Self-assessment of bone conduction hearing threshold using mobile audiometry: comparison with pure tone audiometry

OBJECTIVE

The aim of the research was to evaluate the feasibility of measuring the bone conduction hearing threshold using self-administered mobile audiometry.

DESIGN

A single-centre, closed, cross-over trial was carried out on patients from the ENT Department. A mobile-based, self-administered, audiologist-assisted assessment of the bone conduction hearing threshold was carried out by means of the open-access, freeware app Hearing Test using two types of bone conduction headphones: professional B71 bone transducer and commercially available AfterShokz Openmove open-ear headphones.

STUDY SAMPLE

Seventy-seven ears.

RESULTS

A test-retest examination revealed the lowest standard deviation for open-ear headphones at 3.33 dB (95% CI 2.92-3.79). When compared with pure tone audiometry, the intraclass correlations of 0.95 (95% CI 0.94-0.96) and 0.90 (95% CI 0.88-0.92) were obtained for the bone transducer and for the open-ear headphones, indicating excellent and good reliability, respectively. However, the regression slope of 0.67 was found for the air-bone gap when using open ear headphones, which was significantly different from 1 (p < 0.001).

CONCLUSIONS

Open-ear headphones provide an alternative for estimating bone conduction once the air-bone gap has been adjusted by a factor of 1/0.6 7 ≅1.5. They demonstrate improved reproducibility over the bone transducer and are much easier to use with a mobile device. Trial Registration: Wroclaw Medical University, Science Support Centre, BW60/2020.

Expanding the Capabilities of Nutrition Research and Health Promotion Through Mobile-Based Applications

Mobile-based applications are popular and prevalently used in the US population. Applications focusing on nutrition offer platforms for quantifying and changing behaviors to improve dietary intake. Such behavior changes can intervene in the relation of diet to promote health and prevent disease. Mobile applications offer a safe and convenient way to collect user data and share it back to users, researchers, and to health care providers. Other lifestyle factors like activity, sleep, and sedentary behavior, can also be quantified and included in investigations of how lifestyle is related to health. Yet, challenges in the assessment offered through mobile applications and effectiveness to change behavior still remain, including rigorous evaluation, demonstration of successful health improvement, and participant engagement. The data mobile applications generate, however, expands opportunities for discovery of the integrated and time-based nature of various daily activities in relation to health. This article is a summary of a symposium at Nutrition 2020 Live Online on the role of mobile applications as a tool for nutrition research and health promotion. The types and capabilities of mobile applications, challenges in their evaluation and use in research, and opportunities for the data they generate along with a specific example, are reviewed.

Mobile-Based Lifestyle Intervention in Women with Glucose Intolerance after Gestational Diabetes Mellitus (MELINDA), A Multicenter Randomized Controlled Trial: Methodology and Design

The aims of the 'Mobile-based lifestyle intervention in women with glucose intolerance after gestational diabetes mellitus (GDM)' study (MELINDA) are: (1) to evaluate the prevalence and risk factors of glucose intolerance after a recent history of GDM; and (2) to evaluate the efficacy and feasibility of a telephone- and mobile-based lifestyle intervention in women with glucose intolerance after GDM. This is a Belgian multicenter randomized controlled trial (RCT) in seven hospitals with the aim of recruiting 236 women. Women in the intervention group will receive a blended program, based on one face-to-face education session and further follow-up through a mobile application and monthly telephone advice. Women in the control group will receive follow-up as in normal routine with referral to primary care. Participants will receive an oral glucose tolerance test (OGTT) one year after baseline. Primary endpoint is the frequency of weight goal achievement (≥5% weight loss if pre-pregnancy BMI ≥ 25 Kg/m² or return to pre-gravid weight if BMI < 25 Kg/m²). At each visit blood samples are collected, anthropometric measurements are obtained, and self-administered questionnaires are completed. Recruitment began in May 2019.

Worldwide Prevalence of Hearing Loss Among Smartphone Users: Cross-Sectional Study Using a Mobile-Based App

Background

In addition to the aging process, risk factors for hearing loss in adults include, among others, exposure to noise, use of ototoxic drugs, genetics, and limited access to medical care. Differences in exposure to these factors are bound to be reflected in the prevalence of hearing loss. Assessment of hearing loss can easily be carried out on a large scale and at low cost using mobile apps.

Objective

This study aimed to conduct a worldwide assessment of the differences in hearing loss prevalence between countries in a group of mobile device users.

Methods

Hearing tests were conducted using the open-access Android-based mobile app Hearing Test. The app is available free of charge in the Google Play store, provided that consent to the use of the results for scientific purposes is given. This study included hearing tests carried out on device models supported by the app with bundled headphones in the set. Calibration factors for supported models were determined using the biological method. The tests consisted of self-determining the quietest audible tone in the frequency range from 250 Hz to 8 kHz by adjusting its intensity using the buttons. The ambient noise level was optionally monitored using a built-in microphone. Following the test, the user could compare his hearing threshold against age norms by providing his or her age. The user's location was identified based on the phone’s IP address.

Results

From November 23, 2016 to November 22, 2019, 733,716 hearing tests were conducted on 236,716 mobile devices across 212 countries. After rejecting the tests that were incomplete, performed with disconnected headphones, not meeting the time criterion, repeated by the same user, or carried out regularly on one device, 116,733 of 733,716 tests (15.9%) were qualified for further analysis. The prevalence of hearing loss, defined as the average threshold at frequencies 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz above 25 dB HL in the better ear, was calculated at 15.6% (95% CI 15.4-15.8). Statistically significant differences were found between countries (P<.001), with the highest prevalences for Bangladesh, Pakistan, and India (>28%) and the lowest prevalences for Taiwan, Finland, and South Korea (<11%).

