Monitoring our hearing health has gone mobile, but how reliable are these home hearing test software applications? Can hearing test apps really detect hearing loss accurately?Â
A team of audiology experts out of Alberta, Canada, set out to test the tests with some ear-opening results. Were the apps any good? Well, they certainly deserve a fair hearing!Â
The researchers evaluated two popular hearing test apps: hearWHO and SHOEBOX, comparing them to the standard hearing assessment conducted by audiology professionals. [1] The results were encouraging; both apps performed reasonably well, detecting moderate to severe hearing loss. These apps, the authors say, are good screening tools for preliminary hearing evaluation, and could be invaluable for communities with limited access to audiology facilities. Don’t just take our word for it, though, let’s sound out the evidence together. Â
Listen Up
People know a lot about normal blood pressure, normal vision and even cholesterol levels, but what about your hearing levels? We’re all used to getting a blood draw or an eye test, but getting your hearing checked? Probably not since you were a baby. [2]Â
Our hearing is important. For people who have lived most of their life with regular hearing, losing the ability to engage with family and friends, enjoy music or even get off the bus at the right stop is profoundly isolating. What’s more, in recent years researchers have discovered that age-related hearing loss can be an early indication that cognitive decline is on the horizon. At a time when maintaining relationships and social engagement is vital to keeping your brain healthy, getting a hearing aid can be a lifeline. On the other hand, getting them down to the doctor’s office for a hearing test isn’t always straight forward. Persuading an older relative to accept that their trouble connecting with waiters isn’t just because ‘everybody’s mumbling now!’ can be… a challenge. So what’s the solution? Home hearing tests.
We should all be getting routine hearing tests, but realistically, it’s impractical for everyone to get access to a proper hearing assessment from a trained specialist. Most people, however, can access a smartphone, install a hearing test application and take a hearing test. The question is: do they work?
Hear Them out: The hearWHO and SHOEBOX Hearing Test Apps
The hearWHO app is a hearing test smartphone application developed by the WHO. It tests hearing loss by emitting the sound of digits at various frequencies in a noisy background. The person taking the test listens to a set of 23 digit triplets and keys in the numbers they hear each time. At the end of the exercise, the person gets a score ranging from 0 to 100 points. The app’s developers consider a score above 75 good hearing, whereas a score between 50 and 75 is intermediate. Below 50 points, the researchers deemed the participan to have definite hearing loss.
The SHOEBOX online test is a mix of self-assessment questions and sounds set at different thresholds. The participant fills in the questions and then selects the threshold at which they can hear the different sounds. The final result is either significant hearing loss, hearing loss, or good hearing.
To establish the reliability and validity of these hearing apps, hearWHO and SHOEBOX, the researchers set up a prospective diagnostic accuracy study. This means the scientists developed a hypothesis in advance, in this case that mobile hearing apps perform as well as standard hearing tests. They then designed an experiment to test how the results of a standard hearing test conducted by an audiologist compare to a participant using the app by themselves.
If they showed that the results of the self-administered test were consistently similar to the formal test, it would demonstrate that the tests were accurate. Because this was a prospective study, the researchers had the opportunity to choose participants in a way that would minimize confounding effects. They also decided in advance how many people needed to take part to make the results statistically meaningful. The researchers planned only to invite people who had not yet been diagnosed with hearing loss and would exclude people who already used a hearing aid, had an implant (cochlear, bone conductance, etc.) or had an injury to the part of their skull that houses the inner ear.Â
Calgary Calling
 They administered hearing tests on the apps to people who were coming for audiological assessment at a clinic in Calgary over a period of about 10 months between 2023 and 2024. A total of 130 people participated in the study.Â
First the volunteers would be tested by the audiologist, using the standard reference test. The audiologist would let participants know what their results were. A volunteer would go to another room where they would meet the research coordinator. The coordinator would not know the results of the standard tests. They would then give the volunteer a tablet computer loaded with the hearing test apps and watch while they took each of the self-administered hearing tests twice. The volunteers all used the same tablet and the same headphones, and the research coordinator made sure that ambient noise in the room was the same for all participants.Â
The research coordinator then noted their results and gave them a final round of tests – Revised Hearing Handicap Inventory – Screening (RHHI-S)13 and the Single-Item Self-assessment (SISA) questionnaires.
