Guidance for testing, results interpretation, trends, and data management.
Purpose
Menieres Biometrics takes audiograms and stores results for review and analysis. It can be used by anyone who wants
to track hearing levels over time, but it was written with Meniere's disease patients in mind. Meniere's
patients generally exhibit the "Meniere's triad": hearing loss, vertigo, and tinnitus. Menieres Biometrics tracks
hearing loss and provides a log where you can record vertigo events and changes in tinnitus. The key
output is a "trends" plot that shows hearing changes over time, along with indicators of the items in the event
log, visually illustrating the correlations between hearing level, vertigo, and other logged events. You can also
include weather (temperature, pressure, and humidity) on the trends plot, to help determine if weather affects
your symptoms.
Using Menieres Biometrics is a long-term investment. The trends plot will mean little when it covers only a few days.
Patterns will only become evident when hearing levels have been observed over an extended period,
covering several periods of disease activity and inactivity.
Menieres Biometrics is focused on providing a record of the variation in hearing levels over time.
Absolute hearing levels will be much less accurate. Having a record of hearing variation over time may help you
answer several questions:
Did a particular treatment improve your symptoms?
Did a particular event trigger symptoms?
Can monitoring your hearing level help you predict vertigo attacks?
Menieres Biometrics is NOT a medical device and is NOT intended for medical diagnosis, treatment, or monitoring of any medical condition. This app has NOT been evaluated or approved by the FDA or any other regulatory agency.
Menieres Biometrics can give a good indication of hearing level progression over time, but test results won't have the accuracy of a professional audiogram. Results will be affected by the equipment being used, external sound interference, and potentially by user error or software programming errors. Many Meniere's patients have unilateral disease and are understandably concerned about signs of bilateral disease. A professional audiogram may detect bilateral symptoms before Menieres Biometrics, so don't rule out bilateral disease based on Menieres Biometrics results. If precise hearing measurements are needed, please see an audiologist.
DO NOT use Menieres Biometrics for emergency medical decisions. If you experience sudden hearing loss, severe vertigo, or any other medical emergency, seek immediate medical attention from a qualified healthcare professional.
This app is provided for informational and tracking purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
By downloading, installing, or using Menieres Biometrics, you agree to be bound by these Terms of Service ("Terms"). If you do not agree to these Terms, do not use the app.
License Grant
Menieres Biometrics LLC grants you a limited, non-exclusive, non-transferable, revocable license to use the app for personal, non-commercial purposes in accordance with these Terms.
Acceptable Use
You may use Menieres Biometrics to:
Track your personal hearing level changes over time
Log personal health events and symptoms
Generate personal reports for your own reference
Export your personal data for backup or sharing with healthcare providers
You may NOT:
Use the app for commercial purposes or medical diagnosis
Reverse engineer, decompile, or modify the app
Distribute or sell the app or its components
Use the app in violation of any applicable laws or regulations
Medical Disclaimer and Limitation of Liability
MENIERES BIOMETRICS IS PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NONINFRINGEMENT.
THE APP IS NOT A MEDICAL DEVICE AND SHOULD NOT BE USED FOR MEDICAL DIAGNOSIS, TREATMENT, OR MONITORING. THE DEVELOPERS OF Menieres Biometrics ARE NOT MEDICAL PROFESSIONALS AND THE APP DOES NOT PROVIDE MEDICAL ADVICE.
IN NO EVENT SHALL THE DEVELOPERS, OWNERS, OR LICENSORS OF MENIERES BIOMETRICS BE LIABLE FOR ANY CLAIM, DAMAGES, OR OTHER LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT, OR OTHERWISE, ARISING FROM, OUT OF, OR IN CONNECTION WITH THE APP OR THE USE OR OTHER DEALINGS IN THE APP. THIS INCLUDES, BUT IS NOT LIMITED TO, ANY MEDICAL DECISIONS MADE BASED ON APP RESULTS, DATA LOSS, OR DEVICE DAMAGE.
Indemnification
You agree to indemnify and hold harmless the developers, owners, and licensors of Menieres Biometrics from any and all claims, damages, liabilities, costs, and fees (including reasonable attorney's fees) arising from your use of the app or violation of these Terms.
Termination
We reserve the right to terminate or suspend your access to the app immediately, without prior notice, for conduct that we believe violates these Terms or is harmful to other users, us, or third parties, or for any other reason at our sole discretion.
Governing Law
These Terms shall be governed by and construed in accordance with the laws of the state of Georgia, without regard to its conflict of law principles.
Dispute Resolution
Any disputes arising from these Terms shall be resolved through good faith negotiations between the parties. If a resolution cannot be reached, the dispute shall be resolved in the appropriate courts located in Georgia.
Severability
If any provision of these Terms is found to be unlawful, void, or unenforceable, that provision shall be deemed severable from these Terms and shall not affect the validity and enforceability of any remaining provisions.
Entire Agreement
These Terms constitute the entire agreement between you and Menieres Biometrics LLC regarding the use of the app and supersede all prior agreements, communications, and understandings.
User Comments: Notes and descriptions you add to events may contain personally identifiable information (PII) such as names, locations, or other personal details
Diary entries: Subjective symptom and lifestyle factors, along with any text description you choose to enter
Weather Samples: Local temperature, humidity, and pressure derived from approximate
device location, used only for plotting and CSV export
Device Information: Android device model, OS version (for compatibility purposes)
With the exception of device information, all data is stored locally on your device. We do not transmit,
sell, or share your personal health data with
third parties. You are solely responsible for the content of any PII you choose to include in event
comments or diary entries.
