Abstract
BackgroundAn estimated 360 million people have a disabling hearing impairment globally, the vast majority of whom live in low- and middle-income countries (LMICs). Early identification through screening is important to negate the negative effects of untreated hearing impairment. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals.ObjectiveOur objective was to identify and compare available apps for ear and hearing assessments and consider the incorporation of such apps into hearing screening programsMethodsIn July 2015, the commercial app stores Google Play and Apple App Store were searched to identify apps for ear and hearing assessments. Thereafter, six databases (EMBASE, MEDLINE, Global Health, Web of Science, CINAHL, and mHealth Evidence) were searched to assess which of the apps identified in the commercial review had been validated against gold standard measures. A comparison was made between validated apps.ResultsApp store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry. The literature search identified 11 eligible validity studies that examined 6 different apps. uHear, an app for self-administered audiometry, was validated in the highest number of peer reviewed studies against gold standard pure tone audiometry (n=5). However, the accuracy of uHear varied across these studies.ConclusionsVery few of the available apps have been validated in peer-reviewed studies. Of the apps that have been validated, further independent research is required to fully understand their accuracy at detecting ear and hearing conditions.
Highlights
In 2012, the World Health Organization (WHO) estimated that disabling hearing impairment (DHI) affects approximately 360 million people, or 5.3% of the global population [1,2]
App store search queries returned 30 apps that could be used for ear and hearing assessments, the majority of which are for performing audiometry
Most studies in this review focused on populations in high income countries, in which the need for validated smartphone apps still exists; we focused on screening for hearing impairment in low-resource settings
Summary
In 2012, the World Health Organization (WHO) estimated that disabling hearing impairment (DHI) affects approximately 360 million people, or 5.3% of the global population [1,2]. This scarcity contrasts with Europe, where there is 1 ENT per 10,000-30,000 people [14] Due to these barriers, hearing impairment remains undetected and unmanaged for a substantial number of people in LMICs, and robust data from population-based surveys is lacking. Substantial barriers exist in screening for hearing impairment in LMICs, such as the requirement for skilled hearing health care professionals and prohibitively expensive specialist equipment to measure hearing. These challenges may be overcome through utilization of increasingly available smartphone app technologies for ear and hearing assessments that are easy to use by unskilled professionals
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