Setting the Levels
 Researchers categorized people whose lowest hearing level was 50 decibels (db) or greater as having moderate to severe hearing loss. They assessed those whose lowest hearing level was 20 db as having less severe hearing loss. Participants who could hear at levels below 20 db were categorized as having no hearing loss. For each of the volunteers, researchers compared the results of the standard test to the hearWHO and SHOEBOX tests, and then to the RHHI-S and SISA questionnaires.
Strength in Numbers
 At the end of the study, the researchers used results from 123 or 129 participants to analyse how well the mobile hearing apps worked. This was because some participants did not complete the tests. The volunteers were aged between 47 years and 67 years old and 62.5% were women.
According to the standard test, 16.3% had definite hearing loss (could not hear below 50 db), 72.1% had possible hearing loss (could not hear below 20 db) and 27.9% had no hearing loss.
On the first test attempt, HearWHO flagged 47.7% of volunteers as having hearing loss, 46.2% as indeterminate and 6.2% as having normal hearing. The second round of testing gave quite different results: respectively 34.5%, 56.6% and 8.5%. The reliability score was not great, since there is a clear disparity between the first and second rounds.Â
The SHOEBOX test was more consistent, giving the results: significant hearing loss 3.9% then 4%, some hearing loss 55.5% then 50% and finally, no hearing loss 40.6% and 46%.
Neither test performed as well as the standard audiologist administered hearing tests, but it would be very surprising if they did! Both tests had a low threshold for what they considered ‘hearing loss’. This meant that they were more likely to give false positives. In this context, however, that’s not necessarily a bad thing, as a result indicating hearing loss should encourage the test taker to book a proper hearing test.
Sensitive Ears?
Overall, the researchers found that both apps were a reasonable option for detecting hearing loss. The results were more accurate at the second attempt of the tests. The authors attributed this to a learning effect – the participants knew how to use the apps better on the second trial.
While neither app performed as well as the standard hearing tests, both apps showed promise as screening tools. In a public health campaign intended to identify as many cases of hearing loss as possible, both hearWHO and SHOEBOX are sensitive and reliable enough to identify people who need secondary testing. The hearWHO app, in particular, had better sensitivity; that is, it could be used to cast a wider net, catching many cases. The SHOEBOX app had better specificity, meaning it had fewer false positives and could be a better tool in settings where there are no readily available standard audiological tests.
The hearWHO and SHOEBOX hearing test apps are both great options for screening purposes. Since they are easily available and can be taken conveniently, they can be used as the initial tools of assessment. People who score as having hearing loss on the hearWHO app and SHOEBOX will understand tat they need a definitive hearing assessment by a professional. In the absence of these tools, hearing test questionnaires such as the SISA and RHHI-S can be used for initial assessment, as they too have satisfactory accuracy scores.
References
[1] Lunney M, Wiebe N, Howarth T, et al. Performance of Hearing Test Software Applications to Detect Hearing Loss. JAMA Netw Open. 2025;8(3):e252166. Published 2025 Mar 3. doi:10.1001/jamanetworkopen.2025.2166[2] Carlson ML, Nassiri AM, Marinelli JP, Lohse CM, Sydlowski SA; Hearing Health Collaborative. Awareness, Perceptions, and Literacy Surrounding Hearing Loss and Hearing Rehabilitation Among the Adult Population in the United States. Otol Neurotol. 2022;43(3):e323-e330. doi:10.1097/MAO.0000000000003473[3] Blackwell DL, Lucas J.W., Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 10. 2014;(260):1–161.
