Validation of DPOAE screening conducted by village health workers in a rural community with real-time click evoked tele-auditory brainstem response

Abstract

Objective: This study assessed the validity of DPOAE screening conducted by village health workers (VHWs) in a rural community. Real-time click evoked tele-auditory brainstem response (tele-ABR) was used as the gold standard to establish validity. Design: A cross-sectional design was utilised to compare the results of screening by VHWs to those obtained via tele-ABR. Study samples: One hundred and nineteen subjects (0 to 5 years) were selected randomly from a sample of 2880 infants and young children who received DPOAE screening by VHWs. Method: Real time tele-ABR was conducted by using satellite or broadband internet connectivity at the village. An audiologist located at the tertiary care hospital conducted tele-ABR testing through a remote computing paradigm. Tele-ABR was recorded using standard recording parameters recommended for infants and young children. Wave morphology, repeatability and peak latency data were used for ABR analysis. Results: Tele-ABR and DPOAE findings were compared for 197 ears. The sensitivity of DPOAE screening conducted by the VHW was 75%, and specificity was 91%. The negative and positive predictive values were 98.8% and 27.2%, respectively. Conclusions: The validity of DPOAE screening conducted by trained VHW was acceptable. This study supports the engagement of grass-root workers in community-based hearing health care provision.

Key Words:

• Community-based
• grass roots worker
• DPOAE screening
• telemedicine
• tele-audiology
• tele-auditory brainstem response

Acknowledgements

This study would not have been possible without the support of GSI Inc. in providing the required equipment, accessories and support for repairs. Many thanks to Dr. P. Balasubramanian, Executive Director, RUWSEC for his support in the community throughout this study. We also thank Dr. Mark Krumm, Associate Professor, Music and Speech, Kent State University, Ohio, USA, for his suggestions on this manuscript.

Declaration of interest

No potential conflict of interest was reported by the authors.

This work was supported by Indian Council of Medical Research (No.5/8/10-4(Oto)10-NCD-I).