A Web-Based Listening Test System for Cochlear Implant Research and its Validation for Remote Testing

Web-based applications are increasingly used in clinical audiology, driven by the development of mobile, remote technology, and strong demand. Remote applications also have large potential to increase statistical power, accessibility, and diversity in research studies, but their utility and validity are still unclear. We developed and evaluated a web-based listening test system called AUDITO for cochlear implant (CI) research. By exploiting the advances in wireless streaming technology and personal mobile devices, AUDITO can be used to flexibly implement and administer a wide range of listening tests remotely or in-the-lab. The system was designed to be easy to use without programming. Technical features were implemented to ensure signal quality over wireless streaming. A pilot study with 20 experienced CI recipients was performed to evaluate the validity of remote testing across test paradigms. Comparisons of interest included the presentation of stimuli via cable versus Bluetooth streaming and testing remotely versus in-the-lab. Three listening tests were implemented to measure speech perception for sentences, digits in noise and spectro-temporal resolution. A questionnaire was administered to collect user feedback. The system worked reliably with various Bluetooth-compatible setups including desktop and laptop computers, tablets, and smartphones. Test results were consistent between listening modalities and across tested conditions, confirming the validity of web-based testing for these measures. User feedback was positive for system usability and function, while signal quality was not reported to be compromised via streaming. Web-based systems such as AUDITO can facilitate data collection, enable research collaboration and improve accessibility and inclusion in CI research.