@Article{info:doi/10.2196/23047,
author="Lin, Heng-Yu Haley
and Chu, Yuan-Chia
and Lai, Ying-Hui
and Cheng, Hsiu-Lien
and Lai, Feipei
and Cheng, Yen-Fu
and Liao, Wen-Huei",
title="A Smartphone-Based Approach to Screening for Sudden Sensorineural Hearing Loss: Cross-Sectional Validity Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Nov",
day="11",
volume="8",
number="11",
pages="e23047",
keywords="sudden sensorineural hearing loss; hearing test; telemedicine; mobile apps; pure tone; audiometry",
abstract="Background: Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that warrants urgent management. Pure-tone audiometry remains the gold standard for definitively diagnosing SSNHL. However, in clinical settings such as primary care practices and urgent care facilities, conventional pure-tone audiometry is often unavailable. Objective: This study aimed to determine the correlation between hearing outcomes measured by conventional pure-tone audiometry and those measured by the proposed smartphone-based Ear Scale app and determine the diagnostic validity of the hearing scale differences between the two ears as obtained by the Ear Scale app for SSNHL. Methods: This cross-sectional study included a cohort of 88 participants with possible SSNHL who were referred to an otolaryngology clinic or emergency department at a tertiary medical center in Taipei, Taiwan, between January 2018 and June 2019. All participants underwent hearing assessments with conventional pure-tone audiometry and the proposed smartphone-based Ear Scale app consecutively. The gold standard for diagnosing SSNHL was defined as the pure-tone average (PTA) difference between the two ears being ≥30 dB HL. The hearing results measured by the Ear Scale app were presented as 20 stratified hearing scales. The hearing scale difference between the two ears was estimated to detect SSNHL. Results: The study sample comprised 88 adults with a mean age of 46 years, and 50{\%} (44/88) were females. PTA measured by conventional pure-tone audiometry was strongly correlated with the hearing scale assessed by the Ear Scale app, with a Pearson correlation coefficient of .88 (95{\%} CI .82-.92). The sensitivity of the 5--hearing scale difference (25 dB HL difference) between the impaired ear and the contralateral ear in diagnosing SSNHL was 95.5{\%} (95{\%} CI 87.5{\%}-99.1{\%}), with a specificity of 66.7{\%} (95{\%} CI 43.0{\%}-85.4{\%}). Conclusions: Our findings suggest that the proposed smartphone-based Ear Scale app can be useful in the evaluation of SSNHL in clinical settings where conventional pure-tone audiometry is not available. ",
issn="2291-5222",
doi="10.2196/23047",
url="http://mhealth.jmir.org/2020/11/e23047/",
url="https://doi.org/10.2196/23047",
url="http://www.ncbi.nlm.nih.gov/pubmed/33174845"
}