An Internet-Based Hearing Test for Simple Audiometry in Nonclinical Settings: Preliminary Validation and Proof of Principle

Objective: To investigate the validity and reproducibility of a newly developed internet-based self-administered hearing test using clinical pure-tone air-conducted audiometry as gold standard. Study Design: Cross-sectional intrasubject comparative study. Setting: Karolinska University Hospital, Solna, Sweden. Patients: Seventy-two participants (79% women) with mean age of 45 years (range, 19-71 yr). Twenty participants had impaired hearing according to the gold standard test. Interventions: Hearing tests. Main Outcome Measures: The Pearson correlation coefficient between the results of the studied Internet-based hearing test and the gold standard test, the greatest mean differences in decibel between the 2 tests over tested frequencies, sensitivity and specificity to diagnose hearing loss defined by Heibel-Lidén, and test-retest reproducibility with the Pearson correlation coefficient. Results: The Pearson correlation coefficient was 0.94 (p < 0.0001) for the right ear and 0.93 for the left (p = 0.0001). The greatest mean differences were seen for the frequencies 2 and 4 kHz, with -5.6 dB (standard deviation, 8.29), and -5.1 dB (standard deviation, 6.9), respectively. The 75th percentiles of intraindividual test-gold standard differences did not exceed -10 dB for any of the frequencies. The sensitivity for hearing loss was 75% (95% confidence interval, 51%-90%), and the specificity was 96% (95% confidence interval, 86%-99%). The test-retest reproducibility was excellent, with a Pearson correlation coefficient of 0.99 (p < 0.0001) for both ears. Conclusion: It is possible to assess hearing with reasonable accuracy using an Internet-based hearing test on a personal computer with headphones. The practical viability of self-administration in participants' homes needs further evaluation.