Validation of Non-Soundproof Tablet Audiometry in Pediatrics: Comparison With Traditional Audiometry

Portable, tablet-based audiometry has been proposed as a diagnostic tool for patients unable to access traditional sound booth audiometry. However, the validity of tablet-based audiometry for diagnostic use in pediatric patients has not been established. The objective of this study is to validate self-administered tablet-based diagnostic audiometry in a pediatric clinic setting.

Children 4 to 17.9 years-old were recruited from a pediatric audiology clinic. Tablet audiometry was performed with tablet-based software, SHOEBOX Audiometry (Ottawa, ON) at six frequencies (250-8000 Hz). Hearing thresholds from traditional pure tone audiometry in a sound booth were used as a gold-standard comparison. Hearing loss was defined as ≥ 1 hearing threshold of > 20 dB.

120 children underwent tablet-audiometry, though not all were able to complete the test. In 948 individual frequencies tested, the mean threshold difference was -0.95 dB (95% CI -1.5 to -0.42 dB) between traditional and tablet audiogram. Most tablet-assessed thresholds (92%, n = 873) were within 10 dB of corresponding traditional audiometry thresholds. Tablet audiometry demonstrated 92% sensitivity (95% CI 84%-97%) and 85% specificity (95% CI 77%-92%) for diagnosis of hearing loss. Test-retest reliability of tablet audiometry was high, with 93% (55/59) of test-retest hearing threshold differences falling within ±5 dB.

Tablet audiometry is valid and reliable for children aged 5-17 years who can successfully complete testing in a non-soundproof clinic setting. It may serve as a tool for remote hearing testing, with potential applications in schools, clinics, and research.