Digital Technology for Remote Hearing Assessment—Current Status and Future Directions for Consumers

Abstract

Globally, more than 1.5 billion people have hearing loss. Unfortunately, most people with hearing loss reside in low- and middle-income countries (LMICs) where traditional face-to-face services rendered by trained health professionals are few and unequally dispersed. The COVID-19 pandemic has further hampered the effectiveness of traditional service delivery models to provide hearing care. Digital health technologies are strong enablers of hearing care and can support health delivery models that are more sustainable. The convergence of advancing technology and mobile connectivity is enabling new ways of providing decentralized hearing services. Recently, an abundance of digital applications that offer hearing tests directly to the public has become available. A growing body of evidence has shown the ability of several approaches to provide accurate, accessible, and remote hearing assessment to consumers. Further effort is needed to promote greater accuracy across a variety of test platforms, improve sensitivity to ear disease, and scale up hearing rehabilitation, especially in LMICs.

Digital vs. physical ear-nose-and-throat specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid treatment: a randomized controlled trial

“…Asynchronous healthcare technologies utilized in patient portal email messaging, in-app messaging, specialist-to-patient mobile apps, and delayed interview video consultations have been described more frequently in various medical fields such as in radiology, ophthalmology, dermatology, cardiology, pathology, and psychiatry (24)(25)(26)(27)(28)(29)(30)(31)(32)(33). In hearing healthcare, technology advances and digital communication options such as hearing apps, teleaudiology, and tele-rehabilitation are also trending and have gained further momentum during the COVID-19 pandemic (34)(35)(36)(37)(38). Moreover, the use of artificial intelligence (AI) computer vision algorithms to classify video-otoscopic images has been found to be feasible for classifying ear diseases and enjoy great accuracy (39).…”

Expanding Audiology Services Through Telehealth Enabled Partnerships

“…1 Examples of such technologies include free-standing kiosks or the use of a digital notepad or tablet with noise-canceling earphones to provide an accurate and rapid hearing screening test with results immediately rendered. 1–3 When partnering with the vast array of allied health professionals, audiologists will be the “go-to” professional who will ensure complimentary validated and appropriate hearing screening protocols for these settings. These kiosks can easily provide rapid automated hearing screening for patients in waiting rooms or dedicated quiet spaces.…”

“…Such kiosks are currently available in a variety of allied health professionals’ offices and are typically equipped with headphones, microphones, and computer software that allow patients to complete hearing screenings in a self-directed and private manner. Screening technologies for kiosk testing have been well-validated and include pure tone audiometry or speech-in-noise (e.g., digits-in-noise) screening tests 3 with the necessary quality control features.…”

Remote self-report and speech-in-noise measures predict clinical audiometric thresholds

“…In this study we examined the predictive validity for pure-tone audiometry of self-administered DIN variants delivered to the same participants in the lab and at home. Previous studies have used remote or self-administered DIN versions (Smits et al, 2004 and 2006; Folmer et al, 2017; Swanepoel et al, 2019; De Sousa et al 2021) but, to our knowledge, no study has directly compared results in the same listeners with standard, rigorous lab or clinic testing.…”

“…Advances in mobile technology and global connectivity through the internet have allowed development of sensitized web- and app-based screening and diagnostic tools that can improve assessment of auditory function in several ways. For example, smartphone deliverable variants of the digits-in-noise test (DIN) can reliably detect and differentiate sensorineural and conductive hearing loss (Smits et al 2005; Potgieter et al 2018; Swanepoel et al 2019; Motlagh Zadeh et al 2020; De Sousa et al 2018, 2020, 2021). DIN is a relatively undemanding speech-in-noise test that measures speech recognition abilities objectively, reliably and quickly, in addition to having a strong correlation with audiometric thresholds (Smits et al 2006; Ozimek et al 2009; Leensen et al 2011; Vlaming et al 2014; Folmer et al 2017; Motlagh Zadeh et al 2019, 2020).…”