Hear Glue Ear app delivers remote care for children with otitis media with effusion

The new mobile application Hear Glue Ear is both acceptable and accessible to children, their caregivers, and clinicians as part of otitis media with effusion (OME) management, a study has found. The hearing test of the app delivers a valid estimate of fluctuating hearing levels.

“In scenarios where face-to-face appointments are limited, as in the current COVID-19 pandemic, the app may provide ongoing support and continuity of care to families remotely,” the researchers said. “There is also the potential for use in low resource settings, where it may provide an estimate of changing hearing levels and support speech and language development in communities with limited access to audiology services.”

Sixty children aged 2–8 years with and without OME, attending Cambridge Community Audiology clinics, were included in this evaluation. The performance of these participants in the app’s hearing test was compared to their pure tone average (PTA) obtained in the clinic. Children and caregivers answered questionnaires after their first interaction with the app and after a week of using it at home. Eighteen clinicians completed anonymous questionnaires after trying out the app.

The app’s hearing test demonstrated a significant association with clinic PTA values (r, –0.656; p=0.000251). Majority of the caregivers (73.1 percent) supported the use of the app regularly by their children, and most (85 percent) believed that the app enabled them to provide more accurate reports to clinicians. [Digital Health 2020;doi:10.1177/2055207620966163]

After 1 week, 87.0 percent of families downloaded and used the app at home. Of these, 85.7 percent thought it provided strategies that were helpful to their child. All children (100 percent) liked the app, and 93.3 percent found it easy to use. In addition, 77.8 percent of clinicians approved the regular use of the app for their patients.

“The high number of downloads and uses between appointments demonstrate families’ enthusiasm for this type of support and suggest that parental concerns about screen time do not deter app uptake,” the researchers said. “These concerns may be partially assuaged by the recommendation of the app by a trusted clinician.”

The association between the hearing test and PTA results supports the validity of the app to estimate trends in hearing levels between appointments. However, it is not designed to diagnose hearing loss. Discrepancies between the hearing test and clinic PTA values may be explained by the normal variance in PTA values. Studies have shown a ±10 dB variance between PTA values taken within a short time of each other is normal and expected. [Ear Hear 2012;33:104-111; Int J Audiol 2014;53:S5-S15]

Moreover, a possibility exists for the future use of the app in combination with novel technologies such as bone-conducting headsets via Bluetooth to further improve access and benefit for children with the most severe conductive hearing losses. [Trends Hear 2019;23:29]

“A considerable advantage to the use of mobile health apps is the ability to update and improve in line with best practice at minimal additional cost or inconvenience to end users,” the researchers said.

“Following increasing appreciation of these benefits, technology in the field of paediatric audiology is rapidly evolving and exciting new innovations have the potential to support and guide family-centred care within management pathways, as NICE (National Institute for Health and Care Excellence) advocates,” they added. [https://www.ncbi.nlm.nih.gov/books/NBK51742/]