SHOEBOX Audiometry

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

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

General iPad safety guidelines can be found here