PROJECT SUMMARY/ABSTRACT
Hearing is important to our physical and mental health. Hearing loss, unfortunately, is the third most
common chronic physical condition in the U.S.—more prevalent than diabetes or cancer. Presently, 14.1%
(27.7 million) of adults aged 20–69 years of age have unilateral or bilateral speech-frequency hearing
impairment. Uncorrected hearing loss gives rise to a poorer quality of life and increased symptoms of
depression. For children, hearing loss can negatively impact speech language development, academic
performance and psychosocial behavior. On the other end of our lifespan, recent research has shown hearing
loss is independently associated with accelerated cognitive decline and incident cognitive impairment in
community dwelling older adults.
Many forms of hearing loss are treatable or addressable with technology (e.g., hearing aids). However,
due to a lack of access to diagnostic testing, many cases go untreated. A major limiter to diagnostic quality
hearing tests is the need for expensive infrastructure, i.e., sound-proofed booths, and audiologists with
specialized training in conducting exams, which are traditionally conducted in-person and one-on-one.
Although there has been investment in changing the model of delivering hearing assessment, particularly with
new “boothless” solutions, there remains strong needs for (1) hardware that maintains the quality required for
diagnostic audiometry in “boothless” settings, (2) automated testing for routine testing that would allow
audiologists to focus on the more complex cases, and (3) new approaches to connect audiologists to patients
through teleaudiology—enabling audiologists to provide the expertise needed for the more complex cases
without requiring either the patients nor the audiologists to travel great distances.
Creare, in collaboration with its clinical partners, is developing a mobile, wireless audiometric hearing
test system to address these needs. Creare has chosen to focus on addressing the needs of American Indians
and Alaska Natives (AIAN). In addition to the challenges due to rural and limited infrastructure, AIAN have the
highest rate of hearing issues compared to other race/ethnicity groups. In Phase I, a prototype system was
assembled, evaluated against relevant standards, and used in a pilot study to measure hearing thresholds on
subjects with asymmetric hearing loss. Phase II will focus on refining the device design, building several pre-
production prototypes, and demonstrating their use and performance with human subject studies. The Phase II
outcome will be a portable, wireless audiometric hearing test system that will expand the reach of diagnostic
testing to rural communities. Furthermore, the solution is well-timed with an increasing interest in
teleaudiology—which has been accelerated by the COVID-19 pandemic.