Accuracy and Reliability of Automated iPad Audiometry for Hearing Screening in Community Setting Compared with Gold Standard Pure Tone Audiometry in Sound Booth

ImportanceEfficient and accurate tools for early detection of hearing loss are essential for reducing delays in diagnosis and treatment.ObjectiveTo determine the accuracy and reliability of Automated iPad Hearing Screening (AIHS) as a screening tool compared to a formal pure tone audiometry (PTA).DesignA parallel cross-sectional study.SettingTertiary referral center in Hong Kong.ParticipantsSeventy-nine adult patients (158 ears) aged from 28 to 87 who were diagnosed with hearing loss were included.Exposure or InterventionParticipants underwent the AIHS screening at 1, 2, 4, and 0.5 kHz in the right and left ears, respectively, prior to a formal PTA, focusing solely on air conduction thresholds.Main Outcome MeasuresSensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) for detecting hearing loss at 3 thresholds: >25, >40, and >60 dBHL. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to assess agreement between AIHS and PTA.ResultsExcellent sensitivity and specificity of the AHIS were identified across 3 age groups and different hearing levels. The AUCs of AHIS were .917 (95% CI: .842-.993), .911 (.863-.960), and .968 (.942-.994) for thresholds over 25, 40, and 60 dBHL, respectively. ICC = .901 (.864-.927) and Bland-Altman analysis indicated good agreement between these 2 methods.ConclusionThe AIHS is a simple, intuitive, and portable screening test for hearing loss that can be repeated with high accuracy and reliability at relatively low cost.