Diagnostic Accuracy and Acceptability of a Mobile Health Hearing Screening Program for Older Adults in Primary Care: A Multicenter Study

Purpose: Given that mobile health (mHealth) technology offers a feasible solution for early hearing loss (HL) screening, the purpose of this study was to determine the diagnostic accuracy and acceptability of an mHealth intervention for HL screening in people over 65 years old across four primary health care (PHC) centers. It was hypothesized that the mHealth app would have higher diagnostic accuracy compared with other index tests. Method: Using a multicenter diagnostic accuracy comparative study design, 203 adults over 65 years old ( Mdn = 72 years) were assessed using pure-tone audiometry as the reference-standard test, with mild (> 25 dB) and moderate (≥ 40 dB) HL as cutoffs. Index tests included the following: mHealth hearing screening app, preventive medical examination assessment, diagnostic hearing assessments, and self-reported HL measures. Sensitivity, specificity, and area under the curve (AUC) values were estimated. Acceptability was determined using a validated Likert-type questionnaire. Results: The results of the mHealth HL screening showed the highest sensitivity for mild (90.06%) and moderate (98.44%) HL. The AUC for the mHealth intervention was significantly higher ( p < .001) for mild HL compared with all index tests, and it was significantly higher ( p < .001) for moderate HL compared with the preventive medical examination assessment. Acceptability of the mHealth intervention was rated as highly acceptable by older adults and professionals. Conclusions: mHealth screening is a sensitive, user-friendly, and acceptable tool for HL screening in older adults. Integration within preventive medical examination programs is feasible and could enhance early HL detection and management within PHC contexts. Supplemental Material: https://doi.org/10.23641/asha.32536584