Evidence map›Paper›PMID 35938885›Full record

ReviewJournal of global health2022

Community health workers and mHealth systems for hearing screening in rural Nicaraguan schoolchildren.

James E Saunders, Sarah Bessen, Isabelle Magro, Devin Cowan, Marvin Gonzalez Quiroz, Karen Mojica-Alvarez, Donoso Penalba, Catherine Reike, Christopher E Niemczak, Abigail Fellows and 1 more

Open access · goldAbstract readReview
In one paragraph

Review in Journal of global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

James E SaundersDepartment of Surgery Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Sarah BessenDartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Isabelle MagroDartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Devin CowanDartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Marvin Gonzalez QuirozResearch Centre on Health, Work and Environment (CISTA) at National Autonomous University of Nicaragua, Leon (UNAN-Leon), Leon, Nicaragua.
Karen Mojica-AlvarezMedical Director, Mayflower Medical Outreach, Managua, Nicaragua.
Donoso PenalbaDepartment of Public Health at National Autonomous University of Nicaragua, Leon (UNAN-Leon), Leon, Nicaragua.
Catherine ReikeGeisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Christopher E NiemczakGeisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Abigail FellowsGeisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Jay C BuckeyGeisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
Dartmouth–Hitchcock Medical Center · USDartmouth College · USUniversidad Nacional Autónoma de Nicaragua-León · NIUniversity College London · GB

Funding

Mobile Smartphone Audiometry to Improve Hearing Outcomes in Nicaraguan ChildrenR21DC015133 · NIDCD · DARTMOUTH-HITCHCOCK CLINIC · PI SAUNDERS, JAMES E · 2017 to 2018
$429k
NIDCD NIH HHS R21 DC015133
6 · The paper itself

Abstract

Background: We aimed to investigate the effectiveness of using minimally trained community health workers (CHW) to screen schoolchildren in rural Nicaragua for hearing loss using a tablet-based audiometric system integrated with asynchronous telehealth evaluations and mobile health (mHealth) appointment reminders. Methods: A population-based survey was conducted using community health workers (CHWs) to perform tablet-based audiometry, asynchronous telehealth evaluations, and mHealth reminders to screen 3398 school children (7-9 years of age) in 92 rural Nicaraguan communities. The accuracy of screening, test duration, testing efficiency, telehealth data validity, and compliance with recommended clinic visits were analyzed. Results: Minimally trained CHWs successfully screened children within remote rural schools with automated audiometry (test duration = 5.8 minutes) followed by manual audiometry if needed (test duration = 4.3 minutes) with an estimated manual audiometry validity of 98.5% based on a review of convergence patterns. For children who were referred based on audiometry, the otoscopy and tympanometry obtained during telehealth evaluations were high quality (as reviewed by 3 experts) in 44.6% and 80.1% of ears, respectively. A combination of automated short message service (SMS) text messages and voice reminders resulted in a follow-up compliance of 75.2%. No families responded to SMS messages alone. Conclusions: Tablet-based hearing screening administered by minimally trained CHWs is feasible and effective in low- and middle-income countries. Manual audiometry was as efficient as automated audiometry in this setting. The physical exam tasks of otoscopy and tympanometry require additional training. Mobile phone messages improve compliance for confirmatory audiometry, but the utility of SMS messaging alone is unclear in this population.

Indexed as

TelemedicineText MessagingAudiometryChildCommunity Health WorkersHearingHumans

Identifiers

PMID35938885
PMCPMC9359107
OpenAlexW4290723918

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.