Accuracy and Reliability of Smartphone Self-Test Audiometry in Community Clinics in Low Income Settings: A Comparative Study

Ann Otol Rhinol Laryngol. 2020 Jun;129(6):578-584. doi: 10.1177/0003489420902162. Epub 2020 Jan 22.


Background: There is a lack of hearing health care globally, and tele-audiology and mobile technologies have been proposed as important strategies to reduce the shortfall.

Objectives: To investigate the accuracy and reliability of smartphone self-test audiometry in adults, in community clinics in low-income settings.

Methods: A prospective, intra-individual, repeated measurements design was used. Sixty-three adult participants (mean age 52 years, range 20-88 years) were recruited from ENT and primary health care clinics in a low-income community in Tshwane, South Africa. Air conduction hearing thresholds for octave frequencies 0.5 to 8 kHz collected with the smartphone self-test in non-sound treated environments were compared to those obtained by reference audiometry.

Results: The overall mean difference between threshold seeking methods (ie, smartphone thresholds subtracted from reference) was -2.2 dB HL (n = 467 thresholds, P = 0.00). Agreement was within 10 dB HL for 80.1% (n = 467 thresholds) of all threshold comparisons. Sensitivity for detection hearing loss >40 dB HL in one ear was 90.6% (n = 84 ears), and specificity 94.2% (n = 84 ears).

Conclusion: Smartphone self-test audiometry can provide accurate and reliable air conduction hearing thresholds for adults in community clinics in low-income settings.

Keywords: audiometry; global health; hearing loss; mHealth; smartphone; telemedicine.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Audiometry / methods*
  • Audiometry, Pure-Tone
  • Diagnostic Self Evaluation
  • Female
  • Hearing Loss / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Mobile Applications*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Smartphone*
  • South Africa
  • Young Adult