Abstract:
INTRODUCTION : Standard criteria exist for diagnosing different types of hearing loss, yet
audiologists interpret audiograms manually. This pilot study examined the feasibility of
standardised interpretations of audiometry in a telehealth model of care. The aim of this study was to examine diagnostic accuracy of automated audiometry in adults with hearing loss in
an asynchronous telehealth model using pre-defined diagnostic protocols.
MATERIALS AND METHODS : We recruited 42 study participants from a public audiology and
otolaryngology clinic in Perth, Western Australia. Manual audiometry was performed by an
audiologist either before or after automated audiometry. Diagnostic protocols were applied
asynchronously for normal hearing, disabling hearing loss, conductive hearing loss and
unilateral hearing loss. Sensitivity and specificity analyses were conducted using a two-by-two
matrix and Cohen’s kappa was used to measure agreement. RESULTS : The overall sensitivity for the diagnostic criteria was 0.88 (range: 0.86 – 1) and
overall specificity was 0.93 (range: 0.86 – 0.97). Overall Kappa (k) agreement was
“substantial” k = 0.80 [95%CI 0.70, 0.89] and significant at p<0.001.
DISCUSSION : Pre-defined diagnostic protocols applied asynchronously to automated
audiometry provide accurate identification of disabling, conductive and unilateral hearing
loss. This method has the potential to improve synchronous and asynchronous tele-audiology
service delivery.
