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Analytical methods for evaluating reliability and validity of mobile audiometry tools.

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Remote audiometry using iPhone apps showed moderate reliability, improved by averaging three measurements. Validity analysis indicated potential bias compared to clinical audiometry, suggesting specific statistical methods for evaluation.

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Area of Science:

  • Audiology
  • Biostatistics
  • Health Informatics

Background:

  • Remote audiometry offers a convenient alternative to traditional clinical assessments.
  • Standardized statistical methods are needed to evaluate the reliability and validity of these novel hearing assessment tools.
  • The Nurses' Health Study II provided a dataset for evaluating an iPhone-based hearing assessment application.

Purpose of the Study:

  • To propose and describe statistical approaches for evaluating the reliability and validity of remote audiometry data.
  • To assess the reliability and validity of hearing threshold measurements from an iPhone application compared to clinical audiometry.
  • To guide the development and implementation of standardized methodologies for remote hearing assessments.

Main Methods:

  • Utilized mixed-effects models to analyze multilevel correlations in hearing threshold data.
  • Calculated intraclass correlation coefficients (ICCs) for single and averaged measurements to assess reliability.
  • Employed generalized estimating equations (GEEs) for regression analyses to evaluate validity and account for between-ear correlations.

Main Results:

  • iPhone application measurements demonstrated moderate reliability.
  • Averaging three repeated measurements significantly improved reliability, achieving good levels.
  • Linear regression analyses indicated potential bias in application measurements compared to clinical audiometry, with varying intercepts and slopes.

Conclusions:

  • Mixed-effects models and ICCs are recommended for assessing the reliability of hearing assessment tools and determining the optimal number of repeated measurements.
  • GEE methods are advised for evaluating the validity of remote audiometry data and estimating regression coefficients.
  • Standardized statistical evaluation is crucial for the adoption of reliable and valid remote hearing assessment technologies.