Test-Retest repeatability of automated threshold audiometry in Nicaraguan schoolchildren

Abstract

Objective

Automated threshold audiometry (ATA) could increase access to paediatric hearing assessment in low- and middle-income countries, but few studies have evaluated test-retest repeatability of ATA in children. This study aims to analyse test-retest repeatability of ATA and to identify factors that affect the reliability of this method.

Design

ATA was performed twice in a cohort of Nicaraguan schoolchildren. During testing, the proportion of responses occurring in the absence of a stimulus was measured by calculating a stimulus response false positive rate (SRFP). Absolute test-retest repeatability was determined between the two trials, as well as the impact of age, gender, ambient noise, head circumference, and SRFP on these results.

Study Sample

807 children were randomly selected from 35 schools in northern Nicaragua.

Results

Across all frequencies, the absolute value of the difference between measurements was 5.5 ± 7.8 dB. 89.6% of test-retest differences were within 10 dB. Intra-class correlation coefficients between the two measurements showed that lower SRFP was associated with improved repeatability. No effect of age, gender, or ambient noise was found.

Conclusions

ATA produced moderate test-retest repeatability in Nicaraguan schoolchildren. Participant testing behaviours, such as delayed or otherwise inappropriate response patterns, significantly impacts the repeatability of these measurements.

Keywords:

• Repeatability
• audiometry
• automated audiometry

Acknowledgements

The authors thank the Autonomous National University of Nicaragua at Leon (UNAN-Leon), Mayflower Medical Outreach, and the Otolaryngology and Audiology facilities at the Victoria Motta Hospital in the City of Jinotega for their support throughout the completion of this study. The authors also thank Monica Falk for her work with data collection and project management, Ashley Perez AuD, Amado Perez, and Marianna McIlwain AuD, for their assistance developing training videos for the automated testing, as well as Fabiola Siles Hernandez, Marlene Calderon, and Jorge Zeledon Rizo for their work conducting the automated testing in this cohort.

Additional information

Funding

This research was supported by National Institute on Deafness and Other Communication Disorders [6R21DC015133-03] (PI: Saunders).