Globally applicable solution to hearing loss screening: a diagnostic accuracy study of tablet-based audiometry
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objectives Hearing loss (HL) affects 20% of the world’s population, with shortages of audiologists and audiometric sound booths unable to meet demand for hearing care services. We aimed to assess the accuracy of tablet-based audiometry (TA) to screen for HL at standard (0.25–8 kHz) and extended high frequencies (>8 kHz).
Design Diagnostic accuracy study.
Setting Two secondary care audiology and ear, nose and throat outpatient clinics in the UK between April 2022 and September 2023.
Participants Adults aged≥16 years undergoing sound booth audiometry (SBA).
Interventions TA, hearing-related questionnaires and patient usability questionnaires.
Outcome measures Sensitivity, specificity and accuracy of TA compared with SBA for detecting HL. Patient usability assessment of TA and SBA.
Results 129 patients were enrolled with 127 patients (254 ears) included in the final analysis. Median age was 43 years (IQR 33–56), 55% (70/127) were women. 76% (96/127) and 68% (86/127) of patients had HL defined by British Society of Audiology (BSA) and American Speech–Language–Hearing Association (ASHA) criteria. Age was significantly associated with HL (p<0.0001); however, hearing-related questionnaire scores were not significantly different between those with or without HL. There was no significant difference in detecting HL between TA and SBA using either BSA or ASHA criteria at each frequency. Overall, 92% (1612/1751) of TA results were within 10 dB agreement with SBA results. Sensitivity and specificity of TA for detecting HL were 77–100% and >85%, respectively, between 0.25 and 12.5 kHz. In terms of patient usability, TA showed significantly higher scores in attractiveness (p<0.0001), novelty (p<0.0001), efficiency (p=0.0003), stimulation (p=0.003) and perspicuity (p=0.02).
Conclusions TA demonstrated good sensitivity with high specificity for detecting HL at frequencies 0.25–12.5 kHz and would be an acceptable accurate alternative to SBA. This would increase the accessibility of HL screening and has the potential to be used as a diagnostic test in those without tinnitus where resources are limited.
Trial registration number NCT05847556.
Design Diagnostic accuracy study.
Setting Two secondary care audiology and ear, nose and throat outpatient clinics in the UK between April 2022 and September 2023.
Participants Adults aged≥16 years undergoing sound booth audiometry (SBA).
Interventions TA, hearing-related questionnaires and patient usability questionnaires.
Outcome measures Sensitivity, specificity and accuracy of TA compared with SBA for detecting HL. Patient usability assessment of TA and SBA.
Results 129 patients were enrolled with 127 patients (254 ears) included in the final analysis. Median age was 43 years (IQR 33–56), 55% (70/127) were women. 76% (96/127) and 68% (86/127) of patients had HL defined by British Society of Audiology (BSA) and American Speech–Language–Hearing Association (ASHA) criteria. Age was significantly associated with HL (p<0.0001); however, hearing-related questionnaire scores were not significantly different between those with or without HL. There was no significant difference in detecting HL between TA and SBA using either BSA or ASHA criteria at each frequency. Overall, 92% (1612/1751) of TA results were within 10 dB agreement with SBA results. Sensitivity and specificity of TA for detecting HL were 77–100% and >85%, respectively, between 0.25 and 12.5 kHz. In terms of patient usability, TA showed significantly higher scores in attractiveness (p<0.0001), novelty (p<0.0001), efficiency (p=0.0003), stimulation (p=0.003) and perspicuity (p=0.02).
Conclusions TA demonstrated good sensitivity with high specificity for detecting HL at frequencies 0.25–12.5 kHz and would be an acceptable accurate alternative to SBA. This would increase the accessibility of HL screening and has the potential to be used as a diagnostic test in those without tinnitus where resources are limited.
Trial registration number NCT05847556.
Date Issued
2025-05-01
Date Acceptance
2025-05-09
Citation
BMJ Open, 2025, 15 (5)
ISSN
2044-6055
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open
Volume
15
Issue
5
Copyright Statement
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
License URL
ttps://creativecommons.org/licenses/by/4.0/
Identifier
10.1136/bmjopen-2024-097550
Publication Status
Published
Article Number
e097550
Date Publish Online
2025-05-22