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Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis

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Title: Tablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosis
Authors: Vijayasingam, A
Frost, E
Wilkins, J
Gillen, L
Premachandra, P
Mclaren, K
Gilmartin, D
Picinali, L
Vidal-Diez, A
Borsci, S
Ni, MZ
Tang, WY
Morris-Rosendahl, D
Harcourt, J
Elston, C
Simmonds, NJ
Shah, A
Item Type: Journal Article
Abstract: INTRODUCTION: Individuals with chronic lung disease (eg, cystic fibrosis (CF)) often receive antimicrobial therapy including aminoglycosides resulting in ototoxicity. Extended high-frequency audiometry has increased sensitivity for ototoxicity detection, but diagnostic audiometry in a sound-booth is costly, time-consuming and requires a trained audiologist. This cross-sectional study analysed tablet-based audiometry (Shoebox MD) performed by non-audiologists in an outpatient setting, alongside home web-based audiometry (3D Tune-In) to screen for hearing loss in adults with CF. METHODS: Hearing was analysed in 126 CF adults using validated questionnaires, a web self-hearing test (0.5 to 4 kHz), tablet (0.25 to 12 kHz) and sound-booth audiometry (0.25 to 12 kHz). A threshold of ≥25 dB hearing loss at ≥1 audiometric frequency was considered abnormal. Demographics and mitochondrial DNA sequencing were used to analyse risk factors, and accuracy and usability of hearing tests determined. RESULTS: Prevalence of hearing loss within any frequency band tested was 48%. Multivariate analysis showed age (OR 1.127; (95% CI: 1.07 to 1.18; p value<0.0001) per year older) and total intravenous antibiotic days over 10 years (OR 1.006; (95% CI: 1.002 to 1.010; p value=0.004) per further intravenous day) were significantly associated with increased risk of hearing loss. Tablet audiometry had good usability, was 93% sensitive, 88% specific with 94% negative predictive value to screen for hearing loss compared with web self-test audiometry and questionnaires which had poor sensitivity (17% and 13%, respectively). Intraclass correlation (ICC) of tablet versus sound-booth audiometry showed high correlation (ICC >0.9) at all frequencies ≥4 kHz. CONCLUSIONS: Adults with CF have a high prevalence of drug-related hearing loss and tablet-based audiometry can be a practical, accurate screening tool within integrated ototoxicity monitoring programmes for early detection.
Issue Date: 15-Jul-2020
Date of Acceptance: 20-Apr-2020
URI: http://hdl.handle.net/10044/1/80023
DOI: 10.1136/thoraxjnl-2019-214177
ISSN: 0040-6376
Publisher: BMJ Publishing Group
Start Page: 632
End Page: 639
Journal / Book Title: Thorax
Volume: 75
Copyright Statement: © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. This article has been accepted for publication in [insert journal name] following peer review. The definitive copyedited, typeset version Vijayasingam A, Frost E, Wilkins J, et alTablet and web-based audiometry to screen for hearing loss in adults with cystic fibrosisThorax Published Online First: 14 May 2020 is available online at: http://dx.doi.org/10.1136/thoraxjnl-2019-214177
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: RDB21 79560
Keywords: cystic fibrosis
respiratory Infection
systemic disease and lungs
cystic fibrosis
respiratory Infection
systemic disease and lungs
1103 Clinical Sciences
Respiratory System
Publication Status: Published
Conference Place: England
Online Publication Date: 2020-05-14
Appears in Collections:Department of Surgery and Cancer
National Heart and Lung Institute
Faculty of Medicine
Dyson School of Design Engineering
School of Public Health
Faculty of Engineering