Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review

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Abstract

Background

An estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals.

Objective

Our objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programs

Methods

In July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps.

Results

App store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies.

Conclusions

Very few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions.

Related collections

Most cited references 25

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Hearing loss gives rise to a number of disabilities. Problems in recognizing speech, especially in difficult environments, give rise to the largest number of complaints. Other kinds of disabilities may concern the reduced ability to detect, identify and localize sounds quickly and reliably. Such sounds may be warning or alarm signals, as well as music and birds singing. The communicative disability affects both hearing-impaired people and other people in their environment--family members, fellow workers, etc. Hearing-impaired people are not always aware of all the consequences of the impairment; they do not always know what they are missing. Several studies have shown that uncorrected hearing loss gives rise to poorer quality of life, related to isolation, reduced social activity, and a feeling of being excluded, leading to an increased prevalence of symptoms of depression. These findings indicate the importance of early identification of hearing loss and offers of rehabilitative support, where the fitting of hearing aids is usually an important component. Several studies also point to a significant correlation between hearing loss and loss of cognitive functions. Most of these studies show such a correlation without being able to show whether the hearing loss caused the reduction in cognitive performance or if both the hearing loss and the cognitive decline are parts of a common, general age-related degeneration. A couple of these studies, however, indicate that the uncorrected hearing loss may be the cause of cognitive decline. Whichever alternative is true, the correlation should be seen as a clear indication for early hearing aid fitting for those needing it. Monaural hearing aid fitting in subjects with bilateral hearing loss may give rise to a reduced ability to recognize speech presented to the unaided ear, the so-called late-onset auditory deprivation effect. This functional decline is reversible in some but not all subjects after fitting of a hearing aid also on the previously unaided ear.

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Author and article information

Contributors

Tess Bright:

London School of Hygiene & Tropical MedicineKeppel StLondon, WC1E 7HTUnited Kingdom44 (0)20 7636 863644 (0)20 7436 5389tess.bright1@lshtm.ac.uk

ORCID: http://orcid.org/0000-0003-2079-7216

Journal

Journal ID (nlm-ta): JMIR Rehabil Assist Technol

Journal ID (iso-abbrev): JMIR Rehabil Assist Technol

Journal ID (publisher-id): JRAT

Title: JMIR Rehabilitation and Assistive Technologies

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-2529

Publication date Collection: Jul-Dec 2016

Publication date (Electronic): 23 December 2016

Volume: 3

Issue: 2

Electronic Location Identifier: e13

Affiliations

[1] ¹London School of Hygiene & Tropical Medicine LondonUnited Kingdom

Author notes

Corresponding Author: Tess Bright tess.bright1@ 123456lshtm.ac.uk

Author information

Tess Bright http://orcid.org/0000-0003-2079-7216

Danuk Pallawela http://orcid.org/0000-0002-1652-4007

Article

Publisher ID: v3i2e13

DOI: 10.2196/rehab.6074

PMC ID: 5454564

PubMed ID: 28582261

SO-VID: 6d765a6e-5474-4922-ad8e-4fa07d950e46

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on http://rehab.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 23 June 2016

Date revision requested : 23 August 2016

Date revision received : 15 September 2016

Date accepted : 29 October 2016

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