title: Smartphone threshold audiometry in underserved primary health-care contexts.
abstract: OBJECTIVE
  To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics.
  
  
  METHODS
  A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment.
  
  
  METHODS
  A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth.
  
  
  RESULTS
  In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD.
  
  
  CONCLUSIONS
  Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.
authors.affiliation: a Department of Public Health and Clinical Medicine , Family Medicine, Umeå University , Umeå , Sweden .|b Department of Clinical Science, Otorhinolaryngology , Umeå University , Umeå , Sweden .
authors.forename: Josefin
authors.initials: J
authors.lastname: Sandström
authors.affiliation: c Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa .|d Ear Science Institute Australia , Subiaco , Australia .|e Ear Sciences Centre, School of Surgery , The University of Western Australia , Nedlands , Australia , and.
authors.forename: De Wet
authors.initials: de W
authors.lastname: Swanepoel
authors.affiliation: f Department of Electrical, Electronic, and Computer Engineering , University of Pretoria , Pretoria , South Africa.
authors.forename: Hermanus
authors.initials: H
authors.lastname: Carel Myburgh
authors.affiliation: b Department of Clinical Science, Otorhinolaryngology , Umeå University , Umeå , Sweden .|c Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa .
authors.forename: Claude
authors.initials: C
authors.lastname: Laurent
mesh_terms: D000161:Acoustic Stimulation / Q000295:instrumentation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone / Q000295:instrumentation*; D001309:Auditory Threshold; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D063731:Mobile Applications; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods*; D015203:Reproducibility of Results; D000068997:Smartphone; D013019:South Africa; D055815:Young Adult
keywords: Audiometry; air conduction; ambient noise; automated audiometer; mHealth; smartphone