Teleaudiology for Hearing Assessments

Key Messages

• Teleaudiology can offer hearing and ear care to people, including those living in areas where there are shortages of qualified audiologists and hearing instrument practitioners.
• There is a need to evaluate the potential benefits and harms of teleaudiology to ensure that all people receive high-quality ear care, regardless of their place of residence. There is also a need to evaluate the diagnostic test accuracy of teleaudiology compared with in-person ear assessment across various ear conditions. Given the growing use of teleaudiology, it is also important to identify and critically assess the quality of evidence-based guidelines that provide recommendations on teleaudiology for hearing assessments.
• Understanding the available evidence base is essential to support evidence-informed clinical practice, support equitable access to hearing care, and guide decisions regarding the implementation and use of remote assessment technologies.
• Canada’s Drug Agency conducted a rapid review to identify and summarize evidence that compared the clinical effectiveness and diagnostic test accuracy of teleaudiology to in-person ear assessments.
• We also sought to identify and summarize evidence-based guidelines for the use of teleaudiology.
• We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published between January 1, 2016, and April 24, 2026.
• Importantly, the purpose of this Rapid Review is to summarize and critically appraise the available evidence on the topic, but it does not provide formal recommendations.
• We did not find any studies comparing comprehensive teleaudiology to comprehensive in-person ear assessments in children or adults, and we did not find any evidence-based guidelines for teleaudiology.
• We identified 4 studies addressing diagnostic test accuracy or related measurement agreement outcomes of teleaudiology versus in-person audiological assessment for diagnosing medical conditions of the ear:
  • In children (1 study), teleaudiology results were similar to in-person assessment results, showing acceptable agreement for hearing tests, including air and bone conduction pure-tone audiometry, otoscopy, and tympanometry assessments.
  • In adults (3 studies), teleaudiology produced hearing assessment results that were comparable to those of in-person testing, with similar hearing thresholds, word recognition, and speech reception results.
  • In adults (1 study), teleaudiology showed high sensitivity and specificity for hearing loss (HL), defined as a hearing threshold of 30 dB or higher or 40 dB or higher. This means the tablet audiometer used in this study was good at correctly detecting people with HL and correctly classifying most people with normal hearing.
• Two included studies used devices approved for use by Health Canada for teleaudiology assessments (3 devices in total). The effectiveness of these devices across diverse settings and populations in Canada is uncertain.
• The included studies had important limitations, including incomplete hearing assessments, risk of bias, small sample sizes, and limited available participant characteristics. This limits the interpretation and generalizability of findings.
• Teleaudiology may be an accurate alternative for diagnosing HL in adults and children and for conducting otoscopy and tympanometry in some children, particularly those older than 4 years. However, due to the small number of studies, underpowered sample sizes, risk of bias, and in some cases applicability concerns, the confidence in the findings is low.
• Implementation should be balanced against current evidence limitations, resource implications, equity considerations, and clinical practice in the context of Canada.