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Shah SR, Munhall CC, Nguyen SA, O'Rourke AK, Miccichi K, Meyer TA. Diagnostic accuracy and management concordance of otorhinolaryngological diseases through telehealth or remote visits: A systematic review & meta-analysis. J Telemed Telecare 2024; 30:1386-1397. [PMID: 36916306 DOI: 10.1177/1357633x231156207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
INTRODUCTION COVID-19 has led to delays in providing healthcare in both emergency and non-emergency settings, especially in surgical subspecialties which rely heavily on referrals and in-person visits. Without an established telehealth infrastructure, many otorhinolaryngological departments experienced decreases in consultations. Telemedicine has attempted to bridge the gap between pre- and post-pandemic periods by creating a safe avenue of communication between otorhinolaryngologists and patients. This review hopes to address the accuracy of telemedicine in patient diagnosis and management. METHODS Searches were conducted since study conception until June 30, 2022, on multiple databases including PubMed, SCOPUS, and CINAHL for this systematic review and meta-analysis. Diagnostic accuracy, management accuracy, kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were meta-analyzed by comparing virtual visits to in-person visits (gold standard). RESULTS Nineteen studies were included in this review. A total of 1518 patients were included across all studies. When comparing virtual visits against in-person visits, accurate diagnosis was made in 86.2% [82.1,89.9, I2 = 73.5%, P < 0.0001] of patients and management accuracy was 91.5% [86.1,95.7, I2 = 81.8%, P < 0.0001] when treating patients. Kappa value determining interrater reliability was 0.8 [0.7,0.9, I2 = 81.8%, P < 0.0001]. CONCLUSION Our data suggest that diagnostic and management concordance is above 80% when comparing diagnosis and management strategies in patients who underwent both telehealth and in-person visits with an otorhinolaryngologist. In uncomplicated patients, telehealth might be a reliable source for diagnosis and management however, in-person consultation is likely still required for pathologies in which physical exam, imaging or procedural elements represent a vital component of the work-up.
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Affiliation(s)
- Sunny R Shah
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Christopher C Munhall
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Ashli K O'Rourke
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kate Miccichi
- Department of IT Telemedicine, McLeod Health, Florence, SC, USA
| | - Ted A Meyer
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Alper L, Oron Y, Handzel O, Abu-Eta R, Muhanna N, Ungar OJ. Idiopathic sudden sensorineural hearing loss after COVID-19 vaccination: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08839-y. [PMID: 39012479 DOI: 10.1007/s00405-024-08839-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE To provide pooled analyses on the association between COVID-19 vaccine and the incidence of idiopathic sudden sensorineural hearing loss (ISSNHL). DATA SOURCES "Medline" via "PubMed", "EMBASE", and "Google scholar". REVIEW METHODS Data sources were inspected from January 2020 to January 2024 using search terms relevant to vaccines for COVID-19. Included were papers with reported numbers of vaccinated populations and incidence if ISSNHL in those populations. Quality assessment was performed with the Newcastle-Ottawa Quality Assessment Scale Criteria. RESULTS Three publications encompassing more than 191.8 million patients and at least 283 million vaccine doses were included in the quantitative data synthesis. The pooled reported incidence (95%confidence interval) of ISSNHL among COVID-19 vaccine recipients was 1.2588 per 100,000 (0.1385-3.4836). This incidence is significantly lower than the incidence of 5-27 and 60 per 100,000/year reported in the United States and in the European Union, respectively (P < 0.0001). CONCLUSION There is no evidence to indicate that the COVID-19 vaccine is associated with the incidence of ISSNHL.
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Affiliation(s)
- Lee Alper
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Yahav Oron
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ophir Handzel
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Rani Abu-Eta
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Nidal Muhanna
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Omer J Ungar
- Department of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
- Affiliated to the School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
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Lin MJ, Chen CK. Breaking Sound Barriers: Exploring Tele-Audiology's Impact on Hearing Healthcare. Diagnostics (Basel) 2024; 14:856. [PMID: 38667501 PMCID: PMC11049182 DOI: 10.3390/diagnostics14080856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare.
