Diagnostic Hearing Test System for Telehealth in Underserved Communities

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PROJECT SUMMARY/ABSTRACT Hearing is important to our physical and mental health. Hearing loss, unfortunately, is the third most common chronic physical condition in the U.S.—more prevalent than diabetes or cancer. Presently, 14.1% (27.7 million) of adults aged 20–69 years of age have unilateral or bilateral speech-frequency hearing impairment. Uncorrected hearing loss gives rise to a poorer quality of life and increased symptoms of depression. For children, hearing loss can negatively impact speech language development, academic performance and psychosocial behavior. On the other end of our lifespan, recent research has shown hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community dwelling older adults. Many forms of hearing loss are treatable or addressable with technology (e.g., hearing aids). However, due to a lack of access to diagnostic testing, many cases go untreated. A major limiter to diagnostic quality hearing tests is the need for expensive infrastructure, i.e., sound-proofed booths, and audiologists with specialized training in conducting exams, which are traditionally conducted in-person and one-on-one. Although there has been investment in changing the model of delivering hearing assessment, particularly with new “boothless” solutions, there remains strong needs for (1) hardware that maintains the quality required for diagnostic audiometry in “boothless” settings, (2) automated testing for routine testing that would allow audiologists to focus on the more complex cases, and (3) new approaches to connect audiologists to patients through teleaudiology—enabling audiologists to provide the expertise needed for the more complex cases without requiring either the patients nor the audiologists to travel great distances. Creare, in collaboration with its clinical partners, is developing a mobile, wireless audiometric hearing test system to address these needs. Creare has chosen to focus on addressing the needs of American Indians and Alaska Natives (AIAN). In addition to the challenges due to rural and limited infrastructure, AIAN have the highest rate of hearing issues compared to other race/ethnicity groups. In Phase I, a prototype system was assembled, evaluated against relevant standards, and used in a pilot study to measure hearing thresholds on subjects with asymmetric hearing loss. Phase II will focus on refining the device design, building several pre- production prototypes, and demonstrating their use and performance with human subject studies. The Phase II outcome will be a portable, wireless audiometric hearing test system that will expand the reach of diagnostic testing to rural communities. Furthermore, the solution is well-timed with an increasing interest in teleaudiology—which has been accelerated by the COVID-19 pandemic.