title: An internet-based hearing test for simple audiometry in nonclinical settings: preliminary validation and proof of principle.
abstract: OBJECTIVE
  To investigate the validity and reproducibility of a newly developed internet-based self-administered hearing test using clinical pure-tone air-conducted audiometry as gold standard.
  
  
  METHODS
  Cross-sectional intrasubject comparative study.
  
  
  METHODS
  Karolinska University Hospital, Solna, Sweden.
  
  
  METHODS
  Seventy-two participants (79% women) with mean age of 45 years (range, 19-71 yr). Twenty participants had impaired hearing according to the gold standard test.
  
  
  METHODS
  Hearing tests.
  
  
  METHODS
  The Pearson correlation coefficient between the results of the studied Internet-based hearing test and the gold standard test, the greatest mean differences in decibel between the 2 tests over tested frequencies, sensitivity and specificity to diagnose hearing loss defined by Heibel-Lidén, and test-retest reproducibility with the Pearson correlation coefficient.
  
  
  RESULTS
  The Pearson correlation coefficient was 0.94 (p < 0.0001) for the right ear and 0.93 for the left (p = 0.0001). The greatest mean differences were seen for the frequencies 2 and 4 kHz, with -5.6 dB (standard deviation, 8.29), and -5.1 dB (standard deviation, 6.9), respectively. The 75th percentiles of intraindividual test-gold standard differences did not exceed -10 dB for any of the frequencies. The sensitivity for hearing loss was 75% (95% confidence interval, 51%-90%), and the specificity was 96% (95% confidence interval, 86%-99%). The test-retest reproducibility was excellent, with a Pearson correlation coefficient of 0.99 (p < 0.0001) for both ears.
  
  
  CONCLUSIONS
  It is possible to assess hearing with reasonable accuracy using an Internet-based hearing test on a personal computer with headphones. The practical viability of self-administration in participants' homes needs further evaluation.
authors.affiliation: Department of Otorhinolaryngology, Karolinska University Hospital, Stockhom, Sweden. louise.honeth@karolinska.se
authors.forename: Louise
authors.initials: L
authors.lastname: Honeth
authors.forename: Christin
authors.initials: C
authors.lastname: Bexelius
authors.forename: Mikael
authors.initials: M
authors.lastname: Eriksson
authors.forename: Sven
authors.initials: S
authors.lastname: Sandin
authors.forename: Jan-Eric
authors.initials: JE
authors.lastname: Litton
authors.forename: Ulf
authors.initials: U
authors.lastname: Rosenhall
authors.forename: Olof
authors.initials: O
authors.lastname: Nyrén
authors.forename: Dan
authors.initials: D
authors.lastname: Bagger-Sjöbäck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry / Q000379:methods*; D001301:Audiometry, Pure-Tone; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous; D012015:Reference Standards; D015203:Reproducibility of Results; D055815:Young Adult