Exploring the Potential of Hearing Screening Smartphone Applications to Enhance Access to Hearing Healthcare: A Literature Review

In 2016, the National Academies of Sciences (NAS) published a landmark consensus report with several recommendations to enhance the availability and affordability of hearing healthcare in the United States. Among the most notable of the recommendations was the creation of a new category of FDA-approved Over-the-Counter (OTC) hearing aids. Unlike the traditional hearing aid model, which requires a comprehensive hearing test by a hearing health professional prior to purchase, OTC hearing aids would be directly available for sale to any American adult with a self-perceived mild-to-moderate degree of hearing loss. This proposal has now become reality with the passage of the OTC Hearing Aid Act of 2017 and the release of the first OTC hearing aids in October 2022. The availability of OTC hearing aids, however, raises several questions, including how can individuals accurately self-perceive and self-assess a mild-to-moderate degree of hearing loss. Previously, this was a clinical diagnosis made by licensed hearing professionals using a comprehensive hearing examination in a healthcare setting. Given the emergence of OTC hearing aids meant for those with self-perceived mild-to-moderate hearing loss, the ability to self-assess the degree of hearing loss is more critical than ever. While a variety of potential solutions have been put forward, one potential solution this paper seeks to investigate is the use of smartphone applications that claim to assess hearing sensitivity. Health-related smartphone applications are increasingly used by the public for monitoring and managing their health, and hearing health applications are no exception. The OTC Hearing Aid Act may increase interest among the general public to use self-administered hearing screening smartphone applications (HSSAs) to assess their hearing status now that a professionally performed hearing test in not required prior to obtaining OTC hearing aids. In conversation with the goals of the NAS report, my paper seeks to (1) investigate the potentials and limitations of HSSAs available on the Apple App Store and Google Play Store to enhance accessibility to hearing healthcare, and (2) develop an educational resource for a validated application to guide users on its correct usage