Evaluating the diagnostic accuracy and reliability of mobile audiometry for screening hearing loss in adults in comparison to pure tone audiometry.

Abstract

Background: Hearing loss affects approximately 1.5 billion people globally, with a significant proportion unaware of their condition due to inadequate screening. The current standard for diagnosing hearing loss, pure tone audiometry (PTA), faces limitations in accessibility and cost, especially in low-resource settings. Our study aimed to evaluate mobile audiometry (MA) as a self-assessment screening tool for the general public.

Methods: The study compared audiograms obtained via PTA in a sound-proof room and MA using a smartphone in a physician's office with ambient noise using relatively inexpensive, readily available generic headsets and earphones. MA was a self-assessment test where patients followed instructions from investigators but conducted the test independently under supervision. Each ear was tested separately without masking. Spearman's correlation assessed the association between MA and PTA, and Bland-Altman's analysis evaluated agreement. Diagnostic accuracy, sensitivity, and specificity were calculated using contingency tables. Kappa statistic measured reliability and test-retest reliability was assessed with Intraclass Correlation Coefficient (ICC).

Results: The study consisting of 250 participants (110 males and 140 females), with an average age of 43.5 years revealed strong agreement and correlation between audiograms obtained from PTA and MA. The diagnostic accuracy for classifying the degree of hearing loss was moderate, at 70%. MA exhibited high sensitivity (94.51%) and good specificity (70.96%) for screening hearing loss. The reliability of MA is good with a kappa statistic value of 0.659. The test-retest reliability of MA was assessed using ICC which was found to be 0.843.

Conclusions: MA could serve as an effective screening tool for hearing loss. Individuals identified with hearing loss through MA could be referred to a physician's office for further evaluation and timely management. However, limitations such as environmental noise and variability in headset quality may affect the accuracy of the results. Further research is needed to address these challenges and improve the reliability of MA.