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

The Potential of a Portable, Sound-isolating Device for hearing loss Screening in Low- and Middle-income Countries

INTRODUCTION: An estimated 278 million people worldwide suffer from bilateral moderate to profound hearing loss. Approximately 80% of this population lives in low- or middle- income countries, where access to formal audiologic testing remains a significant challenge, both from an economic and geographic standpoint. In order to addres this issue, screening devices that are not only sensitive, but mobile and affordable as well, must be employed. METHODS: In February, 2017, a population of 49 elementary-school aged children in Jinotega, Nicaragua were enrolled for audiologic screening using a sound-isolating headset. The headset was driven by a tablet running an application designed to produce pure tones. For each subject, a 1,000, 2,000, and 3,000 Hz tone was played at a standardized intensity of 20 dB. A referral for any pitch in either ear was considered a failed screen. Subjects who failed subsequently underwent formal audiologic evaluation in a sound-isolating booth. Prior to screening, each subject underwent an otoscopic evaluation. RESULTS: The final study population consisted of 47 subjects. Ages ranged from 5-7 years old. Nine subjects failed the screening exam while the remaining 38 passed. Of the 9 failed subjects, formal audiogram showed 6 subjects to have normal hearing at the aforementioned frequencies at 20 dB. Two subjects were found to have clinically-significant hearing loss. The results of one subject are pending. CONCLUSION: Our study demonstrates the utility of a low-cost, portable device that can efficiently and effectively screen for hearing loss; however, more information is needed to understand the full screening potential. Subjects who pass the screening should be tested with the gold-standard (formal audiologic testing in a sound-isolating booth), as well. This would provide information on sensitivity and negative predictive value, both of which are important for the assessment of a devices screening utility.

• Realize the potential of affordable, easily-mobile devices for hearing-loss screening
• Observe how such a device adequately identified hearing loss in some subjects
• Understand the type of data that is needed to evaluate the utility of such devices

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Eric Eisen (POC,Primary Presenter,Author,Co-Author), Dartmouth-Hitchcock Medical Center, eeisen88@me.com;

ASHA DISCLOSURE: Financial - Nonfinancial -

AAA DISCLOSURE: Financial - No relevant financial relationship exists.

James Saunders (Co-Author), Dartmouth Hitchcock Medical Center, james.saunders@hitchcock.org;
Dr. James E. Saunders is a Professor of Otology / Neurotology at Dartmouth Hitchcock Medical Center. He completed an M.D. at University of Oklahoma, Residency Training and a Research Fellowship in Otolaryngology at Duke University Medical Center, and a Research and Clinical Fellowship at the House Ear Institute in Los Angeles. Dr. Saunders has many projects related to the etiology, prevention and treatment of hearing loss in the developing world including collaborations with the WHO and the Global Burden of Disease Project. He is past Coordinator for International Affairs and Chairman of the Humanitarian Efforts Committee for the AAO-HNSF. In 1999, he co-founded Mayflower Medical Outreach, an organization that supports and trains otolaryngologists and audiologists in Nicaragua. He currently serves as the co-chair for the Coalition for Global Hearing Health, an international multidisciplinary organization devoted to education and advocacy for hearing health services in low resource areas.

ASHA DISCLOSURE: Financial - Nonfinancial -

AAA DISCLOSURE: Financial - No relevant financial relationship exists.

Debra Fried (Co-Author), Mayflower Medical Outreach, DebraFriedMMO@aol.com;
Debra is a clinical audiologist and Coordinator of Audiology for the ambulatory care clinics at Mount Sinai Hospital in New York. She provides diagnostic audiological, hearing aid and cochlear implant services. She manages the newborn hearing screening program for the hospital which has over 6,000 annual births. Debra volunteers her time as Director of Audiology for Mayflower Medical Outreach, a U.S. based non-governmental organization providing hearing care services in Nicaragua. She works collaboratively to develop hearing health care programs while in Nicaragua as well as remotely. She is also a member of the International Humanitarian Hearing Aid Purchasing Program HHAPP. Debra is the 2019 recipient of the American Academy of Audiology Humanitarian Audiology Award.

ASHA DISCLOSURE: Financial - No relevant financial relationship exists. Nonfinancial - No relevant nonfinancial relationship exists.

AAA DISCLOSURE: Financial -