Conclusions

Hearing thresholds measured by means of mobile devices were congruent with the literature data on worldwide hearing loss prevalence. Uniform recruitment criteria simplify the comparison of the hearing loss prevalence across countries. Hearing testing on mobile devices may be a valid tool in epidemiological studies carried out on a large scale.

Effectiveness of Internet- and Mobile-Based Cognitive Behavioral Therapy to Reduce Suicidal Ideation and Behaviors: Protocol for a Systematic Review and Meta-Analysis of Individual Participant Data

Internet- and mobile-based cognitive behavioral therapy (iCBT) might reduce suicidal ideation. However, recent meta-analyses found small effect sizes, and it remains unclear whether specific subgroups of participants experience beneficial or harmful effects. This is the study protocol for an individual participant meta-analysis (IPD-MA) aiming to determine the effectiveness of iCBT on suicidal ideation and identify moderators. We will systematically search CENTRAL, PsycINFO, Embase, and Pubmed for randomized controlled trials examining guided or self-guided iCBT for suicidality. All types of control conditions are eligible. Participants experiencing suicidal ideation will be included irrespective of age, diagnoses, or co-interventions. We will conduct a one-stage IPD-MA with suicidal ideation as the primary outcome, using a continuous measure, reliable improvement and deterioration, and response rate. Moderator analyses will be performed on participant-, study-, and intervention-level. Two independent reviewers will assess risk of bias and the quality of evidence using Cochrane's Risk of Bias Tool 2 and GRADE. This review was registered with OSF and is currently in progress. The IPD-MA will provide effect estimates while considering covariates and will offer novel insights into differential effects on a participant level. This will help to develop more effective, safe, and tailored digital treatment options for suicidal individuals.

Feasibility of the mobile mindfulness-based stress reduction for breast cancer (mMBSR(BC)) program for symptom improvement among breast cancer survivors

OBJECTIVE

The purpose of this pilot study was to test the feasibility of delivering the mobile mindfulness-based stress reduction for breast cancer (mMBSR(BC)) program using an iPad and to evaluate its impact on symptom improvement.

METHODS

A single group, pre-posttest design was implemented among female stages 0-III breast cancer survivors (BCS) who completed treatment. Data were collected at baseline and week 6 on measures of psychological and physical symptoms and quality of life. The mMBSR(BC) program is a standardized, stress-reducing intervention that combines sitting and walking meditation, body scan, and yoga and is designed to deliver weekly 2-hour sessions for 6 weeks using an iPad.

RESULTS

The mean age of the 15 enrolled BCS was 57 years; one participant was non-Hispanic black, and 14 were non-Hispanic white. Of the 13 who completed the study, there were significant improvements from baseline to 6 weeks post-mMBSR(BC) in psychological and physical symptoms of depression, state anxiety, stress, fear of recurrence, sleep quality, fatigue, and quality of life (P's < .05). Effect sizes for improvements of multiple symptoms ranged from medium to large.

CONCLUSIONS

These results provide preliminary support that the mMBSR(BC) program may be feasible and acceptable, showing a clinical impact on decreasing psychological and physical symptoms. This mobile-based program offers a delivery of a standardized MBSR(BC) intervention to BCS that is convenient for their own schedule while decreasing symptom burden in the survivorship phase after treatment for breast cancer.

Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis

BACKGROUND

The need for effective interventions to improve mental health and emotional well-being at a population level are gaining prominence both in the United Kingdom and globally. Advances in technology and widespread adoption of Internet capable devices have facilitated rapid development of Web-delivered psychological therapies. Interventions designed to manage a range of affective disorders by applying diverse therapeutic approaches are widely available.

OBJECTIVE

The main aim of this review was to evaluate the evidence base of acceptance and commitment therapy (ACT) in a Web-based delivery format.

METHOD

A systematic review of the literature and meta-analysis was conducted. Two electronic databases were searched for Web-delivered interventions utilizing ACT for the management of affective disorders or well-being. Only Randomized Controlled Trials (RCTs) were included.

RESULTS

The search strategy identified 59 articles. Of these, 10 articles met the inclusion criteria specified. The range of conditions and outcome measures that were identified limited the ability to draw firm conclusions about the efficacy of Web-delivered ACT-based intervention for anxiety or well-being.

CONCLUSIONS

ACT in a Web-based delivery format was found to be effective in the management of depression. Rates of adherence to study protocols and completion were high overall suggesting that this therapeutic approach is highly acceptable for patients and the general public.

Development of visible and NIR imaging equipment for small animals with smart pad

The portable visible and near-infrared (NIR) imaging equipment for a pre-clinical test with small animals was designed and developed in this paper. The developed equipment is composed of a CCD camera, a focusing lens, an objective lens, a NIR band pass filter and a NIR filter driving motor. An NIR ray is mainly used for imaging equipment because it has high light penetration depth in biological tissue. Therefore, NIR fluorescent agents are available for chemical conjugation to targeting molecules in vivo. This equipment can provide a visible image, NIR image and merged image simultaneously. A communication system was specifically established to check obtained images through a smart pad in real time. It is less dependent on space and time than the conventional system.