Automated Smartphone Threshold Audiometry: Validity and Time Efficiency

J Am Acad Audiol. 2017 Mar;28(3):200-208. doi: 10.3766/jaaa.16002.


Background: Smartphone-based threshold audiometry with automated testing has the potential to provide affordable access to audiometry in underserved contexts.

Purpose: To validate the threshold version (hearTest) of the validated hearScreen™ smartphone-based application using inexpensive smartphones (Android operating system) and calibrated supra-aural headphones.

Research design: A repeated measures within-participant study design was employed to compare air-conduction thresholds (0.5-8 kHz) obtained through automated smartphone audiometry to thresholds obtained through conventional audiometry.

Study sample: A total of 95 participants were included in the study. Of these, 30 were adults, who had known bilateral hearing losses of varying degrees (mean age = 59 yr, standard deviation [SD] = 21.8; 56.7% female), and 65 were adolescents (mean age = 16.5 yr, SD = 1.2; 70.8% female), of which 61 had normal hearing and the remaining 4 had mild hearing losses.

Data analysis: Threshold comparisons were made between the two test procedures. The Wilcoxon signed-ranked test was used for comparison of threshold correspondence between manual and smartphone thresholds and the paired samples t test was used to compare test time.

Results: Within the adult sample, 94.4% of thresholds obtained through smartphone and conventional audiometry corresponded within 10 dB or less. There was no significant difference between smartphone (6.75-min average, SD = 1.5) and conventional audiometry test duration (6.65-min average, SD = 2.5). Within the adolescent sample, 84.7% of thresholds obtained at 0.5, 2, and 4 kHz with hearTest and conventional audiometry corresponded within ≤5 dB. At 1 kHz, 79.3% of the thresholds differed by ≤10 dB. There was a significant difference (p < 0.01) between smartphone (7.09 min, SD = 1.2) and conventional audiometry test duration (3.23 min, SD = 0.6).

Conclusions: The hearTest application with calibrated supra-aural headphones provides a cost-effective option to determine valid air-conduction hearing thresholds.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Audiometry / methods*
  • Auditory Threshold / physiology*
  • Cohort Studies
  • Female
  • Hearing Loss, Bilateral / diagnosis*
  • Hearing Loss, Bilateral / therapy
  • Humans
  • Male
  • Middle Aged
  • Reaction Time
  • Reference Values
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Smartphone / statistics & numerical data*
  • Telemedicine / methods*
  • Young Adult