Accuracy of Remote Hearing Assessment in Rural Community

​​The study demonstrates the validity of using synchronous telemedicine for conducting hearing assessments with the Kuduwave  audiometer in a remote rural agricultural community without a sound booth. The Kuduwave  audiometer uses insert earphones covered by circumaural ear cups (Ambi-Dome) to attenuate noise. Ambi-Dome technology provides noise attenuation similar to that provided by a single-walled sound booth.

Telemedicine offers unique opportunities for providing access to hearing healthcare services to underserved populations worldwide. However, it is important to validate the potential benefit that the Kuduwave audiometer could have to increase this access.

This study investigated the reliability and accuracy of synchronous Kuduwave audiometry in a rural agricultural community where there is limited access to audiological services.

Three test environments were used to validate the Kuduwave audiometer’s synchronous telemedicine functionality in a natural environment (without a booth).

Booth environment: The test was conducted in a single-walled booth with the clinician and participant/s face-to-face in a hospital.

Kuduwave audiometer without a sound booth: This test was conducted with the clinician and participant/s face-to-face in the participants’ office on the farm.

Tele-audiology configuration using the Kuduwave audiometer : The test was conducted in the second environment (Kuduwave audiometer  used in participants' office on the farm) while the clinician or tester was in a remote location, 1.2 kilometres away from the patient.

A tele-audiology facilitator from the local community and with no formal audiology training or tertiary education facilitated the participants during the test, while an audiologist (clinician) conducted the air-conduction hearing assessment through video conferencing (Skype) and the wireless 3G internet connection.

Test-retest threshold correspondence in the booth and natural environments (Kuduwave audiometer) was within -5 dB in 96.7% and 97.5% of comparisons. Threshold correspondence between the Kuduwave’s telemedicine functionality, compared with booth and natural environments, were within -5 dB in 82% and 85% of comparisons.

Results demonstrate Kuduwave telemedicine-enabled hearing assessments to be comparable to the current “gold standard”. These technologies make it possible for diagnostic hearing assessments to be included as part of a remote telemedicine kit and can lead to new opportunities in telemedicine support.