Automated pure tone audiometry (PTA) in the assessment of hearing loss in pediatric populations: A systematic review and meta-analysis of diagnostic test accuracy studies.
Reem Hasan Alzubaidi, Ali Almania, Suhayb Waleed Alamri et al.
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In 30 seconds
This systematic review and meta-analysis assessed the diagnostic accuracy of automated pure-tone audiometry (PTA) for hearing loss in children. Twelve studies were included. In the bivariate model, pooled sensitivity was 0.745 (95% CI, 0.620-0.840) and specificity was 0.882 (95% CI, 0.785-0.939); the area under the curve was 0.878. Results across individual studies varied substantially. The authors concluded that automated PTA may support initial screening or triage, but should not replace comprehensive diagnostic audiometry.
Key findings
- Across 12 studies, bivariate pooled sensitivity was 0.745 (95% CI, 0.620-0.840) and specificity was 0.882 (95% CI, 0.785-0.939).
- The bivariate model reported a diagnostic odds ratio of 24.667 and an area under the curve of 0.878.
- Individual-study sensitivity ranged from 0.28 to 1.00, while specificity ranged from 0.58 to 1.00.
- Performance was less consistent in children younger than 7 years and varied with ambient noise, hardware, calibration, and testing protocol.
Why it matters
Automated PTA could help extend access to initial hearing assessment where specialist availability, cost, or logistics limit conventional testing. Its pooled specificity suggests potential value for screening or triage, but moderate sensitivity and variable performance mean a negative result cannot be treated as a substitute for comprehensive diagnostic audiometry when hearing loss is suspected.
What to keep in mind
Accuracy varied widely across included studies, and performance depended on age, ambient noise, hardware, calibration, and testing protocol.