In the late 1950’s portable audiometers were developed as an effort to reach populations without access to hearing tests conducted in controlled environments by highly trained professionals. At their least impressive, a portable audiometer is a stripped down tabletop audiometer with a handle attached. Notably, many rugged systems have been successfully used throughout the world in challenging environments. To a large extent, these portable diagnostic audiometers still require a power plug and a modicum of expertise to operate. With the advent of mobile technology, we have witnessed the transformation of dated, audiometer equipment into a new breed of powerful, simple-to-use, internet-connected mobile audiometers.
Limitations of traditional portable diagnostic audiometers
The traditional clinical audiometer mandates the sacrifice of function to facilitate its reduced form factor. While weight is often still an issue, the more portable versions provide basic air and bone testing but lack advanced functionality.
Seldom do these units provide custom tones, masking, speech or special tests. These units are often sturdily built to tolerate harsh conditions but require maintenance to avoid internal rusting and degradation. The procurement of portable audiometers is generally infrequent and hence, most systems in use today are woefully outdated and in need of calibration. While portable systems do provide an opportunity for testing outside traditional venues they usually require special training to operate, manual documentation is often required, and they do not assist with patient tracking or referral. In particular, the management of background noise during portable screening outside a sound booth can be problematic. Ideally, your portable diagnostic audiometer would monitor noise throughout the test. Over the last 50 years, portable systems have filled an important gap in the audiometric armamentarium but have left a lot to be desired.
Benefits of mobile audiometry
With the rapid evolution of robust mobile technology in the past decade, we now have access to lightweight, internet-connected devices. These long-lasting battery-operated devices with touch interfaces are ideal for the workplace or community setting where children, adults, or elderly may be encountered. A mobile device has other sensors such as microphones and GPS with which to monitor background noise in specific locations or provide information about appropriate testing environments. Using a mobile device platform also enables the sharing of patient lists such that multiple systems can be deployed to large groups without missing a single person. Furthermore, the data obtained from these tests can be easily stored and aggregated in the cloud. This data can then help inform policy or healthcare decisions and assist in referral management. Usually, when you buy medical technology it becomes outdated the instant it is purchased, however, with mobile connected technology it is continually updated with the latest information, guidance, and testing tools. Mobile audiometry combines the best of traditional portable audiometry but reduces the size, lower audiometer price, and power requirements while adding additional sensors, software updates, and internet connectivity.
Mobile audiometry in practice
In my own work, I have often relied upon mobile audiometry to provide diagnostic hearing healthcare where other resources are unavailable. In some cases, this has been in a primary care setting but in others, it has been a remote outreach setting. The interactive nature of the testing and the lightweight form factor has been ideal for remote locations. Similarly, in less remote communities where population or school-based screening is being undertaken, the patient management and data aggregation tools have proved useful for research. Finally, occupational hearing conservation programs have found utility in the ease-of-deployment and scalability of mobile devices for testing.
Portable audiometers have historically met a need for the provision of healthcare outside traditional settings. However, this often required the sacrifice of useful features and came in a less than ideal form factor. With the advent of mobile internet-enabled devices, it is now possible to have a full diagnostic audiometer in a long-lasting, battery-operated device. The interactive nature of the touch interface has made these devices simple to use by a wide variety of healthcare workers, in a multitude of settings. The barrier to deploy, manage, and report on hearing testing in the field has been dramatically reduced and now enables the provision of hearing healthcare to a larger segment of the population.
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