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10/13/2017  |   10:30 AM - 11:30 AM   |  West Ballroom at Shalala Student Services Building

Incorporating Mobile Tablet Audiometry into MDR-TB Treatment

Background: Aminoglycosides, such as kanamycin, are often used in the long-term treatment of Multi-Drug Resistant Tuberculosis (MDR-TB). This class of drugs is known to be ototoxic and can lead to permanent hearing loss. Historically, audiometric testing has been out of reach for many TB treatment clinics. Methods: Individual automated tablet-based audiometers were acquired by 10 testing sites. Audiograms were obtained on qualified patients (test frequencies 1000, 2000, 4000, 6000 and 8000 Hz). Interviews were held with the data managers for each organization. A sample of audiograms were reviewed by the authors. Results: A total of 150 audiograms have been conducted over the past 9 months in TB monitoring clinics. Audiometric test experiences were discussed and summarized for a total of 60 patients. Issues surrounding the test site such as high levels of environmental noise (air conditioners, vehicle noise, etc.) were catalogued. Conclusions: Mobile audiometry is a feasible and successful option for MDR-TB clinic sites. Patients are able to learn a new self-testing tool for hearing evaluation. Automated alerts for changes in hearing levels can be a useful addition to MDR-TB treatment regimes. Mobile systems can be used for initial testing as well as detection of changes in hearing over time, but also for long-term management of patients with permanent hearing loss once TB treatment has ended. Central global data repositories and big data analytics may one day help set best practices for TB drug treatment protocols and other ototoxic medications.

  • Appreciate the nature of a MDR-TB program using low cost mobile tools
  • Understand the use and tool available using a mobile tablet audiometer
  • 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,;
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.


Financial -

Nonfinancial -


Financial - No relevant financial relationship exists.

Renee Lefrancois (Co-Author), Clearwater Clinical Ltd.,;
To be added.

Financial - Receives Salary,Ownership interest for Employment from Renée Lefrançois - Clearwater Clinical Ltd.  

Nonfinancial - No relevant nonfinancial relationship exists.


Financial - No relevant financial relationship exists.