Assessing the Effectiveness of the hearWHO Application in Rapid Screening of Hearing Loss Among Military Personnel of the Philippine Air Force

Charisse Genevieve S. Mulles, Angelica Patricia P. Muñoz, Gaston Miguel B. Mutuc, Alyssa Louise A. Naguit, Alyza Jane H. Nalagon, Kristine Kaye M. Nantin, Norberto V. Martinez, Eva Irene Y. Maglonzo

Dec 2025 DOI 10.35460/2546-1621.2024-0036     Access   

Abstract

Rationale/Background: Hearing loss is a significant global issue, particularly affecting low- and middle-income countries like the Philippines, where low awareness and diagnosis rates prevail. Exposure to frequent loud noises, such as in military training, along with less recognized risks from firearms and aircraft, make military personnel highly susceptible to hearing damage. The hearWHO mobile application, introduced in 2019, shows promise as a rapid screening tool in these settings, potentially improving accessibility and increasing awareness of the challenges in managing hearing health.

Objectives: This study evaluated the effectiveness of the hearWHO application in rapid screening of hearing loss among Philippine Air Force military personnel and verifies its results with Pure Tone Audiometry. It aimed to establish baseline data for future research on technological advancements in otolaryngology.

Methodology: The study employed a cross-sectional design and recruited 44 volunteer subjects from the Philippine Air Force using inclusion criteria. Six participants withdrew due to an urgent mission, leaving 38 subjects who were screened using the hearWHO application and subsequently tested with Pure Tone Audiometry. A statistician analyzed the collected data.

Results: A one-sample t-test revealed negative mean differences between hearWHO and Pure Tone Audiometry results indicating that they were not significant. Confounders such as testing room location, use of adapters and non-purposive sampling may have affected the results.

Conclusion: The results suggested that the hearWHO application was not effective in rapid screening of hearing loss among the military personnel of the Philippine Air Force.

Keywords: hearWHO, Rapid screening, Hearing loss, Military personnel, Philippine Air Force

  1. Newall JP, Martinez N, Swanepoel DW, McMahon CM. A national survey of hearing loss in the Philippines. Asia Pac J Public Health [Internet]. 2020;32(5):235–41. Available from: http://dx.doi.org/10.1177/1010539520937086 
  2. Gonzalez-Gonzalez S. Noise-induced hearing loss and tinnitus in military personnel. Matthews Journal of Emergency Medicine. 2017 Dec 29;2(2):1–6.
  3. Chen S-M, Fan Y-T, Martinez RM, Chen C. Noise-induced hearing loss profile among Taiwan Airforce on duty pilots. Am J Otolaryngol [Internet]. 2023;44(3):103802. Available from: http://dx.doi.org/10.1016/j.amjoto.2023.103802
  4. Kuo C-Y, Hung C-L, Chen H-C, Shih C-P, Lu R-H, Chen C-W, et al. The immediate and long-term impact of military aircraft noise on hearing: A cross-sectional comparison of fighter pilots and ground staff. Int J Environ Res Public Health [Internet]. 2021;18(6):2982. Available from: http://dx.doi.org/10.3390/ijerph18062982 
  5. Yong JS-E, Wang D-Y. Impact of noise on hearing in the military. Mil Med Res [Internet]. 2015;2(1):6. Available from: http://dx.doi.org/10.1186/s40779-015-0034-5 
  6. Wells TS, Seelig AD, Ryan MAK, Jones JM, Hooper TI, Jacobson IG, et al. Hearing loss associated with US military combat deployment. Noise Health [Internet]. 2015;17(74):34–42. Available from: http://dx.doi.org/10.4103/1463-1741.149574 
  7. Swanepoel DW, De Sousa KC, Smits C, Moore DR. Mobile applications to detect hearing impairment: opportunities and challenges. Bull World Health Organ [Internet]. 2019;97(10):717–18. Available from: http://dx.doi.org/10.2471/BLT.18.227728
  8. De Sousa KC, Swanepoel DW, Moore DR, Myburgh HC, Smits C. Improving sensitivity of the digits-in-noise test using antiphasic stimuli. Ear Hear [Internet]. 2020;41(2):442–50. Available from: http://dx.doi.org/10.1097/AUD.0000000000000775
  9. Nayak S, Blumenfeld NR, Laksanasopin T, Sia SK. Point-of-care diagnostics: Recent developments in a connected age. Anal Chem [Internet]. 2017;89(1):102–23. Available from: http://dx.doi.org/10.1021/acs.analchem.6b04630
  10. Stenfelt S, Janssen T, Schirkonyer V, Grandori F. E-health technologies for adult hearing screening. Audiol Res [Internet]. 2011;1(1):e14. Available from: http://dx.doi.org/10.4081/audiores.2011.e14 
  11. Davalbhakta S, Advani S, Kumar S, Agarwal V, Bhoyar S, Fedirko E, et al. A systematic review of smartphone applications available for corona virus disease 2019 (COVID19) and the assessment of their quality using the Mobile Application Rating Scale (MARS). J Med Syst [Internet]. 2020;44(9):164. Available from: http://dx.doi.org/10.1007/s10916-020-01633-3 
  12. Suso-Ribera C, Castilla D, Zaragozá I, Ribera-Canudas MV, Botella C, García-Palacios A. Validity, reliability, feasibility, and usefulness of pain monitor, a multidimensional smartphone app for daily monitoring of adults with heterogeneous chronic pain. The Clinical Journal of Pain. 2018 Apr;34(10):1.
  13. Kutz JW. Audiology Pure-Tone Testing: Overview, Indications, Contraindications [Internet]. Meyers A, editor. Medscape.com. 2019. Available from: https://emedicine.medscape.com/article/1822962-overview 
  14. Walker JJ, Cleveland LM, Davis JL, Seales JS. Audiometry Screening and Interpretation. American Family Physician [Internet]. 2013 Jan 1;87(1):41–47. Available from: https://www.aafp.org/pubs/afp/issues/2013/0101/p41.html 
  15. McCartney M. How do we know whether medical apps work? BMJ [Internet]. 2013;346(mar20 1):f1811. Available from: http://dx.doi.org/10.1136/bmj.f1811 
  16. Acharya AS, Prakash A, Saxena P, Nigam A. Sampling: why and how of it? Ind J Med Spec [Internet]. 2013;4(2). Available from: http://dx.doi.org/10.7713/ijms.2013.0032

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.