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International Archives of Occupational and Environmental Health
Published in: International Archives of Occupational and Environmental Health 7/2018

Open Access 01-10-2018 | Original Article

Accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss: incorporating automatic conditional rescreening

Authors: Marya Sheikh Rashid, Wouter A. Dreschler

Published in: International Archives of Occupational and Environmental Health | Issue 7/2018

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Abstract

Purpose

To validate the accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss (HFHL) ‘Occupational Earcheck (OEC)’ incorporating an automatic conditional rescreening, in an occupationally noise-exposed population. Secondary objectives were to assess the effects of age on test accuracy measures, and to assess the test accuracy for different degrees of HFHL.

Methods

A study was conducted on cross-sectional data of occupational audiometric examinations, including the index test OEC and reference standard pure-tone air conduction audiometry, of 80 noise-exposed workers. Sensitivity, specificity, and likelihood ratios were calculated for the OEC, after automatic conditional rescreening, for a younger and an older age group, and for two degrees of HFHL (HFHL25: PTA3,4,6 ≥ 25 dB HL, and HFHL35: PTA3,4,6 ≥ 35 dB HL, both for at least one ear).

Results

Test specificity for HFHL25 after a single test was 63%, and improved to 93% after the automatic conditional rescreen. Test sensitivity for HFHL25 decreased from 65% to 59%. Test sensitivity and specificity including automatic conditional rescreening for HFHL35 was 94% and 90%, respectively. The positive likelihood ratio for HFHL25 was 8.4, and for HFHL35 9.4. The negative likelihood ratio for HFHL35 was below 0.1.

Conclusions

The OEC is an appropriate screening test, especially for HFHL35. Normal-hearing workers who obtained a positive test result for the first test for one or two ears, benefit from having an automatic rescreen, resulting in an improvement of the test specificity, and hence prevent unnecessary referral.
Footnotes
1
The sensitivity of the test reflects the proportion correctly identified individuals with HFHL among all individuals with HFHL. The specificity reflects the proportion correctly identified non HFHL individuals among all non HFHL individuals.
 
2
The positive predictive value is the probability that the individual has hearing loss when OEC shows a positive result. The negative predictive value is the probability that an individual is non HFHL when OEC shows a negative result.
 
3
The positive likelihood ratio is the ratio of the probability of a positive OEC test in workers with HFHL to the probability in non HFHL workers. The negative likelihood ratio is the ratio of the probability of a negative OEC test in workers with HFHL to the probability in non HFHL workers.
 
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Metadata
Title
Accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss: incorporating automatic conditional rescreening
Authors
Marya Sheikh Rashid
Wouter A. Dreschler
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 7/2018
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-018-1332-5

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