Clearwater Clinical and the Children’s Hospital of Eastern Ontario (CHEO)
SHOEBOX Audiometry is an iPad audiometer application that uses an interactive game to diagnose hearing loss. Calibrated headphones and a web-based data management system are included with the monthly licensing.
South America, North America, Asia, Africa
The application portion of the system is free to download. ShoeBox will asses the individual needs provide up to 50% off the monthly licensing – inquires can be made on ShoeBox website. Interview with representative Base price for monthly licensing is unknown. An iPad is required to use the system and costs as low as $400.
Goal 3: to promote good health and well-being. Enable timely diagnosis of hearing loss in pediatric populations.
While the ideal user is a certified audiologist or otolaryngologist, SHOEBOX Audiometry is also intended to be used by family doctors and community health workers that work in primary care settings and do not have formal audiology training. The patient administers the test. Interview with representative
SHOEBOX Audiometery has partnered with World Wide Hearing’s Hearing Express Program to distribute the product. The Hearing Express Program aims to train locals on how to test people’s hearing and provide mobile hearing care kits so that these trained individuals can screen and diagnose hearing loss within their communities. World Wide Hearing works with manufacturers such as Clearwater Clinical to drive down costs associated with of materials. Clearwater charges World Wide Hearing (at a heavily discounted rate) and WWH does not charge for where they donate the unit.
SHOEBOX Audiometry has over 500 customers in 40 countries Interview with representative
Continuous, recharging only, none, other
SHOEBOX requires an iPad, customized software, and calibrated headphones to operate. The ShoeBOX Audiometer creates a Conditioned Play Audiometry (CPA) test where the user plays an interactive listening game that involves touching items on the iPad screen that make sounds. Precise hearing thresholds across all sound frequencies for each ear are recorded as the user plays the game to produce an audiogram. SHOEBOX uses a modified veresion of the gold standard Hughson-Westlake protocol to determine thresholds.The ShoeBOX Audiometry technology automatically adjusts test protocols for masking, ambient noise, and response reliability. The system can generate pure tone or warble tone stimulus and features narrow band noise for masking.
The system is available in three versions, Clinical, diagnostic, and screening. Shoebox Clinical includes additional clinical capabilities required for audiologists and otolaryngologists. Shoebox also features an integrated patient database for adding notes to any patient file and built-in questionnaires to capture patient history. The system includes a HIPAA-compliant web portalthat can be used on any web browser to access, manage, and export hearing test results and patient data.
Additional technical specifications include:
– Device(s) required: iPad Air, iPad Mini, or iPad Pro
– Operating system and version: iOS 8.0 or later
– Languages available: English, Esperanto, French, German, Vietnamese
– Sound generation: 250–8000 Hz, 10–90 dB HL, 0–115 dB HL (Pro edition)
– Accuracy: +/- 1 dB
– Preventative maintenance: annual calibration of headphones
More information can be found here
The manufacturer provides every new user one complimentary hour of “Getting Started” training. Users can receive customized on-site or web-based training for an additional cost. The manufacturer also provides a customer service package that includes annual calibration, a Shoebox Cloud account, ongoing technical support (via email, chat, phone, or web), and software upgrades. The customer service package is free for the first year and is available for an additional charge thereafter. Purchase of the SHOEBOX Audiometer includes a one year warranty. Clearwater provides full technical support and training and the one-year warranty includes a calibration and a new pair of headphones every year. Interview with representative
Calibration of new headphones is offered by ShoeBox. To maintain compliance with ANSI S3.6 standards, ShoeBox offers the following services:
– annual notification of when calibration is due
– automatic swap out of newly calibrated transducers
– return shipment for old transducers
– new calibration certificate for ANSI records management
An iPad’s lifespan is approximately 3 years
To develop a highly portable and cost-efficient solution to diagnosing hearing loss at a young age.
A performance study conducted in a remote region in Canada1 and Uganda diagnosed 139 out of 868 children with hearing loss when using the SHOEBOX Audiometer. A study conducted with 49 participants (44 adults, 5 children) indicated that the results from the SHOEBOX Audiometer were within 10 dB of those determined by conventional audiometry for 164 of 172 hearing levels and did not show proportional bias over the testing range.2 Additionally, a clinical study with 85 consecutive patients revealed that there was no statistically significant difference between thresholds obtained by SHOEBOX and traditional audiometry.3
Children’s Hospital of Eastern Ontario, University of Ottawa, Grand Challenges Canada’s Stars in Global Health program, Mayo Clinic
General iPad safety guidelines can be found here
Otoscopes, hearing aids.
1.Rourke, R., Kong, D.C., Bromwich, M. Tablet Audiometry in Canada’s North: A Portable and Efficient Method for Hearing Screening.Otolaryngol Head Neck Surg. 2016 Sep; 155(3): 473-8.
2.Thompson, G. P., Sladen, D. P., Hughes Borst, B. J., Still, O. L. Accuracy of a Tablet Audiometer for Measuring Behavioral Hearing Thresholds in a Clinical Population. Otolaryngol Head Neck Surg. 2015 Nov; 153(5): 838-842.
3.Yeung, J., Javidnia, H., Heley, S., Beauregard, Y., Champagne, S., Bromwich, M. The new age of play audiometry: prospective validation testing of an iPad-based play audiometer. J Otolaryngol Head Neck Surg. 2013 Mar; 42(1): 21.
Clinical validation studies.
SHOEBOX Audiometry is a recipient of the Grand Challenges Canada award. SHOEBOX Audiometry also won an award for the best technolgoical innovation for care delivery at the Canadian Association of Pediatric Health Centers Innovation Showcase.
Contact ShoeBox for a free trial.
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