Validity of hearing screening with smartphone apps on workers exposed to noise
Hearing loss, smartphone, workers, NIHL and validity.
Objective: To investigate the validity of the hearing screening with smartphone app to identify the hearing loss in workers exposed to noise. Methods: This is a validation study of hearing screening using the hearTest smartphone app in comparison with pure tone audiometry. The population of study included all workers who attended the Social Service of Industry to do the periodic examination. Sensitivity, specificity, Youden index, positive and negative predictive values of the hearing screening with a smartphone app were estimated considering three definitions of hearing loss: any threshold worse than 25dBHL, mean hearing thresholds from 500 to 4000Hz worse than 25dBHL, and average thresholds of 3000, 4000 and 6000Hz worse than 25dBHL. The 95% confidence intervals were calculated for all measurements. Results: 232 workers participated in the study. The hearTest application presented good values of sensitivity (93.8%), specificity (83.9) and Youden index (77.7%) and negative and predictive values (97.2%), except for positive predictive values (69.0) for the identification of hearing loss defined as any hearing threshold worse than 25 dBNA. Similar findings were found for the identification of noise-induced hearing loss (NIHL) using the same definition of hearing loss (91.6%, 83.9% and 75.5%, 97.9% and 54.6%, respectively). For the other definitions of hearing loss analyzed, high specificity and positive and negative predictive values were observed, as well as low sensitivity and Youden index both to identify any hearing loss and specifically hearing loss with NIHL configuration. Conclusion: Hearing screening with the hearTest smartphone app is a good tool to identify hearing loss in workers exposed to noise, including those with NIHL configuration, but it does not replace pure tone audiometry.