@article{AJO5266,
author = {Hugh McMahon and Ian Gutteridge},
title = {Comparison of Apple hearing test function with formal pure tone audiometry within the outpatient setting},
journal = {Australian Journal of Otolaryngology},
volume = {0},
number = {0},
year = {2026},
keywords = {},
abstract = {Background: Hearing impairment is the third most common cause of years lived with disability globally, with accurate audiological assessment fundamental to its diagnosis and management. Formal pure tone audiometry (PTA) is the current gold standard, but it is often costly and can be difficult to access (particularly in low resource settings). Technological developments have increased the availability of app-based hearing assessments; however, evidence regarding their agreement with conventional audiometry in routine clinical environments is limited. This study aimed to evaluate agreement between hearing thresholds obtained using the Apple hearing test (AHT) and conventional PTA in a routine outpatient setting.Methods: This pilot prospective method-comparison study was conducted in an outpatient otolaryngology clinic in Queensland, Australia, between December 2025 and January 2026. Adult patients with a recent formal PTA within the preceding 30 days were consecutively recruited and completed an AHT during their routine outpatient review. The hearing thresholds across six standard audiometric frequencies were compared between methods, with agreement assessed primarily using Bland-Altman analysis.Results: A total of 20 patients were recruited for this study. A total of 17 completed the AHT and were included in the comparative analyses. Bland-Altman analysis demonstrated a mean bias of –1.9 dB hearing level (HL) [95% confidence interval (CI): –5.5 to 1.6], with the AHT recording slightly lower thresholds than PTA, and 95% limits of agreement of –17.9 to 14.1 dB HL. Mean differences at individual frequencies ranged from –4.4 to 4.6 dB HL and none reached statistically significance (all P>0.05). Mixed effects regression identified no significant overall effect of measurement method (P=0.06).Conclusions: This pilot method-comparison study demonstrated comparable threshold measurements between the AHT and PTA in this cohort. The AHT may have potential utility as an adjunct screening or monitoring tool; however, these findings do not establish diagnostic equivalence, and formal audiological assessment remains essential.},
issn = {2616-2792}, url = {https://www.theajo.com/article/view/5266}
}