A Comparative Study of Smartphone Based App with Free Field Hearing For Possible Use as a Screening Test

Abstract

Background:Hearing loss is an invisible injury that has been viewed as an acceptable by-product of military service. It is imperative to detect hearing loss at early stage to take immediate remedial measures. In Indian armed forces the current method of assessment of hearing is primarily by Free Field Hearing which is obsolete and has numerous shortcomings. We contucted a study using free iOS application to detect hearing loss. The objectives of the study were to investigate the validity and reproducibility of app based hearing assement and free field hearing with clinical pure tone audiometer as gold standard. It is cross sectional intra-subject comparative study Methods:The study was conducted at CHAF where 200 patients were accrued. Hearing assessment was carried out by Pure Tone Audiometry (PTA) which is gold standard. Thereafter these patients were subjected to hearing assessment by using windows application “freehearingtestsoftware.com” and by free field hearing (FFH). Results:Hearing assessment by FFH and hearing check app was compared with PTA. Hearing check app was found to be more sensitive than FFH (98% and 73%). Both modalities had high specificity (95% and 99%). The test retest reproducibility measured with Pearson correlation coefficient was high (0.99) with hearing check app. Conclusions:Smart phone application like Hearing check app is a cheap and effective way to assess hearing with reasonable accuracy. It’s high sensitivity and high test retest reproducibility makes it an ideal tool for screening and early detection of hearing loss replacing out-dated free field hearing.

Background:Hearing loss is an invisible injury that has been viewed as an acceptable by-product of military service. It is imperative to detect hearing loss at early stage to take immediate remedial measures. In Indian armed forces the current method of assessment of hearing is primarily by Free Field Hearing which is obsolete and has numerous shortcomings. We contucted a study using free iOS application to detect hearing loss. The objectives of the study were to investigate the validity and reproducibility of app based hearing assement and free field hearing with clinical pure tone audiometer as gold standard. It is cross sectional intra-subject comparative study Methods:The study was conducted at CHAF where 200 patients were accrued. Hearing assessment was carried out by Pure Tone Audiometry (PTA) which is gold standard. Thereafter these patients were subjected to hearing assessment by using windows application “freehearingtestsoftware.com” and by free field hearing (FFH). Results:Hearing assessment by FFH and hearing check app was compared with PTA. Hearing check app was found to be more sensitive than FFH (98% and 73%). Both modalities had high specificity (95% and 99%). The test retest reproducibility measured with Pearson correlation coefficient was high (0.99) with hearing check app. Conclusions:Smart phone application like Hearing check app is a cheap and effective way to assess hearing with reasonable accuracy. It’s high sensitivity and high test retest reproducibility makes it an ideal tool for screening and early detection of hearing loss replacing out-dated free field hearing.