Calibrated finger rub auditory screening test (CALFRAST)

Diego Torres-Russotto, W. M. Landau, G. W. Harding, B. A. Bohne, K. Sun, P. M. Sinatra

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Determination of auditory function is a fundamental part of a complete neurologic examination. Disability from permanent hearing loss is common in the general population. Current bedside auditory tests are unreliable and cumbersome. We evaluated the calibrated finger rub auditory screening test (CALFRAST) as a routine diagnostic tool. METHODS: The sound spectrum and mean peak intensities of standard finger rub were measured, as well as background noise. CALFRAST overlapped the frequency spectrum of normal speech. Patients and companions were recruited from a neurology clinic. With arms extended, two stimulus intensities were presented: strong finger rub (CALFRAST-Strong 70) and the faintest rub that the examiner could hear (CALFRAST-Faint 70). With subjects' eyes closed, each ear's CALFRAST threshold was ascertained and then compared with its audiometric measure. The normal threshold was considered to be 25 dB. Validity, reliability, and discrimination abilities were obtained using standard methods. RESULTS: Two hundred twenty-one subjects (442 ears; 58% women) were examined. Ages ranged from 18 to 88 years, with a mean of 46 years. Eighty-five subjects (39%) had some degree of hearing loss. Both specificity and positive predictive value of CALFRAST-Strong 70 were 100%. Both sensitivity and negative predictive value of CALFRAST-Faint 70 were 99%, with a negative likelihood ratio <0.1. Area under the receiver operating characteristic curve was 0.94, consistent with excellent discrimination ability. Both intrarater and interrater reliability were excellent, both κ >0.8. Subjects' self-assessment of hearing was unreliable. CONCLUSION: The calibrated finger rub auditory screening test (CALFRAST) is simple, accurate, inexpensive, and reliable. As a routine screening tool, CALFRAST may contribute to more efficient identification of auditory impairment.

Original languageEnglish (US)
Pages (from-to)1595-1600
Number of pages6
JournalNeurology
Volume72
Issue number18
DOIs
StatePublished - May 5 2009

Fingerprint

Fingers
Hearing Loss
Ear
Aptitude
Neurologic Examination
Neurology
Reproducibility of Results
Hearing
Noise
Arm

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Torres-Russotto, D., Landau, W. M., Harding, G. W., Bohne, B. A., Sun, K., & Sinatra, P. M. (2009). Calibrated finger rub auditory screening test (CALFRAST). Neurology, 72(18), 1595-1600. https://doi.org/10.1212/WNL.0b013e3181a41280

Calibrated finger rub auditory screening test (CALFRAST). / Torres-Russotto, Diego; Landau, W. M.; Harding, G. W.; Bohne, B. A.; Sun, K.; Sinatra, P. M.

In: Neurology, Vol. 72, No. 18, 05.05.2009, p. 1595-1600.

Research output: Contribution to journalArticle

Torres-Russotto, D, Landau, WM, Harding, GW, Bohne, BA, Sun, K & Sinatra, PM 2009, 'Calibrated finger rub auditory screening test (CALFRAST)', Neurology, vol. 72, no. 18, pp. 1595-1600. https://doi.org/10.1212/WNL.0b013e3181a41280
Torres-Russotto D, Landau WM, Harding GW, Bohne BA, Sun K, Sinatra PM. Calibrated finger rub auditory screening test (CALFRAST). Neurology. 2009 May 5;72(18):1595-1600. https://doi.org/10.1212/WNL.0b013e3181a41280
Torres-Russotto, Diego ; Landau, W. M. ; Harding, G. W. ; Bohne, B. A. ; Sun, K. ; Sinatra, P. M. / Calibrated finger rub auditory screening test (CALFRAST). In: Neurology. 2009 ; Vol. 72, No. 18. pp. 1595-1600.
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AB - BACKGROUND: Determination of auditory function is a fundamental part of a complete neurologic examination. Disability from permanent hearing loss is common in the general population. Current bedside auditory tests are unreliable and cumbersome. We evaluated the calibrated finger rub auditory screening test (CALFRAST) as a routine diagnostic tool. METHODS: The sound spectrum and mean peak intensities of standard finger rub were measured, as well as background noise. CALFRAST overlapped the frequency spectrum of normal speech. Patients and companions were recruited from a neurology clinic. With arms extended, two stimulus intensities were presented: strong finger rub (CALFRAST-Strong 70) and the faintest rub that the examiner could hear (CALFRAST-Faint 70). With subjects' eyes closed, each ear's CALFRAST threshold was ascertained and then compared with its audiometric measure. The normal threshold was considered to be 25 dB. Validity, reliability, and discrimination abilities were obtained using standard methods. RESULTS: Two hundred twenty-one subjects (442 ears; 58% women) were examined. Ages ranged from 18 to 88 years, with a mean of 46 years. Eighty-five subjects (39%) had some degree of hearing loss. Both specificity and positive predictive value of CALFRAST-Strong 70 were 100%. Both sensitivity and negative predictive value of CALFRAST-Faint 70 were 99%, with a negative likelihood ratio <0.1. Area under the receiver operating characteristic curve was 0.94, consistent with excellent discrimination ability. Both intrarater and interrater reliability were excellent, both κ >0.8. Subjects' self-assessment of hearing was unreliable. CONCLUSION: The calibrated finger rub auditory screening test (CALFRAST) is simple, accurate, inexpensive, and reliable. As a routine screening tool, CALFRAST may contribute to more efficient identification of auditory impairment.

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