Validated Smartphone-Based Apps for Ear and Hearing Assessments: A Review.

Only 2 of the 11 validation studies were rated low risk of bias and low concern of applicability in all domains, and selection bias was the main source of bias. The included studies had small samples (25 to 110 participants) and limited variability in degree and type of hearing loss, so results may not generalise. App accuracy varied with ambient noise, transducer, device, and calibration, and only half of the 10 audiometry studies performed calibration. Most studies were in high-income countries, while the review focused on screening in low-resource settings. The app store search could not use complex search functions, did not give total hits, relied on titles and descriptions, and was completed in July 2015, so apps may have been missed or newer apps not captured. No apps were identified for tympanometry, otoacoustic emissions, or auditory brainstem response testing, and current audiometry apps did not typically test 8000 Hz, so some conditions may be missed.

The review authors declared no conflicts of interest. In the included validation studies, uHear studies did not declare conflicts, while shoeBOX, EarTrumpet, AudCal, and hearScreen studies declared conflicts.

Do not read the high sensitivity figures as proof that these apps can diagnose hearing loss. The review found only 5 of 30 commercial apps validated, accuracy varied with noise, and the authors concluded apps cannot replace gold standard pure tone audiometry conducted by an audiologist.