The Reliability of Click-Evoked and Frequency-Specific Auditory Brainstem Response Testing Using Telehealth Technology

Abstract

The purpose of this study was to examine the reliability of auditory brainstem responses obtained from a distant site using telemedicine technology. Fifteen subjects were located with the examiners in Minot, North Dakota, while the data were acquired by an audiologist in Logan, Utah. All test procedures were performed with accepted clinical protocols. Statistical analysis of the data indicated that trials conducted locally had a strong correlation with those collected from a distance. The analysis also indicated that any intrasubject variances were due to factors other than the site of testing. The test results fell within accepted clinical allowances as defined by prior normative studies. These results indicate that this procedure may be accepted for clinical use.Learning Outcomes: As a result of this activity, participants will be able to (1) list the limitations of telehealth technology as a means of acquiring reliable ABR data, and (2) describe the value of telehealth technology in audiology.

Telehealth in audiology: The need and potential to reach underserved communities

“…This should preferably also be performed whilst continuously monitoring environmental noise levels at the remote testing site to ensure reliable recordings (Elangovan, 2005). Auditory evoked potentials can be used synchronously with interactive video, whereby the audiologist may monitor and direct the paraprofessional on aspects such as electrode and transducer placement before taking control of the software remotely through application sharing for assessments of auditory functioning or intraoperative monitoring (Towers et al, 2005). Vestibular assessments using electronystagmography or videonystagmography can be used within similar models (Yates & Campbell, 2005).…”

A Systematic Review of Telehealth Applications in Audiology

“…In a comparison between remote ABR recordings using desktop sharing software and face-to-face recordings in a group of 15 adults, comparable wave latencies within the clinically allowable range of variability were obtained. 29 Recordings included ABRs elicited with toneburst (500 and 3,000 Hz) and broadband click stimuli presented at 55 and 75 dB. No significant effect as a result of different test sites was reported, and the results suggested that remote test was as reliable as face-to-face testing.…”

“…Reports of tele-audiology using objective measures of auditory functioning have included DPOAE, ABR, and intraoperative monitoring. 24,29,30 A study investigating the correspondence between DPOAE measures recorded remotely (through desktop sharing software and interactive video) and face-to-face assessments in 30 adult subjects demonstrated that there were essentially no differences between the findings. 24 An overall agreement of 97-99% was reported across frequencies (2,000, 2,500, 3,000, 4,000, and 5,100 Hz) and was comparable to the agreement between face-to-face assessments, which was 97% on average.…”

Verificação da prótese auditiva realizada face a face e via teleconsulta: medidas repetidas

“…Uma das preocupações com relação à teleconsulta é a consistência e qualidade do envio das informações de um local ao outro. Estudos 15,30,31 relatam falhas no sinal de áudio e na transmissão dos dados do teste realizado à distância, em momentos de pico na rede, quando o tráfego na internet era intenso, fazendo com que a informação enviada pelo computador remoto não chegasse de maneira ótima no ambiente de ondas estacionárias geradas no mesmo. Em consequência, no caso das frequências baixas o tubo sonda posicionado em qualquer lugar do conduto irá medir, essencialmente, um nível de pressão sonora igual ao gerado próximo na membrana timpânica 4 .…”

“…Pesquisadores vêm empregando a teleconsulta síncrona para a realização de diferentes procedimentos audiológicos como a audiometria tonal 10 , emissões otoacústicas evocadas 14 , potenciais auditivos evocados de tronco encefálico 15 e programação do implante coclear 16,17 . Tais estudos demonstram concordância entre os resultados obtidos com os procedimentos padrão e de teleconsulta.…”