At Christian Medical College (CMC) in Vellore, India, patients in clinic who met indications for a conventional audiogram also subsequently underwent a portable audiogram. The results of the portable audiogram were then compared with the results of the conventional audiogram. Both air conduction and bone conduction testing were performed, and masking techniques were employed with the portable audiograms in a regular clinic office to mimic outreach clinic settings. Our preliminary data show that overall sensitivity and specificity for the tablet are 89%(95%CI: 80% to 94%) and 70%(95%CI: 56% to 82%), respectively. It can accurately identify hearing impairment and can be used as a screening tool for hearing loss in low-resource settings.
Explore This Issue
June 2018
Dr. Yalamanchali’s amamamma (her mother’s mother) using the Shoebox portable audiogram.
Dr. Yalamanchali on her last day at Modale Hostel.
The portable audiogram was further used in rural clinics around CMC and was fairly easy to transfer, delivering hearing services to areas that previously lacked, but needed, such testing. For example, an inpatient portable audiogram was performed in a rural hospital on an elderly woman. She was noted to have significant sensorineural hearing loss. A printout of the audiogram could then be used to help her obtain hearing aids, with the aid of some monetary plans in that specific rural area. Furthermore, local audiology students, audiologists, and otolaryngology residents were easily trained to use the portable audiogram and could administer tests without any barriers.
Main entrance to the
CMC campus.
Overcoming Stigmas
When my grandmothers’ friends learned that I was able to perform an audiogram at home, they all came over for lunch on a Saturday and waited excitedly and anxiously for me to test their hearing. They were reluctant to enter a hospital for a hearing testing, although in reality all of my grandmothers’ friends were worried about their hearing and wanted testing. We discussed hearing aids and, once the stigmas related to hearing aids were dissipated and the audiograms completed and reviewed, showing varying degrees of hearing loss, my grandmother and her friends seemed more at ease and willing to try hearing aids. The same barriers and stigmas related to hearing testing and hearing aids are found in our own community in the United States and, while the portable audiogram is a great tool for hearing testing, it is also a valuable tool for patient education.