Smartphone-Based Hearing Screening at Primary Health Care Clinics

Ear Hear. 2017 Mar/Apr;38(2):e93-e100. doi: 10.1097/AUD.0000000000000378.


Objective: To evaluate the performance of smartphone-based hearing screening with the hearScreen application in terms of sensitivity, specificity, referral rates, and time efficiency at two primary health care clinics.

Design: Nonprobability purposive sampling was used at both clinics. A total of 1236 participants (mean age: 37.8 ± SD 17.9 and range 3 to 97 years; 71.3% female) were included in the final analysis. Participants were screened using the hearScreen application following a two-step screening protocol and diagnostic pure-tone audiometry to confirm hearing status.

Results: Sensitivity and specificity for smartphone screening was 81.7 and 83.1%, respectively, with a positive and negative predictive value of 87.6 and 75.6%, respectively. Sex [χ(1, N = 126) = 0.304, p > 0.05] and race [χ(1, N = 126) = 0.169, p > 0.05)] had no significant effect on screening outcome for children while for adults age (p < 0.01; β = 0.04) and sex (p = 0.02; β = -0.53) had a significant effect on screening outcomes with males more likely to fail. Overall referral rate across clinics was 17.5%. Initial screening test times were less than a minute (48.8 seconds ± 20.8 SD) for adults and slightly more than a minute for children (73.9 seconds ± 44.5 SD).

Conclusions: The hearScreen smartphone application provides time-efficient identification of hearing loss with adequate sensitivity and specificity for accurate testing at primary health care settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Audiometry, Pure-Tone
  • Child
  • Child, Preschool
  • Female
  • Hearing Loss / diagnosis*
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Mobile Applications*
  • Primary Health Care*
  • Sensitivity and Specificity
  • Smartphone*
  • Young Adult