验证基于智能手机和网络的远程听力评估应用程序

Validating Smartphone-Based and Web-Based Applications for Remote Hearing Assessment.

作者信息

Mui Boaz, Swanepoel De Wet, Manchaiah Vinaya, Muzaffar Jameel, Bidargaddi Niranjan, Shekhawat Giriraj Singh

出版信息

J Am Acad Audiol. 2025 Mar 31. doi: 10.3766/jaaa.240055.

Abstract

High prevalence of hearing loss and its physical, mental, and social impacts when unaddressedunderscore a need for early identification. However, in-person hearing assessment may beinaccessible in certain countries and areas. As such, numerous smartphone-based and web-basedapplications (apps) have been developed to perform remote hearing assessment, and yet many ofthem remain unvalidated.
The purpose of this study was to evaluate the performance, ecological validity, and usabilityof two freely available smartphone-based hearing assessment apps-Hearing Test (Android) and MimiHearing Test (iOS)-alongside a web-based app, MDHearing Aid.
This is a cross-sectional validation study.
This study included 60 adults with hearing thresholds no greater than 20 dB HL or anydegree of sensorineural hearing loss.
Participants completed standard audiometric testing followed byassessments using three apps in a controlled laboratory setting. The assessments were repeated byparticipants at home the subsequent day. The mHealth App Usability Questionnaire (MAUQ) wasadministered to evaluate the apps' usability. Performance metrics included sensitivity, specificity, accuracy,and test-retest reliability. Intraclass correlation coefficient (ICC) estimates were calculated tomeasure the apps' accuracy, test-retest reliability, and ecological validity.
All apps had moderate to good sensitivity (0.67-1.00) and specificity (0.72-0.99). The HearingTest app showed poor accuracy at lower frequencies (ICC: 0.24-0.53) and moderate to good accuracy above 1000 Hz (ICC: 0.74-0.83). The Mimi Hearing Test showed poor accuracy at lower frequencies(ICC: 0.27-0.50) and moderate to good accuracy above 2000 Hz (ICC: 0.68-0.85). The web-basedMDHearing Aid test showed moderate to good accuracy across frequencies (ICC: 0.64-0.85). All appshad moderate to excellent test-retest reliability (ICC: 0.66-0.99) and showed poor ecological validity below500 Hz (ICC: 0.20-0.51) and moderate to excellent ecological validity above 1000 Hz (ICC: 0.54-0.95).Usability was rated highly across all apps, with MAUQ scores ranging from 5.4 to 5.9 out of 7.
The examined apps exhibit varied accuracy levels and generally reasonable sensitivity,specificity, test-retest reliability, ecological validity, and usability. With additional validation, the HearingTest app may be useful for hearing screening and monitoring in adults. There is a necessity for furtherresearch to unlock the examined apps' full clinical potential.

摘要

听力损失的高患病率及其未得到解决时对身体、心理和社会造成的影响凸显了早期识别的必要性。然而，在某些国家和地区，可能无法进行面对面的听力评估。因此，人们开发了许多基于智能手机和网络的应用程序（应用）来进行远程听力评估，但其中许多仍未经验证。

本研究的目的是评估两款免费的基于智能手机的听力评估应用程序——听力测试（安卓系统）和米米听力测试（iOS系统），以及一款基于网络的应用程序MD听力辅助设备的性能、生态效度和可用性。

这是一项横断面验证研究。

本研究纳入了60名听力阈值不超过20 dB HL或患有任何程度感音神经性听力损失的成年人。

参与者先完成标准听力测试，然后在受控的实验室环境中使用三款应用程序进行评估。次日，参与者在家中重复进行评估。使用移动健康应用程序可用性问卷（MAUQ）来评估这些应用程序的可用性。性能指标包括灵敏度、特异度、准确性和重测信度。计算组内相关系数（ICC）估计值以衡量应用程序的准确性、重测信度和生态效度。

所有应用程序的灵敏度（0.67 - 1.00）和特异度（0.72 - 0.99）均为中等至良好。听力测试应用程序在低频时准确性较差（ICC：0.24 - 0.53），在1000 Hz以上时准确性为中等至良好（ICC：0.74 - 0.83）。米米听力测试在低频时准确性较差（ICC：0.27 - 0.50），在2000 Hz以上时准确性为中等至良好（ICC：0.68 - 0.85）。基于网络的MD听力辅助设备测试在各个频率的准确性为中等至良好（ICC：0.64 - 0.85）。所有应用程序的重测信度均为中等至优秀（ICC：0.66 - 0.99），在500 Hz以下时生态效度较差（ICC：0.20 - 0.51），在1000 Hz以上时生态效度为中等至优秀（ICC：0.54 - 0.95）。所有应用程序的可用性评分都很高，MAUQ分数在7分制中为5.4至5.9分。

所研究的应用程序表现出不同的准确性水平，总体上具有合理的灵敏度、特异度、重测信度、生态效度和可用性。经过进一步验证后，听力测试应用程序可能对成人听力筛查和监测有用。有必要进行进一步研究以充分发挥所研究应用程序的全部临床潜力。