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10/09/2015  |   8:30 AM - 9:45 AM   |  Technology   |  Andrew Foster Auditorium

Mobile Tablet Audiometry - Building a low cost school screening program

Background: Newborn hearing screening is an important and effective investigation where available but it does not detect late onset, acquired, or progressive hearing loss. For every 10 newborns detected, an estimated 5-9 children will present with some form of hearing loss by the age of 9. These cases can often be detecting by school screening programs. Access to hearing testing is not only limited by the costs involved, but also by the necessity for consultation with specialized personnel and equipment. Methods: A school screening program conducted by Medical students and assistants trained in use of the Shoebox tablet audiometer conducted audiograms on children in Ontario. Screenings were completed using supra-aural headphones at 500, 1000, 2000 and 4000 Hz bilaterally, as well as otoscopy. Those children identified as possibly having a hearing loss on screening were retested by a certified Audiologist. Potential hearing losses were referred for medical follow-up. Results: Since January 2015, iHEAR members visited 8 schools, screened 251 students, and have detected 12 previously undiagnosed children with hearing related concerns. The follow-up of traditional audiology testing is still ongoing and to date, one child was found to have severe unilateral sensorineural hearing loss. The average test took around 300 seconds to complete. The Shoebox Audiometer was often used by the children themselves to test their own hearing with minimal instruction/supervision. Conclusions: The iPad App “Shoebox Audiometer” presents a valuable, easy to perform, inexpensive and portable medium to perform conditioned play audiometry (CPA). The application is easy to learn and enables many patients to be screened in a short time, creating a more efficient healthcare system. The application allows for identification of hearing loss and referral to Otolaryngology for follow-up in a low resource setting where many of these cases would normally go unidentified.

  • Understand the use and tool available using a mobile tablet audiometer
  • Appreciate the nature of a school screening program using low cost mobile tools
  • Be able to participate in world wide data collection of audiometric data

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Matthew Bromwich (POC,Primary Presenter), Children's Hospital of Eastern Ontario, mabromwich@gmail.com;
Dr. Matthew Bromwich has been a pediatric surgeon at the Children’s Hospital of Eastern Ontario since July 2009. He completed his medical training at Queen’s University, followed by a residency at the London Health Sciences Centre and a Fellowship at the Cincinnati Children’s Hospital Medical Centre. He has published 19 papers and four book chapters on Otolaryngology. Dr. Bromwich is the inventor of several medical innovations and holds 4 patents on various products in Canada and the U.S. Other research endeavors include treatments for dizziness, mobile hearing testing, video endoscopy and surgical airway reconstruction. His research aims to democratize access to medical care by delivering innovative and inexpensive solutions. In 2005 Dr. Bromwich founded Clearwater Clinical, a company that develops mobile medical solutions targeting the Endoscopy, Audiology and Vestibular markets. Clearwater’s mission is to accelerate and democratize access to medical solutions by delivering solutions that are quick to deploy at a fraction of the cost of traditional approaches. In 2013, Clearwater introduced the ClearScope Endoscope Adaptor. ClearScope enables full high definition Video Recording using any smart phone attached any endoscope. In 2014, Clearwater introduced an iPad based Audiometer called ShoeBOX. ShoeBOX is a multi-award winning, breakthrough method of hearing testing for adults and children which in 2014 won the national “TELUS Award for mHealth Innovation”. Over the past year the company has grown and is bringing modern healthcare to far flung places such as Uganda, Guyana and Haiti.

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