Smartphone threshold audiometry in underserved primary health-care contexts

Abstract

Objective: To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. Design: A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. Study sample: A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18–88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. Results: In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of −1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of −1.0 dB ± 7.1 SD. Conclusions: Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Key Words:

• Audiometry
• air conduction
• mHealth
• smartphone
• automated audiometer
• ambient noise

Acknowledgements

Thanks to the audiology students at the University of Pretoria for having performed the conventional examinations, and also thanks to the audiologists at Steve Biko Academic Hospital for doing the same. Thanks to Christine Louw and Leigh Biagio de Jager for their practical assistance.

Declaration of interest

Travel support for the main author was given by SIDA (Swedish International Development Cooperation Agency). The hearScreen™ application is intellectual property owned and trademarked by the University of Pretoria. The second and third authors are listed as co-inventors of the hearScreen software application which may be commercialized.