Feasibility of efficient smartphone-based threshold and loudness assessments in typical home settings

Reliable hearing assessment at home can improve accessibility and reduce dependence on in-clinic testing. To be viable, home-based procedures must provide accurate results within short measurement times and remain robust to factors such as ambient noise and variable user attention. This study validated two such procedures--a Graded Response Bracketing method for pure-tone threshold estimation and a reinforced adaptive categorical loudness scaling method for loudness-growth assessment--using remote, smartphone-based testing. Fifteen young adults with normal hearing completed the tasks at home and in the laboratory. Ambient noise levels in home environments were also recorded. Test-retest reliability was assessed by repeating the home measurements on a separate occasion. Remote measurements closely matched laboratory results, with mean differences below 1 dB for threshold estimation and below 5 dB for loudness scaling. Test-retest differences obtained at home were small, remaining below 2 dB for threshold estimation and below 1 dB for loudness scaling. These findings demonstrate that smartphone-based pure-tone audiometry and loudness-scaling assessments can achieve high accuracy, efficiency, and reliability when using these procedures, provided that basic acoustic-hygiene conditions (e.g., sufficiently low ambient noise) are maintained.