Accuracy and Reliability of Smartphone Self-Test Audiometry in Community Clinics in Low Income Settings: A Comparative Study
Accuracy and Reliability of Smartphone Self-Test Audiometry in Community Clinics in Low Income Settings: A Comparative Study
Background: There is a lack of hearing health care globally, and tele-audiology and mobile technologies have been
proposed as important strategies to reduce the shortfall.
Objectives: To investigate the accuracy and reliability of smartphone self-test audiometry in adults, in community clinics
in low-income settings.
Methods: A prospective, intra-individual, repeated measurements design was used. Sixty-three adult participants (mean
age 52 years, range 20-88 years) were recruited from ENT and primary health care clinics in a low-income community
in Tshwane, South Africa. Air conduction hearing thresholds for octave frequencies 0.5 to 8 kHz collected with the
smartphone self-test in non-sound treated environments were compared to those obtained by reference audiometry.
Results: The overall mean difference between threshold seeking methods (ie, smartphone thresholds subtracted from
reference) was −2.2 dB HL (n = 467 thresholds, P = 0.00). Agreement was within 10 dB HL for 80.1% (n = 467 thresholds)
of all threshold comparisons. Sensitivity for detection hearing loss >40 dB HL in one ear was 90.6% (n = 84 ears), and
specificity 94.2% (n = 84 ears).
audiometry, global health, hearing loss, mHealth, smartphone, telemedicine
Background: There is a lack of hearing health care globally, and tele-audiology and mobile technologies have been
proposed as important strategies to reduce the shortfall.
Objectives: To investigate the accuracy and reliability of smartphone self-test audiometry in adults, in community clinics
in low-income settings.
Methods: A prospective, intra-individual, repeated measurements design was used. Sixty-three adult participants (mean
age 52 years, range 20-88 years) were recruited from ENT and primary health care clinics in a low-income community
in Tshwane, South Africa. Air conduction hearing thresholds for octave frequencies 0.5 to 8 kHz collected with the
smartphone self-test in non-sound treated environments were compared to those obtained by reference audiometry.
Results: The overall mean difference between threshold seeking methods (ie, smartphone thresholds subtracted from
reference) was −2.2 dB HL (n = 467 thresholds, P = 0.00). Agreement was within 10 dB HL for 80.1% (n = 467 thresholds)
of all threshold comparisons. Sensitivity for detection hearing loss >40 dB HL in one ear was 90.6% (n = 84 ears), and
specificity 94.2% (n = 84 ears).
audiometry, global health, hearing loss, mHealth, smartphone, telemedicine