title: Smartphone-Based Hearing Screening at Primary Health Care Clinics.
abstract: To evaluate the performance of smartphone-based hearing screening with the hearScreen application in terms of sensitivity, specificity, referral rates, and time efficiency at two primary health care clinics.
  
  
  
  Nonprobability purposive sampling was used at both clinics. A total of 1236 participants (mean age: 37.8 ± SD 17.9 and range 3 to 97 years; 71.3% female) were included in the final analysis. Participants were screened using the hearScreen application following a two-step screening protocol and diagnostic pure-tone audiometry to confirm hearing status.
  
  
  
  Sensitivity and specificity for smartphone screening was 81.7 and 83.1%, respectively, with a positive and negative predictive value of 87.6 and 75.6%, respectively. Sex [χ(1, N = 126) = 0.304, p > 0.05] and race [χ(1, N = 126) = 0.169, p > 0.05)] had no significant effect on screening outcome for children while for adults age (p < 0.01; β = 0.04) and sex (p = 0.02; β = -0.53) had a significant effect on screening outcomes with males more likely to fail. Overall referral rate across clinics was 17.5%. Initial screening test times were less than a minute (48.8 seconds ± 20.8 SD) for adults and slightly more than a minute for children (73.9 seconds ± 44.5 SD).
  
  
  
  The hearScreen smartphone application provides time-efficient identification of hearing loss with adequate sensitivity and specificity for accurate testing at primary health care settings.
authors.affiliation: 1Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; 2Ear Science Institute Australia, Subiaco, Australia; 3Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands, Australia; and 4Department of Electrical, Electronic and Computer Engineering, University of Pretoria, Pretoria, South Africa.
authors.forename: Christine
authors.initials: C
authors.lastname: Louw
authors.forename: De Wet
authors.initials: W
authors.lastname: Swanepoel
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eikelboom
authors.forename: Hermanus C
authors.initials: HC
authors.lastname: Myburgh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D063731:Mobile Applications; D011320:Primary Health Care; D012680:Sensitivity and Specificity; D000068997:Smartphone; D055815:Young Adult