Reasons and motivations for remote testing
The need for remote testing began prior to 2020, however, it has now been accelerated due to the COVID-19 global pandemic. Lab closures or restrictions on in-lab testing due to quarantine or social-distancing recommendations have forced many investigators to decide between suspending progress of human-participant research and turning to alternatives to in-lab data collection such as meta-analyses, use of computational models, and remote testing of human participants.
Access to rare populations
Previous remote testing needs have included testing individuals in rural populations and recruitment of rare populations. Specifically, researchers and hearing healthcare providers may need to reach clinical patients and potential research subjects located in different counties or even states from specialized health care clinics and research laboratories. Often, financial stipends may be offered in these situations to incentivize the patients or research subjects to travel to specialized clinics and laboratories. However, there are many situations where even stipend travel is not justified. Families with young children and caregivers for older adults with mobility and health issues or individuals with special needs may not be able to visit specialized clinics and laboratories. Additionally, patients and research subjects at a distant location may only be able to make the trip once and would be unable to participate in studies requiring multiple visits or longitudinal components.
While there are obvious benefits in testing rare clinical and rural populations, there are also many conveniences in remote testing for families. Families with multiple children have very busy schedules and are often unable to work around parents work schedules, multiple children’s school schedules, and extra-curricular activities. Additionally, many families may be caring for their elderly parents or other dependents with various mobility or other needs. All of these scenarios may cause appointments to be delayed or limit the amount of in-person testing completed per visit, particularly if testing locations include commutes with excess traffic and poor parking. The ability to test remotely would be convenient for families and caretakers and could potentially be more efficient when several transportation related barriers are eliminated in the process.
Remote applications of auditory research and select clinical audiology services may begin to alter how people think about their hearing healthcare in the future. Mobile applications of hearing tests have been developed and refined for decades catered mostly to industrial audiology applications in accordance to the Occupational Safety and Health Administration (OSHA) regulations for hearing conservation programs. However, patient-oriented healthcare for personal use has been expanding in recent years. Unmonitored hearing tests are far from gold standard audiological testing, but it could be argued that access to mobile pure tone testing at home or at locations such as pharmacies could help identify those with hearing loss before they are ready to visit an audiology clinic. In terms of patient care, there may be unexplored auditory analogies to white coat hypertension that researchers and clinicians are unaware of due to the constrained current diagnostic hearing testing protocol. However, monitoring the ambient and other noises in a mobile test environment is potentially much more complex than other patient-centered healthcare applications.
Motivation for remote testing of hearing currently vary from continuing research testing outside of the laboratory to remote clinical applications including hearing device fittings and adjustments as well as aural rehabilitation or auditory training plans. During this period of COVID-19, most researchers and clinicians simply hope to continue their research data collection to improve clinical practice and to minimize the disruption of safely diagnosing and treating their patients. Conducting research experiments and treating clinical audiology patients in the comfort of their homes is in everyone’s best interest during a global pandemic. Further, lessons learned from remote testing now may open opportunities for more efficient data collection and more realistic hearing healthcare in the future.
Remote testing can also be used to support data collection in real-world environments, which may be an important issue for some questions of ecological validity. Longitudinal studies or trials of at-home training paradigms could also benefit from robust approaches to remote testing with online or portable platforms. Future developments aimed at enhancing the rigor and robustness of at-home tests could pay significant dividends for a wide variety of studies which might be freed from lab-based constraints and therefore achieve greater validity in terms of the listening environment, sampled population, etc.