Development of a Mobile-app based free field click test against conventional free field voice test: A randomized controlled trial

Abstract

Objective:Hearing loss is a prevalent disease with free field voice test (FFVT) being a common hearing test performed.FFVT has its own disadvantage as a screening tool as there is no standardization of speech among examiners.We aim to invent mobile-app based hearing screening using Flutter-Dart programming language that mimics findings of FFVT.The app is termed as Free field click test (FFCT).Our aim is to compare sensitivity&specificity of FFCT and FFVT with Pure Tone audiogram (PTA). Methods:This is an open-labelled randomized controlled trial. This study was conducted at the (removed for blind peer review) from December-March 2020. 50 patients from 18-80 years old with complaint of hearing loss were recruited.These patients were randomly assigned into two groups; FFVT&FFCT which were compared with PTA.Categorical data were analyzed with Chisquare test,non-categorical data were calculated with Student t-test for statistical significance. Results:Results were calculated based on degree of hearing loss against PTA.FFCT's rate of detection of hearing loss was significant for all degrees of hearing loss with p-values of <0.05. FFVT's detection rate was only significant to normal hearing, moderate & severe hearing loss.FFCT had higher sensitivity of 94.1% for normal hearing compared to 52% for FFVT.FFVT had higher specificity but with a marginal difference only.A higher rate of accuracy (94%) and strength of the correlation (0.97) were obtained for FFCT than FFVT. Conclusion:FFCT is a more sensitive&accurate tool than FFVT in detecting hearing thresholds. It proves to be an ideal tool to screen hearing loss and is convenient in times of social distancing during COVID-19 pandemic now. Key points1.To overcome the disadvantages of the current hearing screening methods 2. To eliminate the disadvantages of the conventional FFVT 3.To invent a digital option to screen hearing loss 3. To test the accuracy and sensitivity of the mobile-app and FFVT compared to PTA 4. To have more accessibility to screen hearing loss nationwide Level of evidence : Level 2