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10/13/2017  |   9:10 AM - 10:10 AM   |  West Ballroom at Shalala Student Services Building

Decentralised access to screening with a smartphone digits-in-noise test: Improving accuracy and efficiency

Despite estimates of 360 million people globally living with disabling hearing loss, only a minority of cases are detected and obtain treatment. To further exacerbate the issue, the majority of these individuals reside in resource-scarce countries with very limited access to hearing healthcare services. One of these underserved regions is sub-Saharan Africa with a predicted 36.8 million people with disabling hearing loss. Novel ways to decentralise access to detection of hearing loss has seen the digits-in-noise test used as an internet and landline phone-based hearing screening. Due to the poor penetration of landlines in this region, a downloadable smartphone digits-in-noise test called hearZA was made available as South Africa’s national hearing test. To date, already more than 27 000 tests were undertaken since launching in 2016. HearZA delivers a digit triplet screening test binaurally for improved time-efficiency. This approach however lacks sensitivity for unilateral and asymmetric hearing loss. A novel test paradigm using dichotic (antiphasic) stimuli may allow for increased sensitivity, at least for listeners with unilateral hearing loss, without extending test time. Preliminary data indicated large improvements of approximately 7dB in the signal to noise ratio of normal hearing participants when the digit triplets were presented dichotically. Participants with unilateral and asymmetric sensorineural hearing loss demonstrated a significantly reduced effect, likely because they do not benefit from hearing two different phase stimuli. This additional loss in the dichotic condition indicates that this test paradigm can be used to sensitise the digits-in-noise screening test for unilateral and asymmetrical hearing loss. This new method for hearing screening can have widespread application in telehealth models and offers an innovative, inexpensive solution to improve sensitivity and time efficiency of detection of hearing loss.

  • At the end of this session, attendees will be able to understand how the digits-in-noise test, challenges current practice of pure tone hearing screening.
  • At the end of this session, attendees will be able to understand how the digits-in-noise test offers a cost effective means of hearing screening through telehealth.
  • At the end of this session, attendees will be able to understand how dichotic stimulation further sensitises the digits-in-noise test test, especially for unilateral and asymmetrical hearing loss.

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Karina Swanepoel (POC,Primary Presenter,Author), University of Pretoria, Gauteng, South Africa, karinaswanepoel@live.com;
As an Audiologist, new to the field of research, I have a keen interest in improving access to hearing healthcare, particularly in under-served world regions such as sub-Sahara Africa, through novel service delivery models. In 2015, I obtained my Bachelors Degree in Audiology in 2015 where I received the South Africa Speech Language and Hearing Association (SASLHA) prize for best student in clinical Audiology, as well as the South African Association of Audiologists (SAAA) prize for the best student in practical Audiology. Since obtaining my Bachelor's Degree, I have been practicing clinical Audiology for two years. At the beginning of 2017, I have started my Master's degree at the University of Pretoria, South Africa where I aim to improve on the current practice of detection of hearing loss through translational research.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

De Wet Swanepoel (Co-Author), University of Pretoria, Pretoria , South Africa; Ear Sciences Centre, School of Surgery , The University of Western Australia, Nedlands , Australia; Ear Science Institute Australia , Subiaco , Australia; Callier Center for Communication Disorders , University of Texas at Dallas , USA, dewet.swanepoel@up.ac.za;
De Wet Swanepoel is professor in audiology at the University of Pretoria, South Africa and a senior research fellow at the Ear Science Institute Australia with adjunct positions at the University of Texas at Dallas and the University of Western Australia. He has published more than 100 peer-reviewed articles, books and book chapters and has received numerous awards in recognition of his work. His research capitalises on the growth in information and communication technologies to explore, develop and evaluate innovative solutions to improve access to ear and hearing health care. He is lead inventor of the award winning and patented hearScreenTM smartphone hearing test. Prof Swanepoel also serves as associate editor for the International Journal of Audiology, as president-elect for the International Society of Audiology and as co-chair for the telehealth task force of the American Academy of Audiology.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

David Moore (Co-Author), Cincinnati Children's Hospital Medical Center, david.moore2@cchmc.org;
Professor David Moore has a passion for translational research and has the expertise, experience and leadership necessary to achieve ambitious research goals. His background is mainly in auditory neuroscience, but with substantial experience in experimental psychology going back to degrees and forward to recent large scale studies involving psycho-acoustic and cognitive evaluation of hundreds of people. This work has included development of a variant of the internet and smartphone deliverable Digits in Noise test that makes it more sensitive to high frequency hearing loss. Combined with his track record of leadership in hearing science within Europe, including continuous research funding from the UK Medical Research Council from 1980-2013, he can make a unique and wide-ranging contribution to this research.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Cas Smits (Author,Co-Author), VU University Medical Centre, C.Smits@vumc.nl ;
Dr Cas Smits pioneered research in the field of Audiology and developed the first digits-in-noise hearing screening test via landline telephone in 2004. Since then, he has conducted many other studies on the digits-in-noise screening test that have been published in peer reviewed journals. Dr Cas Smits has the unique skill set and expertise essential to make a contribution in this field of research.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.