The sensitivity and specificity of wideband absorbance measure in identifying pathologic middle ears in adults living with HIV.
Ben Sebothoma, Katijah Khoza-Shangase, Duane Mol and 1 others
PMID 34636595WHAT IT FOUND
Wideband absorbance detected more middle ear problems than standard tympanometry in adults with HIV, especially at low frequencies.
However, its overall accuracy was modest. It should not replace clinical judgment but may help screen when specialist access is limited.
Key findings
01Wideband absorbance had higher sensitivity (59%–82%) than standard tympanometry at low to mid frequencies, but specificity was comparable.
02The area under the ROC curve for wideband absorbance was only 0.41–0.64, indicating limited diagnostic accuracy compared to previous studies.
03Sensitivity dropped significantly to 23.5% at frequencies above 971.43 Hz.
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How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study had a very small number of ears with pathology (17 out of 161), which limits the reliability of the sensitivity and specificity calculations. The 'gold standard' was based on visual inspection of video otoscopic images, which may miss pathologies that do not change the appearance of the eardrum but do affect its mechanics. Participants were recruited from a single clinic using non-probability sampling, so the results may not apply to other populations. The study did not include an HIV-negative control group, so it is unclear if the test performs differently in this population compared to the general adult population.
Declared interests
None reported.
The easy way to misread this
Do not assume wideband absorbance is a superior screening tool because it found more cases than standard tympanometry. Its overall accuracy was low, and it missed most pathologies at higher frequencies, meaning it should not be used to rule out middle ear disease.