Monitoring our hearing health has gone mobile, but how reliable are these home hearing test software applications? Can hearing test apps really detect hearing loss accurately?Â
A team of audiology experts out of Alberta, Canada, set out to test the tests with some ear-opening results. Were the apps any good? Well, they certainly deserve a fair hearing!Â
The researchers evaluated two popular hearing test apps: hearWHO and SHOEBOX, comparing them to the standard hearing assessment conducted by audiology professionals. [1] The results were encouraging; both apps performed reasonably well, detecting moderate to severe hearing loss. These apps, the authors say, are good screening tools for preliminary hearing evaluation, and could be invaluable for communities with limited access to audiology facilities. Don’t just take our word for it, though, let’s sound out the evidence together. Â
Listen Up
People know a lot about normal blood pressure, normal vision and even cholesterol levels, but what about your hearing levels? We’re all used to getting a blood draw or an eye test, but getting your hearing checked? Probably not since you were a baby. [2]Â
Our hearing is important. For people who have lived most of their life with regular hearing, losing the ability to engage with family and friends, enjoy music or even get off the bus at the right stop is profoundly isolating. What’s more, in recent years researchers have discovered that age-related hearing loss can be an early indication that cognitive decline is on the horizon. At a time when maintaining relationships and social engagement is vital to keeping your brain healthy, getting a hearing aid can be a lifeline. On the other hand, getting them down to the doctor’s office for a hearing test isn’t always straight forward. Persuading an older relative to accept that their trouble connecting with waiters isn’t just because ‘everybody’s mumbling now!’ can be… a challenge. So what’s the solution? Home hearing tests.
We should all be getting routine hearing tests, but realistically, it’s impractical for everyone to get access to a proper hearing assessment from a trained specialist. Most people, however, can access a smartphone, install a hearing test application and take a hearing test. The question is: do they work?
Hear Them out: The hearWHO and SHOEBOX Hearing Test Apps
The hearWHO app is a hearing test smartphone application developed by the WHO. It tests hearing loss by emitting the sound of digits at various frequencies in a noisy background. The person taking the test listens to a set of 23 digit triplets and keys in the numbers they hear each time. At the end of the exercise, the person gets a score ranging from 0 to 100 points. The app’s developers consider a score above 75 good hearing, whereas a score between 50 and 75 is intermediate. Below 50 points, the researchers deemed the participan to have definite hearing loss.
The SHOEBOX online test is a mix of self-assessment questions and sounds set at different thresholds. The participant fills in the questions and then selects the threshold at which they can hear the different sounds. The final result is either significant hearing loss, hearing loss, or good hearing.
To establish the reliability and validity of these hearing apps, hearWHO and SHOEBOX, the researchers set up a prospective diagnostic accuracy study. This means the scientists developed a hypothesis in advance, in this case that mobile hearing apps perform as well as standard hearing tests. They then designed an experiment to test how the results of a standard hearing test conducted by an audiologist compare to a participant using the app by themselves.
If they showed that the results of the self-administered test were consistently similar to the formal test, it would demonstrate that the tests were accurate. Because this was a prospective study, the researchers had the opportunity to choose participants in a way that would minimize confounding effects. They also decided in advance how many people needed to take part to make the results statistically meaningful. The researchers planned only to invite people who had not yet been diagnosed with hearing loss and would exclude people who already used a hearing aid, had an implant (cochlear, bone conductance, etc.) or had an injury to the part of their skull that houses the inner ear.Â
Calgary Calling
 They administered hearing tests on the apps to people who were coming for audiological assessment at a clinic in Calgary over a period of about 10 months between 2023 and 2024. A total of 130 people participated in the study.Â
First the volunteers would be tested by the audiologist, using the standard reference test. The audiologist would let participants know what their results were. A volunteer would go to another room where they would meet the research coordinator. The coordinator would not know the results of the standard tests. They would then give the volunteer a tablet computer loaded with the hearing test apps and watch while they took each of the self-administered hearing tests twice. The volunteers all used the same tablet and the same headphones, and the research coordinator made sure that ambient noise in the room was the same for all participants.Â
The research coordinator then noted their results and gave them a final round of tests – Revised Hearing Handicap Inventory – Screening (RHHI-S)13 and the Single-Item Self-assessment (SISA) questionnaires.