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Affiliation(s)
- Mien-Jen Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
| | - Chin-Kuo Chen
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204201, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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Loughrey DG, Jordan C, Ibanez A, Parra MA, Lawlor BA, Reilly RB. Age-related hearing loss associated with differences in the neural correlates of feature binding in visual working memory. Neurobiol Aging 2023; 132:233-245. [PMID: 37866083 DOI: 10.1016/j.neurobiolaging.2023.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/09/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023]
Abstract
The underlying neural mechanisms underpinning the association between age-related hearing loss (ARHL) and dementia remain unclear. A limitation has been the lack of functional neuroimaging studies in ARHL cohorts to help clarify this relationship. In the present study, we investigated the neural correlates of feature binding in visual working memory with ARHL (controls = 14, mild HL = 21, and moderate or greater HL = 23). Participants completed a visual change detection task assessing feature binding while their neural activity was synchronously recorded via high-density electroencephalography. There was no difference in accuracy scores for ARHL groups compared to controls. There was increased electrophysiological activity in those with ARHL, particularly in components indexing the earlier stages of visual cognitive processing. This activity was more pronounced with more severe ARHL and was associated with maintained feature binding. Source space (sLORETA) analyses indicated greater activity in networks modulated by frontoparietal and temporal regions. Our results demonstrate there may be increased involvement of neurocognitive control networks to maintain lower-order neurocognitive processing disrupted by ARHL.
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Affiliation(s)
- David G Loughrey
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Trinity College Institute of Neuroscience, Trinity College, The University of Dublin, Ireland.
| | - Catherine Jordan
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
| | - Agustin Ibanez
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Cognitive Neuroscience Center, University of San Andrés, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Brian A Lawlor
- Global Brain Health Institute, Trinity College, The University of Dublin, Ireland; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
| | - Richard B Reilly
- Trinity College Institute of Neuroscience, Trinity College, The University of Dublin, Ireland; Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Ireland; School of Engineering, Trinity College, The University of Dublin, Ireland; School of Medicine, Trinity College, The University of Dublin, Ireland
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Cohen Michael O, Tamir SO, O'Rourke N, Marom T. Audiometry-Confirmed Sudden Sensorineural Hearing Loss Incidence among COVID-19 Patients and BNT162b2 Vaccine Recipients. Otol Neurotol 2023; 44:e68-e72. [PMID: 36624589 PMCID: PMC9835237 DOI: 10.1097/mao.0000000000003777] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To compare sudden sensorineural hearing loss (SSNHL) incidence rates over the coronavirus disease 2019 (COVID-19) outbreak and the COVID-19 vaccination campaign periods to pre-COVID-19 periods. STUDY DESIGN Retrospective cohort. SETTING Secondary hospital. PATIENTS Patients >12 years with auditory-confirmed SSNHL were enrolled. COVID-19 status and BNT162 inoculation records ≤28 days before SSNHL diagnosis were retrieved. Patients were categorized according to their date of presentation over four equal periods: 1) July 2018-April 2019 (first prepandemic period), 2) May 2019-February 2020 (second prepandemic period), 3) March 2020-December 2020 (COVID-19 outbreak), and 4) January 2021-October 2021 (BNT162b2 vaccinations campaign). INTERVENTIONS Pre- and post-COVID-19 emergence; BNT162b2 vaccine. MAIN OUTCOME MEASURES Incidence rate ratios (IRRs) were calculated to compare SSNHL cases during the COVID-19 and vaccination periods with pre-COVID-19 periods. RESULTS Of the 100 patients with SSNHL over the four periods, 1 had COVID-19 and 8 were vaccinated. The annual SSNHL incidence was 12.87, 12.28, 13.45, and 19.89 per 100,000 over periods 1 to 4, respectively. SSNHL incidence over the third period was not significantly different than the first/second periods (IRR = 1.045, 95% confidence interval [CI] = 0.629-1.85, ρ = 0.788, and IRR = 1.095, 95% CI = 0.651-1.936, ρ = 0.683, respectively), whereas SSNHL incidence rate over the fourth period was higher (IRR = 1.545, 95% CI = 0.967-2.607, ρ = 0.068, and IRR = 1.619, 95% CI = 1-2.73, ρ = 0.05, respectively). SSNHL incidence in vaccine recipients was lower than prepandemic unvaccinated patients (IRR = 0.584, 95% CI =0.464-1.67, ρ = 0.984, and IRR = 0.612, 95% CI =0.48-1.744, ρ = 0.92, respectively). CONCLUSION There were fewer SSNHL cases during the first COVID-19 months. Although the SSNHL rate over the COVID-19 vaccination campaign increased, it was not higher for patients who received the BNT162b2 vaccine.
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Affiliation(s)
- Ori Cohen Michael
- Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Sharon Ovnat Tamir
- Department of Otolaryngology–Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Norm O'Rourke
- Department of Epidemiology and Community Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Tal Marom
- Department of Otolaryngology–Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Alhussaini K, Saleh S, Aleid A, Alkhalaf S, Badghaish R, Altinawi A, Alwasel A. Software Application toward Accessible Hearing Care Assessment: Gap in Noise Test. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1112598. [PMID: 35529544 PMCID: PMC9076313 DOI: 10.1155/2022/1112598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
Currently, several methods are being applied to assess auditory temporal resolution in a controlled clinical environment via the measurements of gap detection thresholds (GDTs). However, these methods face two issues: the relatively long time required to perform the gap detection test in such settings and the potential of inaccessibility to such facilities. This article proposes a fast, affordable, and reliable application-based method for the determination of GDT either inside or outside the soundproof booth. The proposed test and the acoustic stimuli were both developed using the MATLAB® programming platform. GDT is determined when the subject is able to distinguish the shortest silent gap inserted randomly in one of two segments of white noise. GDTs were obtained from 42 normal-hearing subjects inside and outside the soundproof booth. The results of this study indicated that average GDTs measured inside the booth (5.12 ± 1.02 ms) and outside (4.78 ± 1.16 ms) were not significantly different. The measured GDTs were also comparable to that reported in the literature. In addition, the GDT screening time of the proposed method was approximately 5 minutes, a screening time that is much less than that reported by the literature. Data show that the proposed application was fast and reliable to screen GDT compared to the standard method currently used in clinical settings.
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Affiliation(s)
- Khalid Alhussaini
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, 10219 Riyadh, Saudi Arabia
| | - Shaza Saleh
- King Abdullah Ear Specialist Center, King Abdulaziz University, King Saud University, 10219 Riyadh, Saudi Arabia
- Ear Institute, University College London, London, UK
| | - Adham Aleid
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, 10219 Riyadh, Saudi Arabia
| | - Saad Alkhalaf
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, 10219 Riyadh, Saudi Arabia
| | - Reem Badghaish
- King Abdullah Ear Specialist Center, King Abdulaziz University, King Saud University, 10219 Riyadh, Saudi Arabia
| | - Amir Altinawi
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, 10219 Riyadh, Saudi Arabia
| | - Abdullatif Alwasel
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, 10219 Riyadh, Saudi Arabia
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Meng X, Wang J, Sun J, Zhu K. COVID-19 and Sudden Sensorineural Hearing Loss: A Systematic Review. Front Neurol 2022; 13:883749. [PMID: 35572936 PMCID: PMC9096262 DOI: 10.3389/fneur.2022.883749] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/30/2022] [Indexed: 12/23/2022] Open
Abstract
A growing body of evidence suggests that patients with the 2019 Coronavirus disease (COVID-19) have a risk of developing sudden sensorineural hearing loss (SSNHL). The pathogenesis of COVID-19-related SSNHL remains unclear. This systematic review examined whether COVID-19 causes an increased incidence of SSNHL and the clinical characteristics of patients with COVID-19-related SSNHL according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. SSNHL usually developed between a few days and 2 months after the diagnosis of COVID-19, and a proportion of patients developed it before the diagnosis of COVID-19. The literature is inconsistent regarding whether COVID-19 causes an increased incidence of SSNHL, and this matter remains unclear. This review included 23 patients with COVID-19-related SSNHL, all adult patients with an average age of 43.1 years. Of these patients, 60.9% had accompanying tinnitus symptoms. Glucocorticoids are the preferred medication to treat COVID-19-related SSNHL. Intratympanic administration may be considered to reduce the side effects of the drug. Hearing tests are suggested when hearing loss is suspected in COVID-19 individuals, and if SSNHL is detected, prompt and aggressive treatment is vital. Large-scale, multicenter research on the pathophysiology, treatment, and prognosis of COVID-19- related SSNHL should be conducted in the future.
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Affiliation(s)
- Xiangming Meng
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, Wuxi, China
- *Correspondence: Xiangming Meng
| | - Jing Wang
- Department of Otolaryngology, Huadong Sanatorium, Wuxi, China
| | - Jian Sun
- Department of Rheumatology and Immunology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Kangxu Zhu
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, Wuxi, China
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