Abstract：
OBJECTIVE: Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy.
METHODS: A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
METHODS: Adults and children, with and without diagnosis of hearing impairment.
METHODS: A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL.
RESULTS: Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability.
CONCLUSIONS: MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.
METHODS: A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
METHODS: Adults and children, with and without diagnosis of hearing impairment.
METHODS: A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL.
RESULTS: Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability.
CONCLUSIONS: MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.
摘要：
目的：移动测听（MA）的技术进步使使用平板电脑和智能手机进行听力评估成为可能。本系统综述(PROSPEROID:CRD42021274761)旨在确定医疗服务提供者可用的MA选项，评估他们测量听力阈值的准确性，并探索可能影响其准确性的因素。
方法：对包括PubMed，Embase,科克伦,证据搜索和Dynamed于2021年12月13日进行，并于2022年10月30日重复，使用适当的医学主题词（MeSH）术语。合格的研究报告了使用MA来确定听力阈值，并将结果与传统的纯音测听（CA）进行了比较。调查MA进行听力筛查的研究（即报告只是通过/失败）不符合纳入条件。两位作者独立回顾了研究，提取的数据，并使用诊断准确性研究质量评估2（QUADAS-2）工具评估方法学质量和偏倚风险。
方法：成人和儿童，有和没有听力障碍的诊断。
方法：进行了荟萃分析，以获得在dBHL中使用MA和CA测量的阈值之间的平均差。
结果：搜索返回了858篇文章。经过系统的审查，分析了17篇文章，包括1032名参与者。最常用的软件应用程序是ShoeboxTM（6/17），其次是HearingTestTM（3/17），然后HeartTestTM（2/17）。十项研究中使用了平板电脑，六部智能手机，和一台电脑。MA和CA阈值之间的平均差异为1.36dB（95％CI，0.07-2.66，p=0.04）。在500Hz测量的阈值中观察到移动测听（MA）和常规测听（CA）阈值之间的显着差异，在儿童中，当MA在一个音响亭进行时，当MA是自我管理的时候。然而,这些差异未超过临床显著阈值10分贝(dB).纳入的研究表现出高度的异质性，偏差风险高，对适用性的担忧低。
结论：MA在测量听力阈值方面优于CA，并且在CA不可用或不可行的情况下提供听力评估的机会。未来的研究应优先考虑将纯音阈值评估与其他测试相结合，如语音识别和噪声数字，为了更全面地评估听力，评估可接受性和可行性，以及MA在非专业环境中的成本效益。
方法：对包括PubMed，Embase,科克伦,证据搜索和Dynamed于2021年12月13日进行，并于2022年10月30日重复，使用适当的医学主题词（MeSH）术语。合格的研究报告了使用MA来确定听力阈值，并将结果与传统的纯音测听（CA）进行了比较。调查MA进行听力筛查的研究（即报告只是通过/失败）不符合纳入条件。两位作者独立回顾了研究，提取的数据，并使用诊断准确性研究质量评估2（QUADAS-2）工具评估方法学质量和偏倚风险。
方法：成人和儿童，有和没有听力障碍的诊断。
方法：进行了荟萃分析，以获得在dBHL中使用MA和CA测量的阈值之间的平均差。
结果：搜索返回了858篇文章。经过系统的审查，分析了17篇文章，包括1032名参与者。最常用的软件应用程序是ShoeboxTM（6/17），其次是HearingTestTM（3/17），然后HeartTestTM（2/17）。十项研究中使用了平板电脑，六部智能手机，和一台电脑。MA和CA阈值之间的平均差异为1.36dB（95％CI，0.07-2.66，p=0.04）。在500Hz测量的阈值中观察到移动测听（MA）和常规测听（CA）阈值之间的显着差异，在儿童中，当MA在一个音响亭进行时，当MA是自我管理的时候。然而,这些差异未超过临床显著阈值10分贝(dB).纳入的研究表现出高度的异质性，偏差风险高，对适用性的担忧低。
结论：MA在测量听力阈值方面优于CA，并且在CA不可用或不可行的情况下提供听力评估的机会。未来的研究应优先考虑将纯音阈值评估与其他测试相结合，如语音识别和噪声数字，为了更全面地评估听力，评估可接受性和可行性，以及MA在非专业环境中的成本效益。
