Apple hearing test feature for the AirPods Pro 2 : accuracy, reliability, and time-efficiency

Abstract

OBJECTIVE : To evaluate the accuracy, test-retest reliability, and time-efficiency of Apple's Hearing Test Feature (HTF) compared to reference standard pure-tone audiometry (PTA). STUDY DESIGN : Cross-sectional validation study. SETTING : Single-center study at a university clinic. PTA was performed in a sound-treated booth. HTF testing occurred in a quiet room. METHODS : A sample of 25 adults (mean age 50.1 years [SD 14.2]; 68% female) with self-reported mild-to-moderate hearing loss participated. Each contributed 16 thresholds, yielding 400 comparisons. Participants underwent PTA by an audiologist, followed by two independent HTF assessments (start and end of session) using Apple AirPods Pro 2 paired with an iPhone 13. Outcomes included threshold accuracy versus PTA, test-retest reliability, and test duration. RESULTS : Across 400 comparisons, 86.5% of HTF thresholds were within 10 dB HL of PTA. Root mean square deviation (RMSD) values ranged from 3.3 to 7.9 dB HL (left ear) and 5.8 to 9.7 dB HL (right ear), meeting minimally acceptable accuracy (≤10 dB HL). Test-retest was reliable, 84.1% of thresholds within 5 dB HL and 96.6% within 10 dB HL. Desired reliability (≤6 dB HL) was met at all frequencies except 250 Hz (left ear), which met minimum acceptable level. HTF was significantly faster (median 5.5 minutes) than PTA (10.0 minutes; P < .001). CONCLUSION : Apple's HTF demonstrated clinically acceptable accuracy and reliability, with improved time-efficiency compared to PTA. Findings support its potential for consumer-led hearing monitoring and OTC hearing aid self-fitting. Further research should assess inter-device reliability and integration with Apple's Hearing Aid Feature.