The Impact of Ambient Noise on the Reliability of Home-Based Remote Audiometry

Authors: Iordanis Thoidis1, Amaury Hazan1, Ad Snik1, Jonatan Rivilla1, Kamil Budzyński1, Num Mendez1, Jacques Kinsbergen1

1Jacoti BV

Background: Traditional clinical audiometry, which relies on specialized equipment and professional supervision, is increasingly strained by the rising global demand for hearing healthcare and the prevalence of hearing loss. With the evolution of mobile technology, remote home-based audiometry has become an increasingly viable option for global hearing healthcare. However, the challenges presented by uncontrolled conditions, such as environments with high ambient noise levels, could compromise the reliability of the hearing assessment.

Method: The Jacoti Hearing Center (JHC) is an iOS-based application designed for home-based self-administered pure-tone audiometry without professional supervision. JHC uses calibrated consumer-grade equipment to deliver accurate hearing testing, as continuously monitor ambient noise levels during the test using the internal microphone of the device. Data collection involved collecting, anonymizing, and analyzing audiometric test results from 1115 users who performed tests between 2015 and 2023. Tests were categorized based on the average ambient noise level during each measurement, allowing for the evaluation of the test-retest reliability across conditions with low and high ambient noise, as well as in mismatched conditions.

Results: The median test-retest differences were consistent at 3.3 dB for both quiet and noisy conditions, with a median absolute deviation of 1.7 dB, with no clinically significant differences between these settings (effect size r=-0.02). Additional analyses across mismatched noise conditions showed no significant differences in threshold levels (p > 0.05).

Conclusions: Our findings demonstrate that the JHC application delivers reliable audiometric results for hearing assessments in non-ideal acoustic conditions. This highlights the effectiveness of continuous noise monitoring and adaptive test control, demonstrating its potential for remote home-based hearing assessment.