三种自助纯音测听APP在正常人群中的准确度和便捷性研究

Accuracy and Easiness of Three Self-Administered Pure Tone Audiometry Apps in a Normal Hearing Population

目的评估基于移动智能终端的自助测听应用程序(App)在听力正常人群中的准确度和便捷性。方法在基于iOS系统的移动智能终端上,自行下载NIOSH SLM(Sound Level Meter,声级计)App及三款自助纯音测听App(*伴/Mimi/*通)。应用NIOSH SLM选定本底噪声小于40dB A的安静环境,招募20名听力正常的受试者,分别自助应用三款测听App完成双耳0.25、0.5、1、2、4、8kHz六个倍频程纯音的气导听阈测试;同时用秒表记录各应用程序测听的耗时。于医院听力中心完成入组筛查(鼓膜完整、外耳道无耵聍堵塞、A型鼓室图等)后,采用Hughson-Westlake法以GSI 61诊断型听力计对受试者进行气导纯音测听,并用秒表记录耗时。比较自助测听App和临床纯音测听所测气导听阈及耗时的差异。结果三款自助纯音测听App中,*伴、Mimi两者测得的气导听阈与临床纯音测听结果一致性较好,耗时也无显著性差异。*通测得的气导听阈与临床纯音测听在250Hz、500Hz有显著性差异,其他频率无显著差异,但耗时较其他两款应用程序及临床纯音测听显著缩短。结论*伴、Mimi所测气导听阈与临床纯音测听法所获听阈的一致性较好;*通所测气导听阈在低频区有明显偏差,但测听所用耗时较短。现行多款基于移动智能终端的自助测听App,若要获得快捷可靠的自助纯音气导测听结果,仍有很大的改进空间。

Objective To evaluate the accuracy and easiness of mobile device-based self-service audiometric applications(apps)in a normal hearing population.Methods The NIOSH SLM(Sound Level Meter)app and three audiometric apps(*Assistant/Mimi/*Tone)were downloaded onto iOS smartphones.The NIOSH SLM application was used in a quiet environment with background noise levels less than 40 dBA.Twenty subjects with normal hearing were recruited to complete binaural air conduction thresholds test at six octave frequencies(0.25kHz,0.5 kHz,1 kHz,2 kHz,kHz 4 and 8 kHz)using the three audiometric apps and the time required to complete testing using each app was recorded.The same subjects were also screened(eardrum intact,external ear cerumen unblocked,type A tympanogram,etc.)and received formal air-conduction pure-tone audiometry using a GSI 61 diagnostic audiometer and the Hughson-Westlake method at the hospital hearing center,with the test time also recorded.Differences in hearing thresholds and test time between audiometric apps and formal audiometry were compared.Results Among the three pure-tone self-service audiometric apps,thresholds measured by the*Assistant and Mimi apps were highly consistent with those obtained via formal pure-tone audiometry,with no significant difference in test time.Thresholds measured by the*Tone apps were different from those by formal audiometry at 250 Hz and 500 Hz,although with significantly less amount of time needed than the other two apps and formal audiometry.Conclusion Air conduction hearing thresholds measured by the*Assistant and Mimi apps are in good agreement with clinical pure tone audiometry;but those measured by the*Tone app show significant deviations at low frequencies.The*Tone app requires the shortest test time.Much remains to be improved for many of the existing mobile device-based self-assessment audiometric apps to provide fast and reliable selfservice pure tone audiometric screening.