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Smartphone-Facilitated In-Situ Hearing Aid Audiometry for Community-Based Hearing Testing
Caitlin Frisby1,2, Karina C De Sousa1,2, Robert H Eikelboom1,3,4,5
1Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
Ear and Hearing
|March 1, 2024
Summary
Smartphone-facilitated in-situ audiometry offers a reliable method for hearing tests in communities, enabling community health workers to conduct screenings. This technology can improve hearing aid access, especially in underserved regions.
Area of Science:
- Audiology
- Public Health
- Biomedical Engineering
Background:
- Growing global hearing loss prevalence necessitates scalable hearing care solutions.
- Smartphone technology and task-shifting are key WHO priorities for improving access.
- Community health workers (CHWs) can be trained to deliver hearing care using innovative tools.
Purpose of the Study:
- To validate smartphone-facilitated in-situ audiometry for hearing aid fitting.
- To determine maximum permissible ambient noise levels (MPANL) for this method.
- To assess inter-device reliability, accuracy, and real-world performance.
Main Methods:
- Experiment 1: Determined MPANLs using noise-attenuating earcups over hearing aids.
- Experiment 2: Assessed inter-device reliability of hearing aid pure-tone output.
- Experiments 3 & 4: Compared automated in-situ audiometry with clinical audiometry in sound booths and community settings, involving CHWs.
Main Results:
- MPANLs were higher with earcups than standard headphones (24-47.3 dB SPL).
- High inter-device reliability was observed (differences < 3 dB).
- 83-85% of automated in-situ thresholds were within 10 dB of clinical results; test-retest reliability was high (ICC 0.83-0.97).
Conclusions:
- Smartphone-facilitated in-situ audiometry is a valid and reliable method for community-based hearing testing.
- CHWs can effectively use this technology with minimal training.
- This approach can significantly improve hearing aid access and fitting in low- and middle-income countries.
