiological visit, depending on the result of the hearing screening test performed in the first days of a child's life and the presence or absence of risk factors of hearing impairment. (2) Methods: We analyzed 6,580,524 children, of which 8.9% required further diagnostics. The mean time of follow-up diagnostic visit in the analyzed group was 130 days and differed due to the presence or absence of risk factors for hearing loss before and after the neonatal period. (3) Results: Although the risk of hearing loss in children with risk factors is 2.31 to 6.38 times higher than in children without risk factors depending on the result of the screening test, more than 40% of parents do not report to scheduled audiological visits. (4) Conclusions: Doctors, nurses, and midwives who screen hearing at the neonatological level play an important role in educating parents about the possibility of hearing loss in a child and the need for an audiological examination. [ABSTRACT FROM AUTHOR]