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 primary health care clinic environment. STUDY SAMPLE : 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 -1.6dB ± 9.9SD. 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 ±7.1SD. 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.