Niall A M Klyn1, Samantha Kleindienst Robler2,3, Razan Alfakir4, Donald W Nielsen5, James W Griffith6, Deborah L Carlson7, Larry Lundy4, Sumitrajit Dhar1,8, David A Zapala4. 1. Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA. 2. Division of Audiology, Mayo Clinic, Scottsdale, Arizona, USA. 3. Department of Audiology, Norton Sound Health Corporation, Nome, Alaska, USA. 4. Department of Otorhinolaryngology, Mayo Clinic, Jacksonville, Florida, USA. 5. Don Nielsen Consulting, LLC, Dublin, Ohio, USA. 6. Department of Medical Social Science, Northwestern University, Chicago, Illinois, USA. 7. Department of Otolaryngology, University of Texas Medical Branch, Galveston, Texas, USA. 8. The Hugh Knowles Center, Northwestern University, Evanston, Illinois, USA.
Abstract
OBJECTIVES: The purpose of this study was to evaluate the specificity and sensitivity of two red flag protocols in detecting ear diseases associated with changes in hearing. DESIGN: The presence of red-flag symptoms was determined in a chart review of 307 adult patients from the Mayo Clinic Florida Departments of Otorhinolaryngology and Audiology. Participants formed a convenience sample recruited for a separate study. Neurotologist diagnosis was the criterion for comparisons. RESULTS: Of the 251 patient files retained for analysis, 191 had one or more targeted diseases and 60 had age- or noise-related hearing loss. Food and Drug Administration red flags sensitivity was 91% (confidence interval [CI], 86 to 95%) and specificity was 72% (CI, 59 to 83%). American Academy of Otolaryngology-Head and Neck Surgery red flags sensitivity was 98% (CI, 95 to 99%) and specificity was 20% (CI, 11 to 32%). CONCLUSIONS: Stakeholders must determine which diseases are meaningful contraindications for hearing aid use and whether these red-flag protocols have acceptable levels of sensitivity and specificity. As direct-to-consumer models of hearing devices increase, a disease detection method that does not require provider intercession would be useful.
OBJECTIVES: The purpose of this study was to evaluate the specificity and sensitivity of two red flag protocols in detecting ear diseases associated with changes in hearing. DESIGN: The presence of red-flag symptoms was determined in a chart review of 307 adult patients from the Mayo Clinic Florida Departments of Otorhinolaryngology and Audiology. Participants formed a convenience sample recruited for a separate study. Neurotologist diagnosis was the criterion for comparisons. RESULTS: Of the 251 patient files retained for analysis, 191 had one or more targeted diseases and 60 had age- or noise-related hearing loss. Food and Drug Administration red flags sensitivity was 91% (confidence interval [CI], 86 to 95%) and specificity was 72% (CI, 59 to 83%). American Academy of Otolaryngology-Head and Neck Surgery red flags sensitivity was 98% (CI, 95 to 99%) and specificity was 20% (CI, 11 to 32%). CONCLUSIONS: Stakeholders must determine which diseases are meaningful contraindications for hearing aid use and whether these red-flag protocols have acceptable levels of sensitivity and specificity. As direct-to-consumer models of hearing devices increase, a disease detection method that does not require provider intercession would be useful.
Authors: Samantha J Kleindienst; David A Zapala; Donald W Nielsen; James W Griffith; Dania Rishiq; Larry Lundy; Sumitrajit Dhar Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-10-01 Impact factor: 6.223
Authors: Samantha J Kleindienst; Sumitrajit Dhar; Donald W Nielsen; James W Griffith; Larry B Lundy; Colin Driscoll; Brian Neff; Charles Beatty; David Barrs; David A Zapala Journal: Am J Audiol Date: 2016-09-01 Impact factor: 1.493
Authors: Patrick M Bossuyt; Johannes B Reitsma; David E Bruns; Constantine A Gatsonis; Paul P Glasziou; Les Irwig; Jeroen G Lijmer; David Moher; Drummond Rennie; Henrica C W de Vet; Herbert Y Kressel; Nader Rifai; Robert M Golub; Douglas G Altman; Lotty Hooft; Daniël A Korevaar; Jérémie F Cohen Journal: Radiology Date: 2015-10-28 Impact factor: 11.105
Authors: Niall A M Klyn; Samantha Kleindienst Robler; Jamie Bogle; Razan Alfakir; Donald W Nielsen; James W Griffith; Deborah L Carlson; Larry Lundy; Sumitrajit Dhar; David A Zapala Journal: Ear Hear Date: 2019 Nov/Dec Impact factor: 3.570