Online hearing tests seem like an attractive, easy option to assess your hearing and check for any problems. Plug in your headphones or earbuds and react to sounds that you hear, and the website will spit out your results, giving you good results that you can then act on, presumably with the help of a professional. But there are several obstacles that make online hearing tests unreliable — so much so that they are useless. Non-professional equipment and poor acoustics make for inaccurate testing. While in-person hearing tests combine pure-tone testing with other specialized tests to gain a more comprehensive picture of the health of your ears. If you’re experiencing issues with your hearing or just want to make sure that you are experiencing the world and conversations in the best way possible, the only option is to go in for a professional hearing test.
Online hearing tests are a form of pure-tone air conduction testing, where the patient hears a range of frequencies through headphones and confirms which sounds they can hear. Then, with the responses to different frequencies, a hearing threshold level is established, which shows the levels of hearing ability or loss at those different frequencies. But these tests are really only useful for determining hearing sensitivity, without the further examination necessary to identify the specific problem.
This might seem obvious, but the quality of sound and acoustics are hugely important to the success of a hearing test. Audiologists have high-quality headphones designed for hearing tests so that they can get the most precise sounds, and therefore, the best results. Amateur headphones, cheap Apple earbuds, or, worst-case scenario, device speakers, are all inadequate ways to listen to the test, which needs to be broadcasted accurately to ensure correct results. Professional audiologists also have specific soundproof testing rooms, so that the sounds heard from the professional equipment can be heard accurately. At home, there can be issues with the acoustics of the room or ambient background noise which can affect the results of the test. The tones heard during the test need to be very precise so that the results can be accurately interpreted. Combine non-professional hearing technology with bad acoustics, and you can see that the test is not very accurate or reliable.
A huge benefit of going for an in-person hearing test is having a professional audiologist guide you through the process and evaluate the test results. Doctors will ask you about medical history and can explain some possible issues that might arise. For example, if you were taking the online hearing test, but had tinnitus, the results could be skewed. But an audiologist would go through your medical history, asking, for example, if you work at a job with a lot of loud noises. Then they would identify the possibility of tinnitus and adjust the test accordingly. In addition, you can ask any questions you’re wondering about and get an expert response. If you’re taking a hearing test, you probably are experiencing some problems. What better way to address these problems than with a professional who can investigate as an expert, as well as having an expert to ask your specific question.
Otoscopy is another important part of a hearing test that you can’t do at home. An otoscopy is a visual examination of the ears and ear canals, performed with the otoscope, which is that magnifying glass on a handle that a doctor uses to look into your ear. These examinations look for blockages or infections that can lead to pain and hearing loss–like acute otitis media, perforation of the tympanic membrane, and cholesteatoma–but would not be otherwise evident from a simple pure-tone hearing test.
Part of the comprehensive professional hearing test is the bone conduction test. Bone conduction tests work in conjunction with pure tone tests to identify where exactly a hearing problem is located. In this test, a device is placed directly on the patient’s head, and the device vibrates, sending sound directly to the cochlea, bypassing the outer and middle ear. If the results from the pure tone and bone conduction tests are the same or close, the problem is with the inner ear — called sensorineural hearing loss — since the results from the whole ear pure tone test match the results from the test of only the inner ear. If the results are different, then the problem must be with the outer or middle ear, and more testing is needed to be able to specifically determine the location and nature of the problem. You just can’t do this with headphones and a website.
Accurate interpretation is another benefit of going to a professional audiologist for your hearing test. Ignoring the technical issues with taking an online hearing test at home, the results just won’t get you very far. They might show that you are experiencing hearing loss, but not what is causing the problem. As noted, otoscopy and bone conduction tests are further needed to identify the specific cause of the problem. Also, these more in-depth tests can identify problems that would not show up on a simple air conduction pure-tone test, like cholesteatoma or perforations in the tympanic membrane.
You wouldn’t want to take a yearly physical online. You want to be there, with a doctor to guide you through the whole process and the proper equipment to best carry out the necessary tests. Online hearing tests are the same way — you wouldn’t want to do it at home, without professional guidance. Plus, without using proper headphones, bone conduction equipment, and soundproofing, the testing is doubtful anyway. If you’re going to take a hearing test, there’s no reason to risk inaccurate or incomplete results just for the ease of doing it online.