{
    "abstract": "Determine whether an electronic tablet-based Wireless Automated Hearing-Test System can perform high-quality audiometry to assess schoolchildren for hearing loss in the field in Nicaragua.\nCross-sectional.\nA school and hospital-based audiology clinic in Jinotega, Nicaragua.\nSecond and third graders (n\u200a=\u200a120) were randomly selected for hearing testing in a school. Air conduction hearing thresholds were obtained bilaterally using a Wireless Automated Hearing-Test System at 1000, 2000, and 4000\u200aHz. Referral criteria were set at more than 25\u200adBHL at one or more frequencies. A cohort of children was retested with conventional audiometry in a hospital-based sound booth. Factors influencing false-positive examinations, including ambient noise and behavior, were examined.\nAll children with hearing loss were detected using an automated, manual, or two-step (those referred from automated testing were tested manually) protocol in the school (sensitivity\u200a=\u200a100%). Specificity was 76% for automated testing, 97% for manual testing, and 99% for the two-step protocol. The variability between thresholds obtained with automated testing was greater than manual testing when compared with conventional audiometry. The percentage of participant responses when no stimulus tone was presented during automated testing was higher in children with false-positive examinations.\nA Wireless Automated Hearing-Test System identified all children with hearing loss in a challenging field setting. A two-step protocol (those referred from automated testing are tested manually) reduced false-positive examinations and unnecessary referrals. Children who respond frequently when no tone is presented are more likely to have false-positive automated examinations and should be tested manually.",
    "authors": [
        {
            "affiliation": "Geisel School of Medicine at Dartmouth.",
            "firstname": "Isabelle",
            "initials": "I",
            "lastname": "Magro"
        },
        {
            "affiliation": "Creare, Limited Liability Corporation, Hanover.",
            "firstname": "Odile",
            "initials": "O",
            "lastname": "Clavier"
        },
        {
            "affiliation": "Viv\u00edan Pellas Hospital, Managua, Nicaragua.",
            "firstname": "Karen",
            "initials": "K",
            "lastname": "Mojica"
        },
        {
            "affiliation": "Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.",
            "firstname": "Catherine",
            "initials": "C",
            "lastname": "Rieke"
        },
        {
            "affiliation": "Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.",
            "firstname": "Eric",
            "initials": "E",
            "lastname": "Eisen"
        },
        {
            "affiliation": "Mount Sinai Hospital.",
            "firstname": "Debra",
            "initials": "D",
            "lastname": "Fried"
        },
        {
            "affiliation": "Center for Hearing and Communication, New York, New York.",
            "firstname": "Anita",
            "initials": "A",
            "lastname": "Stein-Meyers"
        },
        {
            "affiliation": "Geisel School of Medicine at Dartmouth.",
            "firstname": "Abigail",
            "initials": "A",
            "lastname": "Fellows"
        },
        {
            "affiliation": "Geisel School of Medicine at Dartmouth.",
            "firstname": "Jay",
            "initials": "J",
            "lastname": "Buckey"
        },
        {
            "affiliation": "Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.",
            "firstname": "James",
            "initials": "J",
            "lastname": "Saunders"
        }
    ],
    "conclusions": "A Wireless Automated Hearing-Test System identified all children with hearing loss in a challenging field setting. A two-step protocol (those referred from automated testing are tested manually) reduced false-positive examinations and unnecessary referrals. Children who respond frequently when no tone is presented are more likely to have false-positive automated examinations and should be tested manually.",
    "copyrights": null,
    "doi": "10.1097/MAO.0000000000002534",
    "journal": "Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology",
    "keywords": [],
    "methods": null,
    "publication_date": "2019-12-19",
    "pubmed_id": "31851067",
    "results": "All children with hearing loss were detected using an automated, manual, or two-step (those referred from automated testing were tested manually) protocol in the school (sensitivity\u200a=\u200a100%). Specificity was 76% for automated testing, 97% for manual testing, and 99% for the two-step protocol. The variability between thresholds obtained with automated testing was greater than manual testing when compared with conventional audiometry. The percentage of participant responses when no stimulus tone was presented during automated testing was higher in children with false-positive examinations.",
    "title": "Reliability of Tablet-based Hearing Testing in Nicaraguan Schoolchildren: A Detailed Analysis.",
    "xml": "<Element 'PubmedArticle' at 0x7885033885e0>"
}