CLINICAL QUESTION
Given the lack of consensus on the most accurate remote hearing test application, what can be learned in evaluating the correlation of commercial and consumer-based audiometric applications with traditional audiometry, both in patients with normal hearing and in those with hearing loss?
BOTTOM LINE
Commercial-grade, app-based pure tone audiometry demonstrates an overall strong correlation and accuracy with traditional audiometry, but it is not intended to replace an evaluation performed in a controlled environment with calibrated equipment and a skillfully trained clinician.
BACKGROUND: Many rehabilitation services can be provided remotely for patients with hearing aids and cochlear implants. Promising, increasingly available, and designed to mimic traditional protocols used by audiologists, application-based hearing assessment programs on electronic devices can provide a self-administered screening of hearing; however, their validity and accuracy remain a concern.
STUDY DESIGN: Prospective study.
SETTING: Department of Otolaryngology–Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Ky.
SYNOPSIS: Researchers placed 39 adults into two cohorts: normal hearing (13 females, eight males; average age 31.4 years) and hearing loss (nine females, nine males; average age 65.7 years). Participants completed a traditional audiogram, two consumer app-based tests, one commercial app-based test, and a Hearing Handicap Inventory screening version (HHI-S). Results revealed a significant difference in correlation strength between the commercial and consumer iOS applications in normal ears, for which the commercial hearing test app had a statistically significant pure tone average correlation in both ears with traditional audiometry. Both consumer and commercial apps had statistically significant correlations in both ears in patients with hearing loss. For accuracy within 10 dB of the pure tone average of the traditional audiogram of all tested ears, the commercial app-based test was accurate in 94% of all ears; the consumer app-based tests fell between 14% and 36%. The HHI-S indicated no hearing impairment in 95% of those with normal hearing and hearing impairment in 89% of those with hearing loss. Authors note that the widespread use of accurate and validated audiometric applications could increase access to hearing healthcare, especially for patients in remote locations. Study limitations include its small set of hearing test applications.
CITATION: Adkins D, Phuong A, Shinn J, et al. Tools for telehealth: a correlational analysis of app-based hearing testing. Laryngoscope Investig Otolarygol. 2024;9:e1255.