Can an average of thresholds at 2 kHz and 4 kHz substitute for the threshold at 3 kHz in pure tone audiometry? A study based on the Korean National Health and Nutrition Examination Survey 2010-2012

The cell phone vibration test: A telemedicine substitute for the tuning fork test

OBJECTIVE

An at home-test for differentiating between conductive and sensorineural hearing loss remains elusive. Our goal was to validate the novel cell-phone vibration test (CPVT) against the Weber tuning fork test (WTFT) and to assess if the CPVT can be self-administered by patients reliably.

STUDY DESIGN

Cross-sectional.

METHODS

The CPVT involves placement of a vibrating cellphone on the center of the forehead to determine which ear perceives the sound louder. 40 consecutive adult patients with an audiogram within 6 months and no report of recent hearing changes were recruited. Group 1 consisted of 20 patients who were examined by the provider with the CPVT and WTFT using various tuning forks (256, 512, and 1024 Hz). Group 2 consisted of an additional 20 patients who received instructions on self-administering the CPVT. Kappa statistics were calculated to assess the strength of concordance between the CPVT, WTFT, and audiometric findings for group 1 and between patient self-administered and provider administered CPVT and WTFT for group 2.

RESULTS

Concordance between CPVT and WTFT in the entire cohort was substantial (Kappa coefficient: 0.81 for 256 Hz, 0.73 for 512 Hz, and 0.62 for 1024 Hz) with similar concordances between actual and expected results based on audiogram (Kappa coefficient: 0.52 for CPVT and 0.52 for WTFT). Concordance between patient-administered and provider-administered CPVT showed almost perfect agreement (Kappa coefficient: 0.92).

CONCLUSIONS

The CPVT provides consistent results when compared to a formal WTFT and can be reliably self-administered by patients with appropriate instructions.Level of evidence: 4.