Purpose of App Review
The purpose of this review is to assess the clinical applications of the Hearing Test app from Siemens; in particular, determining the appropriate target audience.
Hearing problems are common in the general population.
Determining the hearing capabilities of patients is part of the standard neurological exam.
Tools for quick and valid screening of hearing are needed to improve the assessment of overall hearing as well as the consideration of the need for a hearing aid.
The Siemens Hearing Test app is designed to help patients–and potentially healthcare professionals–determine the need for a more formal hearing assessment. The app opens in the test hearing window with directions on how to complete the test.
The test can be completed with ear buds or over-the-ear headphones. I found the over-the-ear headphones option best for blocking ambient noise distraction. This app tests for vocal discrimination, an approach different from standard hearing thresholds at various frequencies.
Users are presented with background noise and then with a spoken four letter word from nine words with similar phonetics. Users can choose the word they heard, have the word repeated or select not understood. The interfaces cycles through tests for the left and right ear and takes only two or three minutes to complete.
I have had formal audiology assessment that has shown I have a high-frequency hearing deficit worse in my left ear than my right (presbycusis). Presbycusis is a common age-related hearing deficit so I was interested in my performance on this app.
Following the hearing test, a results window is presented with a summary of left and right ear performance. The graphic plots the number of correct and incorrect responses in each ear and can be saved on the device for later review. The app correctly identified that I had a possible hearing loss for your left ear.
Siemens is a medical device manufacturing company and they make hearing aids. Following the results panel, users can tap a button labeled Find a Hearing Care Professional.
Strangely, when I selected this button, the only hearing professionals identified were in Canada, quite a distance from my location in Tulsa, Oklahoma. I went to the Siemens website where a hearing professional locator webpage identified three hearing professionals within 5 miles of my location.
These referral sites were focused on hearing aid assessment and sales and did not include any primary care physicians or otolaryngologists. Discussing abnormal results with the patient’s primary care physician would be a reasonable first step but is not recommended by the app.
The app has an About hearing tab with a single page on the ear, hearing impairment and hearing related symptoms. This highlights an important issue. Subjective and family reported hearing problems are a complement to testing and need to be considered when deciding on whether to see a hearing professional.
Evidence to support use
- I was unable to find any research support for the Siemens hearing test app. It would be helpful to test the app in a series of patients followed by formal hearing assessment. This would allow for estimation of the sensitivity and specificity of the app.
- I suspect the threshold for recommending referral is low and the app might produce some false positive results. However, Siemens is a reputable company with strong credentials in hearing aid devices. Also, the app did correctly identify my hearing deficit.
- Rapid screening of hearing using a phonetic screening technique
- Ease of use
- Ability to save results for later review
- Hearing results plot somewhat confusing to interpret
- No discussion of the types of hearing professionals and their role in hearing assessment
- Lack of Android app
Healthcare providers that would benefit from the app
- This app appears to adequately provide a tool for hearing screening. Lack of validity testing limits the ability for primary care physicians to encourage this app as an alternative to other hearing screening methods for their patients. This app may serve a role as a demonstration tool or have use in resource-limited settings. I will review additional hearing screening apps that may be better tools for use by primary care providers in future posts.
Patients that may benefit from app
- This app is appropriate as a hearing assessment tool in high-risk patients. It needs to be considered in the context of whether a real world subjective hearing problem is present.
- Siemens Hearing Test is a simple, quick app that provides screening for the need for further hearing assessment. It appears primarily targeted to consumers rather than medical professionals. Validity testing is lacking but the phonetic screening method may be a good strategy for assessing conversational hearing problems.
- Yes, in appropriate contexts (see above)
Type of device used for review-iPad version 3
Version of the app-2.0.4
3.5 stars on 1 to 5 star scale