Validation of the Wireless Automated Hearing Test System for Clinical Use in Adults

Objective To evaluate the validity of the Wireless Automated Hearing Test System (WAHTS) in comparison to clinically acquired unmasked air conduction thresholds. Design A cross-sectional study comparing WAHTS and manual audiometry thresholds, with participants at Clinic 1 completing WAHTS followed by manual audiometry, and those at Clinic 2 completed manual audiometry first, followed by WAHTS, both on the same day. Study Sample Ninety-three thresholds from 28 participants at Clinic 1 and 112 thresholds from 24 participants at Clinic 2 were analyzed. Participants were U.S. Service Members and represented a range of ages and hearing difficulties. Results The mean absolute difference between repeated WAHTS measurements was 2.21 dB (SD = 2.52 dB). Correlation coefficients for WAHTS and clinical thresholds were 0.95 (R2 = 0.91) at Clinic 1 and 0.94 (R2 = 0.94) at Clinic 2. Kappa agreement within ±10 dB was 90% at Clinic 1 and 87% at Clinic 2. Bland-Altman analysis indicated a slight bias, with WAHTS thresholds averaging 2-3 dB better than clinical thresholds. Conclusions Wireless Automated Hearing Test System demonstrated strong agreement with clinical audiometry, supporting its use for unmasked threshold evaluations. Its portability and accuracy suggest potential for expanding access to hearing health care, particularly in remote or resource-limited environments.