Analytical methods for evaluating reliability and validity of mobile audiometry tools

Author:

Kelkar Mona1,Hou Zhaoxun1,Curhan Gary C.2,Curhan Sharon G.2,Wang Molin2

Affiliation:

1. Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, USA

2. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA

Abstract

Statistical approaches that could be used as standardized methodology for evaluating reliability and validity of data obtained using remote audiometry are proposed. Using data from the Nurses' Health Study II ( n = 31), the approaches to evaluate the reliability and validity of hearing threshold measurements obtained by a self-administered iPhone-based hearing assessment application (Decibel Therapeutics, Inc., Boston, MA) compared with measurements obtained by clinical (soundbooth) audiometry are described. These approaches use mixed-effects models to account for multilevel correlations, intraclass correlation coefficients (ICCs) of single and averaged measurements, and regression techniques with the generalized estimating equations (GEEs) to account for between-ear correlations. Threshold measurements obtained using the iPhone application were moderately reliable. The reliability was improved substantially by averaging repeated measurements; good reliability was achieved by averaging three repeated measurements. In the linear regression analyses that assessed validity, the range of intercepts (2.3–8.4) and range of slopes (0.4–0.7) indicated that the measurements from the application were likely biased from those obtained by clinical audiometry. When evaluating alternative hearing assessment tools, it is recommended to assess reliability through mixed-effects models and use ICCs to determine the number of repeated assessments needed to achieve satisfactory reliability. When evaluating validity, GEE methods are recommended to estimate regression coefficients.

Funder

National Institutes of Health

Publisher

Acoustical Society of America (ASA)

Subject

Acoustics and Ultrasonics,Arts and Humanities (miscellaneous)

Reference42 articles.

1. American National Standards Institute (1996). ANSI S3.6-1996, Specification For Audiometers (American National Standards Institute, New York).

2. American National Standards Institute (1999). ANSI S3.1-a999, Maximum Permissible Ambient Noise Levels For Audiometric Test Rooms (American National Standards Institute, New York).

3. ASHA (American Speech-Hearing-Language Association) (2005). Guidelines for Manual Pure-Tone Threshold Audiometry (American Speech-Language-Hearing Association, Rockville, MD), available at https://www.asha.org/policy/gl2005-00014/ (Last viewed May 18, 2022).

4. Origin, Methods, and Evolution of the Three Nurses’ Health Studies

5. Using Genetic Algorithms with Subjective Input from Human Subjects: Implications for Fitting Hearing Aids and Cochlear Implants

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