Setting the Levels
 Researchers categorized people whose lowest hearing level was 50 decibels (db) or greater as having moderate to severe hearing loss. They assessed those whose lowest hearing level was 20 db as having less severe hearing loss. Participants who could hear at levels below 20 db were categorized as having no hearing loss. For each of the volunteers, researchers compared the results of the standard test to the hearWHO and SHOEBOX tests, and then to the RHHI-S and SISA questionnaires.
Strength in Numbers
 At the end of the study, the researchers used results from 123 or 129 participants to analyse how well the mobile hearing apps worked. This was because some participants did not complete the tests. The volunteers were aged between 47 years and 67 years old and 62.5% were women.
According to the standard test, 16.3% had definite hearing loss (could not hear below 50 db), 72.1% had possible hearing loss (could not hear below 20 db) and 27.9% had no hearing loss.
On the first test attempt, HearWHO flagged 47.7% of volunteers as having hearing loss, 46.2% as indeterminate and 6.2% as having normal hearing. The second round of testing gave quite different results: respectively 34.5%, 56.6% and 8.5%. The reliability score was not great, since there is a clear disparity between the first and second rounds.Â
The SHOEBOX test was more consistent, giving the results: significant hearing loss 3.9% then 4%, some hearing loss 55.5% then 50% and finally, no hearing loss 40.6% and 46%.
Neither test performed as well as the standard audiologist administered hearing tests, but it would be very surprising if they did! Both tests had a low threshold for what they considered ‘hearing loss’. This meant that they were more likely to give false positives. In this context, however, that’s not necessarily a bad thing, as a result indicating hearing loss should encourage the test taker to book a proper hearing test.
Sensitive Ears?
Overall, the researchers found that both apps were a reasonable option for detecting hearing loss. The results were more accurate at the second attempt of the tests. The authors attributed this to a learning effect – the participants knew how to use the apps better on the second trial.
While neither app performed as well as the standard hearing tests, both apps showed promise as screening tools. In a public health campaign intended to identify as many cases of hearing loss as possible, both hearWHO and SHOEBOX are sensitive and reliable enough to identify people who need secondary testing. The hearWHO app, in particular, had better sensitivity; that is, it could be used to cast a wider net, catching many cases. The SHOEBOX app had better specificity, meaning it had fewer false positives and could be a better tool in settings where there are no readily available standard audiological tests.
The hearWHO and SHOEBOX hearing test apps are both great options for screening purposes. Since they are easily available and can be taken conveniently, they can be used as the initial tools of assessment. People who score as having hearing loss on the hearWHO app and SHOEBOX will understand tat they need a definitive hearing assessment by a professional. In the absence of these tools, hearing test questionnaires such as the SISA and RHHI-S can be used for initial assessment, as they too have satisfactory accuracy scores.
References
[1] Lunney M, Wiebe N, Howarth T, et al. Performance of Hearing Test Software Applications to Detect Hearing Loss. JAMA Netw Open. 2025;8(3):e252166. Published 2025 Mar 3. doi:10.1001/jamanetworkopen.2025.2166[2] Carlson ML, Nassiri AM, Marinelli JP, Lohse CM, Sydlowski SA; Hearing Health Collaborative. Awareness, Perceptions, and Literacy Surrounding Hearing Loss and Hearing Rehabilitation Among the Adult Population in the United States. Otol Neurotol. 2022;43(3):e323-e330. doi:10.1097/MAO.0000000000003473[3] Blackwell DL, Lucas J.W., Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 10. 2014;(260):1–161.
