Pure-Tone Air-Conduction and Bone-Conduction Threshold Audiometry with and without Masking in Adults and Older Children (ECPG):

Pure-Tone Air-Conduction and Bone-Conduction Threshold Audiometry with and without Masking in Adults and Older Children (ECPG)

"last update: 26 August 2024"

- Methods

Methods of development

➡️Stakeholder Involvement

Individuals who were involved in the development process. Included the above-mentioned Audiology Chief Manager, Audiology Executive Manager, Assembly Board, Grading Board and Reviewing Board.

Information about target population experiences were not applicable for this topic.

The adaptation cycle passed over: set-up phase, adaptation phase (Search and screen, assessment: currency, content, quality & /decision/selection) and finalization phase that included revision and external reviewing.

➡️Search Method

Electronic database searched: Pubmed, Medline, Google Scholar, Egyptian Knowledge Bank, Medscape.

➡️Keywords

Puretone Audiometry, Air Conduction, Bone Conduction, Masking, Hearing Loss, Guidlines

Time period searched: From 2005 to 2018

➡️Results

Four guidelines were assessed by three audiovestibular medicine experts. The “Pure-tone air- conduction and bone-conduction threshold audiometry with and without masking” the recommended procedure by the British Society of Audiology BSA (2017) had the highest scores as regards the currency, contents, and quality. It was graded by 23 audiovestibular medicine consultants and reviewed by four expert reviewers.

➡️Setting

Primary, secondary and tertiary care centers & hospitals, and related specialties.

Interpretation of strong and conditional recommendations for an intervention

Audience	Strong recommendation	Conditional recommendation
Patients	Most individuals in this situation would want the recommended course of action; only a small proportion would not. Formal decision aides are not likely to be needed to help individuals make decisions consistent with their values and preferences.	Most individuals in this situation would want the suggested course of action, but many would not
Clinicians	Most individuals should receive the intervention. Adherence to the recommendation could be used as a quality criterion or performance indicator.	Different choices will be appropriate for individual patients, who will require assistance in arriving at a management decision consistent with his or her values and preferences. Decision aides may be useful in helping individuals make decisions consistent with their values and preferences.
Policymakers	The recommendation can be adopted as policy in most situations.	Policy-making will require substantial debate and involvement of various stakeholders.

WHO handbook for guideline development – 2nd ed.

Chapter 10, page 129

The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to Decision frameworks

(GRADE Working Group 2013)

Grade	Definition
High	We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate	We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low	Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very Low	We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect