Abstract
Background Up to 80% of audiograms could be automated which would allow more time for provision
of specialty services. Ideally, automated audiometers would provide accurate results
for listeners with impaired hearing as well as normal hearing. Additionally, accurate
results should be provided both in controlled environments like a sound-attenuating
room but also in test environments that may support greater application when sound-attenuating
rooms are unavailable. Otokiosk is an iOS-based system that has been available for
clinical use, but there are not yet any published validation studies using this product.
Purpose The purpose of this project was to complete a validation study on the OtoKiosk automated
audiometry system in quiet and in low-level noise, for listeners with normal hearing
and for listeners with impaired hearing.
Research Design Pure tone air conduction thresholds were obtained for each participant for three
randomized conditions: standard audiometry, automated testing in quiet, and automated
testing in noise. Noise, when present, was 35 dBA overall and was designed to emulate
an empty medical exam room.
Study Sample Participants consisted of 11 adults with hearing loss and 15 adults with normal hearing
recruited from the local area.
Data Collection and Analysis Thresholds were measured at 500, 1,000, 2,000, and 4,000 Hz using the Otokiosk system
that incorporates a modified Hughson-Westlake method. Results were analyzed using
descriptive statistics and also by a linear mixed-effects model to compare thresholds
obtained in each condition.
Results Across condition and participant group 73.6% of thresholds measured with OtoKiosk
were within ± 5 dB of the conventionally measured thresholds; 92.8% were within ± 10 dB.
On average, differences between tests were small. Pairwise comparisons revealed thresholds
were ∼3.5–4 dB better with conventional audiometry than with the mobile application
in quiet and in noise. Noise did not affect thresholds measured with OtoKiosk.
Conclusions The OtoKiosk automated hearing test measured pure tone air conduction thresholds
from 500 to 4,000 Hz at slightly higher thresholds than conventional audiometry, but
less than the smallest typical 5 dB clinical step-size. Our results suggest OtoKiosk
is a reasonable solution for sound booths and exam rooms with low-level background
noise.
Keywords
audiology - audiometry - automated - diagnostics - hearing loss - noise
