Affiliation:
1. Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health University of Manchester Manchester UK
2. Paediatric ENT Department, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester UK
3. Division of Psychology Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences University of Manchester Manchester UK
4. Lancaster Medical School Lancaster University Lancaster UK
5. Research and Innovation Manchester University NHS Foundation Trust Manchester UK
Abstract
AbstractObjectivesTechnological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy.Design and SettingA systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure‐tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool.ParticipantsAdults and children, with and without diagnosis of hearing impairment.Main outcome measuresA meta‐analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL.ResultsSearches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07–2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self‐administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability.ConclusionsMA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure‐tone threshold assessment with additional tests, such as Speech Recognition and Digits‐in‐Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost‐effectiveness of MA in non‐specialist settings.
Funder
Manchester Biomedical Research Centre
Reference36 articles.
1. OremuleB SaundersG KlukK NichaniJ BruceI.A systematic review of mobile hearing testing devices.2021[cited 2022 Jun 9]. Available from:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274761
2. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
3. QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies
4. RevMan.Cochrane Training. [cited 2022 Aug 1]. Available from:https://training.cochrane.org/online-learning/core-software/revman
5. HigginsJPT ThomasJ ChandlerJ CumpstonM LiT PageMJ et al.Cochrane handbook for systematic reviews of interventions. Cochrane training.2022[cited 2022 Aug 1]. Available from:https://training.cochrane.org/handbook#how-to-cite