Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 2, 2019
Date Accepted: May 15, 2020
Worldwide Prevalence of Hearing Loss Among Smartphone Users: Cross-Sectional Study Using a Mobile-Based App
ABSTRACT
Background:
Risk factors for hearing loss in adults in addition to the aging process include, among others, exposure to noise, use of ototoxic drugs, genetics and limited access to medical care. The differences in exposure to these factors are bound to be reflected in the hearing loss prevalence. Assessment of hearing loss can easily be carried out on a large scale and at low cost using mobile applications.
Objective:
Worldwide assessment of the differences in hearing loss prevalence between countries on a group of mobile device users.
Methods:
Hearing tests have been carried out using the open-access Android-based mobile app Hearing Test. The app is available free of charge in the Google Play provided that consent to the use of the results for scientific purposes is given. The study includes hearing tests carried out on device models supported by the app with bundled headphones in the set. Calibration factors for supported models have been determined using the biological method. The tests consisted in self-determining the quietest audible tone in the frequency range from 250 Hz to 8 kHz by adjusting its intensity using the buttons. The ambient noise level was optionally monitored by a built-in microphone. Following the test, the user could compare his hearing threshold against age norms by providing the age. The user's location was identified based on the IP address.
Results:
733,716 hearing tests have been conducted on 236,716 mobile devices across 212 countries from November 23, 2016 to November 22, 2019. After rejecting the tests that were incomplete, performed with disconnected headphones, not meeting the time criterion, repeated by the same user or carried out regularly on one device, 116,733 out of 733,716 tests (15.91%) were qualified for further analysis. The prevalence of hearing loss, defined as the average threshold at frequencies 0.5 kHz, 1 kHz, 2 kHz and 4kHz above 25dB HL in the better ear, was calculated at 15.6% (95% CI 15.4-15.8). Statistically significant differences were found between countries (P<.001) with the highest frequency for Bangladesh, Pakistan and India (above 28%) and the lowest frequency for Taiwan, Finland and South Korea (less than 11%).
Conclusions:
Hearing thresholds measured by means of mobile devices were congruent with the literature data on worldwide hearing loss prevalence. Uniform recruitment criteria simplify the comparison of the hearing loss prevalence across countries. Hearing test on mobile devices may be a valid tool in epidemiological studies carried out on a large scale. Clinical Trial: Science Support Center of Wroclaw Medical University BW-572
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