Hearing test Page Page last modified: July 26, 2020
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 pretty close and 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.
Other efforts are ongoing to produce home hearing tests, using dedicated (and more expensive) equipment. These seem to be doing very well (Margolis et al, 2018)
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.
Barczik and Serpanos (2018) reported on 2 self-administered hearing tests using the iphone (uHear, uHearing Test). They reported that the uHear app using the iPhone standard Earpod earbud earphones was accurate between 1K and 6K, and was valid for screening for hearing loss > 25 dB at 500-6000 Hz. Regarding the UHearing test, it was accurate using supra-aural headphones at 2,4 and 8K.
Here we provide our assessment of several free iphone apps that we were able to download on an iphone. As of 2017, we like best the "Mimi" hearing app, which will email you a pdf of your test (see below). The "Hearing Test" application also provides a scale somewhat similar to a "real" audiogram, but it looks a little strange. The Starkey sound-check is crude in comparison.
|Sound Check by Starkey (https://itunes.apple.com/us/app/sound/id427587943?mt=8)||Hearing Test and Ear Age Test Ver 1.3 (https://itunes.apple.com/ca/app/uhear/id309811822?mt=8)||Mimi hearing test app. Apple iphone-6, with headphones.|
In our opinion, the iphone is the best device for "do it yourself" hearing tests. The main reason for this is that the iphone 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. If you use your iphone earbud, and put a headphone over the top of that, you will likely get pretty good sound isolation.
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.
Mimi hearing test (our current favorite -- but we have some anxiety about its accuracy).
We tried the MIMI free app (https://apps.apple.com/us/app/mimi-hearing-test/id932496645) out using iphone earbuds on 6/2017. It provided a fairly conventional, and only slightly wrong looking hearing test result for the author of this page (see above) with worse hearing than expected at low pitches. Nevertheless, because this apps output looks somwhat like a "real hearing test", we prefer this program so far. Issues with Mimi are as follows:
- It does not put the date of the test on top, and we could live without the "Powered by miMi".
- This app takes quite a while as well, and has some rough spots. It doesn't use the usual "3 beeps", but rather has a continuous beeping strategy. We would think that this could be less accurate than sticking with a single pitch-- at least you know what you are testing.
- We also do not like the chattiness of the app -- we would prefer a more business-like presentation, and we also did not like that the app asked for personal information (our email and age). We would prefer a program that kept a local store of past results as well.
- We did not like it that the app tried to tell us how good our hearing was compared to others of the same age -- we don't care what an app thinks about our hearing, we don't trust it either, and we wish it would mind its own business.
- One has to email oneself a pdf and look at it, to get something possibly useful.
- It would be nice to have some side-side comparisons of this app with a "real" audiogram.
Hearing Test and Ear age Test ver 1.3
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 (https://itunes.apple.com/us/app/sound/id427587943?mt=8)
We think the "sound check" by Starkey (https://itunes.apple.com/us/app/sound/id427587943?mt=8)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 (https://itunes.apple.com/ca/app/uhear/id309811822?mt=8)
The Uhear application (https://itunes.apple.com/ca/app/uhear/id309811822?mt=8), 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.
According to https://pubmed.ncbi.nlm.nih.gov/30242342/ , this application is reasonably accurate between 1000-6000 Hz. This is not as good as a conventional audiogram (250-8000 Hz), but it is not bad.
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. Note that this program was thought to be accurate by Barczik and Serpanos (2018).
"Hearing check" application from England (Action on Hearing Loss, https://itunes.apple.com/gb/app/hearing-check/id485312957)
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. This is just too "dumbed down". (https://itunes.apple.com/gb/app/hearing-check/id485312957)
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.