Hearing Page Page last modified: October 26, 2016
Timothy C. Hain, MD. Marcello Cherchi M.D. Ph.D. Chicago Dizziness and Hearing
Recent advances in smart-phone apps have produced a few new methods to find and follow hearing loss. This is an exciting advance as it allows one to follow hearing over time -- something very helpful for disorders where hearing fluctuates (e.g. Meniere's disease, sudden hearing loss). These are not as good as a "real audiogram", done in a sound booth, but they are a lot better than just guessing. Even if they document hearing loss, they don't tell you whether you have wax in your ear or a tumor of the nerve between the ear and brain. Still, they are a good start.
Louw et al (2016) reported on a smartphone screener called hearScreen. They reported "Sensitivity and specificity for smartphone screening was 81.7 and 83.1%, respectively, with a positive and negative predictive value of 87.6 and 75.6%, respectively. Sex [χ(1, N = 126) = 0.304, p > 0.05] and race [χ(1, N = 126) = 0.169, p > 0.05)] had no significant effect on screening outcome for children while for adults age (p < 0.01; β = 0.04) and sex (p = 0.02; β = -0.53) had a significant effect on screening outcomes with males more likely to fail." Unfortunately, this "app" is not in the Apple store. It seems to be common for programs like this to pop up and then vanish, perhaps because they compete with conventional audiometry.
Here we provide our assessment of several free iphone apps that we were able to download on an iphone. The "Hearing Test" application is a little better as it provides a scale somewhat similar to a "real" audiogram.
|Sound Check by Starkey||Hearing Test and Ear Age Test Ver 1.3|
In our opinion, the iphone is the best device for "do it yourself" hearing tests. The main reason for this is that the i-phone is standardized. It has a well known hardware platform. If you use the iphone to generate sounds, and a standard device such as a iphone ear-bud set or a high-end earphone, you are less likely to be confounded by, lets say, unusual sound chips in a particular android device.
A second suggestion is to do your testing in a very quiet room. Don't test your hearing outdoors, with the TV on, or with the fan running. This reduces makes the test more accurate.
Of course, you can always test these apps on a normal hearing associate.
We compared hearing of a normal person on each of the free hearing test applications. In the future we hope to be able to compare some "real" audiograms with these smart-phone audiograms, using patient supplied tests. In other words, we want to calibrate these apps.
Hearing Test and Ear age Test ver 1.3 (our current favorite).
We tried this free app out using iphone earbuds on 10/2016. It provided a somewhat unusual looking hearing test result for the author of this page (see above) with worse hearing than expected at low pitches. Nevertheless, because this app actually has an "Y axis", unlike the others that we tried, we prefer this program so far. It seems to be thoughtfully designed, and even put the date on the top of the test result.
We would prefer a plot that was a little more conventional -- red for right ear, blue for left ear, circles and x's. Maybe even have a "masking" option.
This app has advertisements scrolling away during the testing procedure. A little tacky.
Sound Check by Starkey
We think the "sound check" by Starkey for the iphone is reasonable as it produces something fairly closely resembling a "real" hearing test. Starkey is a hearing aid company and they should know what they are doing.
There is some intelligence to this app as well as it checks for ambient noise and adapts to the method that sounds is being presented (i.e. ear-buds or headphones). The results can be emailed to whoever, including yourself.
We would far prefer a scale that was in real units (i.e. NL dB) rather than the straight lines without any numbers shown here. We think it is very tacky for Starkey to put in "needs amplification", as this naturally brings up Starkey's motivation in producing this app (presumably to make money for Starkey by selling more hearing aids). At least they didn't say "visit your hearing aid sales person".
Uhear application, by Unitron
The Uhear application, by Unitron (another hearing aid company), is also a good effort, but we could not get it to produce a reasonable plot with earbuds. It worked well with an expensive passive set of headphones. It checks one more frequency than the Sound check application. This is good because noise often affects the highest frequencies.
The Uhear application takes longer and does not provide a mechanism to save the test other than a screen shot. The blue background is somewhat odd.
"Hearing check" application from England (Action on Hearing Loss)
We don't think that the "hearing check" application from England is useful. It doesn't test "pure tone" hearing, but rather assesses speech in noise.
A more intelligent design would allow one to build a database and plot hearing vs time, somewhat like the exercise applications on the iphone. We also think that these apps are somewhat "predictable" -- one knows exactly when the 3 beeps will start. We would prefer a little more randomness.
Most of these "apps" look very little like "real" audiograms. We would prefer output in conventional colors (i.e. red and blue), and using conventional symbols (i.e. x and o). For those of us who are used to looking at these things, the information comes in faster.
We also disliked apps that are "pay first", and try out later. As almost all of these hearing test "apps" are awful, we are not willing to take the risk of paying $5, for garbage. We would prefer apps that "gave away" the first 5 hearing tests, and then asked for money.