Kids are not just small adults: An attempt to validate pediatric tablet-based digits in noise testing

Objective

The objective of this study is to investigate whether conductive hearing loss (CHL) can be differentiated from sensorineural hearing loss in children ages 3–18 using a diotic and antiphasic digits-in-noise (DIN) tablet-based test using existing adult cut-off criteria.

Methods

A blinded multi-institutional prospective cohort of 64 children aged 3–18 scheduled for an audiometric soundbooth evaluation with a pediatric audiologist and a same-day otolaryngologist examination were recruited for the study. Following a conventional audiogram, the subjects underwent diotic (same-phased stimuli) and antiphasic (out-of-phase stimuli) DIN testing on a HearX Samsung Galaxy tablet with over-the-ear headphones, for a total of 128 measurements. DIN test results were compared with soundbooth audiometry using known adult “cut off criteria.”

Results

A logistic regression analysis adjusted for demographics (age, sex) and race was performed to compare CHL determination from DIN testing to CHL determination with soundbooth audiometry. The results showed 50% agreement with a p-value of .753. The determinations based on combined DIN testing agreed with each other 33% of the time and had a p-value of .373. Otologic pathology and age were not predictive of outcome.

Conclusion

This preliminary analysis of DIN testing indicated that DIN and audiometric testing completed in a soundbooth were not significantly predictive of one another in the population of children aged 3–18 when using the adult cut-off criteria for CHL differentiation. Given these findings, further testing is required in children to determine pediatric specific cut-off values.