title: Hearing Tests on Mobile Devices: Evaluation of the Reference Sound Level by Means of Biological Calibration.
abstract: BACKGROUND
  Hearing tests carried out in home setting by means of mobile devices require previous calibration of the reference sound level. Mobile devices with bundled headphones create a possibility of applying the predefined level for a particular model as an alternative to calibrating each device separately.
  
  
  OBJECTIVE
  The objective of this study was to determine the reference sound level for sets composed of a mobile device and bundled headphones.
  
  
  METHODS
  Reference sound levels for Android-based mobile devices were determined using an open access mobile phone app by means of biological calibration, that is, in relation to the normal-hearing threshold. The examinations were conducted in 2 groups: an uncontrolled and a controlled one. In the uncontrolled group, the fully automated self-measurements were carried out in home conditions by 18- to 35-year-old subjects, without prior hearing problems, recruited online. Calibration was conducted as a preliminary step in preparation for further examination. In the controlled group, audiologist-assisted examinations were performed in a sound booth, on normal-hearing subjects verified through pure-tone audiometry, recruited offline from among the workers and patients of the clinic. In both the groups, the reference sound levels were determined on a subject's mobile device using the Bekesy audiometry. The reference sound levels were compared between the groups. Intramodel and intermodel analyses were carried out as well.
  
  
  RESULTS
  In the uncontrolled group, 8988 calibrations were conducted on 8620 different devices representing 2040 models. In the controlled group, 158 calibrations (test and retest) were conducted on 79 devices representing 50 models. Result analysis was performed for 10 most frequently used models in both the groups. The difference in reference sound levels between uncontrolled and controlled groups was 1.50 dB (SD 4.42). The mean SD of the reference sound level determined for devices within the same model was 4.03 dB (95% CI 3.93-4.11). Statistically significant differences were found across models.
  
  
  CONCLUSIONS
  Reference sound levels determined in the uncontrolled group are comparable to the values obtained in the controlled group. This validates the use of biological calibration in the uncontrolled group for determining the predefined reference sound level for new devices. Moreover, due to a relatively small deviation of the reference sound level for devices of the same model, it is feasible to conduct hearing screening on devices calibrated with the predefined reference sound level.
authors.affiliation: Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wrocław, Poland. marcin.masalski@pwr.edu.pl.
authors.forename: Marcin
authors.identifier: http://orcid.org/0000-0001-8086-1465
authors.initials: M
authors.lastname: Masalski
authors.forename: Lech
authors.identifier: http://orcid.org/0000-0002-2922-3510
authors.initials: L
authors.lastname: Kipiński
authors.forename: Tomasz
authors.identifier: http://orcid.org/0000-0003-2763-6212
authors.initials: T
authors.lastname: Grysiński
authors.forename: Tomasz
authors.identifier: http://orcid.org/0000-0001-9934-5794
authors.initials: T
authors.lastname: Kręcicki
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002138:Calibration; D005260:Female; D034381:Hearing Loss / Q000628:therapy*; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D008297:Male; D063731:Mobile Applications / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: hearing test, mobile device, calibration