Monitoring Hearing in an Infectious Disease Clinic with mHealth Technologies

J Am Acad Audiol. 2019 Jun;30(6):482-492. doi: 10.3766/jaaa.17120. Epub 2018 Sep 25.


Background: Decentralized detection and monitoring of hearing loss can be supported by new mobile health technologies using automated testing that can be facilitated by minimally trained persons. These may prove particularly useful in an infectious disease (ID) clinic setting where the risk of hearing loss is high.

Purpose: To evaluate the clinical utility of mobile and automated audiometry hearing health technology in an ID clinic setting.

Research design: Smartphone-automated pure-tone audiometry (PTA) (hearTestâ„¢) and speech-in-noise testing (SA English digits-in-noise [DIN] test) were compared with manual audiometry (2, 4, and 8 kHz). Smartphone-automated PTA and the DIN test were repeated to determine the test-retest reliability.

Study sample: Two hundred subjects (73% female and 27% male) were enrolled. Fifty participants were retested with the smartphone applications. Participants ranged from an age of 18 to 55 years with a mean age of 44.4 (8.7 standard deviation).

Data analysis: Threshold comparisons were made between smartphone audiometry testing and manual audiometry. Smartphone-automated PTA, manual audiometry, and test-retest measures were compared (Wilcoxon signed ranked test). Spearman rank correlation test was used to determine the relationship between the smartphone applications and manual audiometry, as well as for test-retest reliability.

Results: Within all participants, 88.2% of thresholds corresponded within 10 dB or less between smartphone audiometry and manual audiometry. There was a significant difference (p < 0.05) between the right ear at 4 and 8 kHz and in the left ear at 2 and 4 kHz between smartphone and manual audiometry, respectively. No significant difference was noted (p < 0.05) between test and retest measures of smartphone technology.

Conclusions: Smartphone audiometry with calibrated headphones provides reliable results in an ID clinic setting and can be used as a baseline and monitoring tool at ID clinics.

MeSH terms

  • Adolescent
  • Adult
  • Audiometry, Pure-Tone / methods
  • Auditory Threshold / physiology*
  • Female
  • Hearing Loss / etiology
  • Hearing Loss / physiopathology*
  • Humans
  • Infections / complications*
  • Infections / physiopathology
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods*
  • Reproducibility of Results
  • Smartphone*
  • Telemedicine / methods*
  • Young Adult