Data Storage and Security
Local Storage: All data is stored locally on your device using Android's standard storage
mechanisms
Automatic Backups: On most devices, Android may automatically back up app data (including
hearing test results, events, and diary entries) to your Google account if system backups are enabled. Backups and restore are
operated by Android/Google, not by Menieres Biometrics. You can control backup in system settings for your device or
for this app.
Manual Backups: You can export CSV files for your own records or sharing. Exported CSV
files are unencrypted and beyond the app's control.
Data Format: Data is stored in a SQLite database using Room persistence library. The app does not implement additional encryption beyond any device-level encryption you may have enabled
No Server Storage: We do not maintain servers or databases containing your personal health information
Export Limitations: Security protections apply only to data stored within the app. Exported CSV
files are unencrypted and beyond the app's control
Data Retention
Your data remains on your device until you choose to delete it. You can delete individual test results, events,
or all app data through the app's interface. When you uninstall the app, all locally stored data is removed from
the device. If Android's automatic backup is enabled, copies may be stored in your Google backup and restored to
new devices until you disable backup or delete the backup in your Google account settings.
Data Security Warning: Standard app uninstallation removes app data from normal access, but may not prevent forensic recovery of sensitive health information. If you plan to sell, give away, or dispose of your device, perform a factory reset and consider using secure data wiping tools to ensure complete removal of all personal data. For maximum security, physically destroy storage media.
Exported Data and Backups: When you export data or create backups, exported CSV files are saved
as unencrypted files. Once exported, these files are beyond the control of Menieres Biometrics and may be
shared, copied, or stored in locations with different security practices. You are responsible for securing any
exported data and should consider using encryption or secure storage. Exported data includes any user-entered
comments, which will be readable by anyone viewing the exported data.
Shared Devices and Multiple Users
Your hearing test results and other app data are stored privately on your device under your Android user account.
If your device supports multiple user accounts (common on tablets and some phones), each Android user maintains
completely separate app data. Your audiograms, events, diary entries, and settings are not visible to other
Android users on the same device.
For privacy, avoid sharing your Android account credentials with others. If multiple people share the same
Android user account, they will have access to all app data stored under that account, including hearing test
results and any personal information entered in event comments or diary entries.
User Rights and Data Control
You have the following rights regarding your data:
Access: View all your stored test results and events within the app
Modification: Delete test results and edit or delete event log entries
Deletion: Remove all app data through device settings or app controls
Data Portability: Export your data in CSV format for use in other applications
Backup Control: Complete control over when and where to back up your data
International Compliance
GDPR: For users in the European Union, this app processes data under the legitimate interest basis for providing the requested service. You maintain full control over your data.
CCPA: For California residents, this app does not sell personal information. All data is stored locally on your device, giving you complete control over your data. You can view and delete your data directly through the app's interface at any time. Since Menieres Biometrics does not maintain a central database or server storage of user data, there is no separate process to request data deletion from us.
Children's Privacy: This app is not directed to children under the age of 13. We do not knowingly collect personal information from children under 13.
Data Security Measures
All sensitive health data is stored locally on your device
No internet connectivity required for core functionality
Optional, consent-based Firebase Analytics is used only for anonymous usage statistics
(for example, counting completed audiograms). It collects no test thresholds or PII.
Changes to This Policy
We may update this privacy policy from time to time. The updated policy will be available within the app and will indicate the effective date.
Menieres Biometrics uses Google Firebase Analytics to collect anonymous usage statistics to help improve the app.
We only track minimal events, such as a count of completed audiograms. We do not collect your test thresholds,
event notes, or any personally identifiable information (PII) through analytics.
Consent and regional defaults
Analytics is opt-in for users in the European Economic Area (EEA), United Kingdom, and
Switzerland. For other regions (for example, the United States), analytics may be enabled by default. In all
cases, you remain in control and can change your choice at any time from the Settings screen.
What is sent
Minimal usage events (for example, audiogram completed)
Device-level metadata required by Firebase (for example, app version) for aggregate reporting
Not sent: audiogram threshold values, event log contents, diary notes, names, locations, or any
PII that you may enter elsewhere in the app
Advertising signals
Menieres Biometrics does not show ads. We do not enable ad personalization, and we deny ad personalization and
ad user data consent in Firebase Analytics.
How to change your choice
Open the Settings screen and toggle Share anonymous usage statistics on or off. Changes take
effect immediately.
Having hearing loss doesn't mean your ears are immune to damage from loud sounds. Please be careful while
running a test not to expose your ears to excessive sound levels. This could happen, for example, with faulty
audio connections. It could also happen if you have severe hearing loss at certain frequencies. The sound level
required for you to hear those frequencies might be loud enough to damage your ears. There's no way for
Menieres Biometrics to know if this is
the case with your ears or your audio equipment, so please use your judgment and safeguard your hearing.
Avoid leaving sound on for extended periods. In particular, be careful not to fall asleep during a test!
If a loud tone is playing it could continue playing, potentially damaging your hearing. The app should
stop playing sound after a few minutes, or when the phone goes idle, but these safety measures shouldn't
be your first-line defense against exposing your ears to excessive sound levels, or to any sound levels for an extended
period.
To get the best test results requires a good audio headset. Please read the Equipment
section. If this is the first time you've used Menieres Biometrics you may want to test it with whatever earbuds or
headphones you already have. If you already have good headphones, you're all set. If you are testing with
sub-optimal equipment, that is fine for learning what Menieres Biometrics does, but you are strongly encouraged to
get more ideal equipment quickly. The reason is simple: the key output of Menieres Biometrics is a record of how your
hearing has changed over time. Different headsets may differ in amplitude response by a surprisingly large
amount, so switching equipment will corrupt the trends plot -- it will be displaying the change in the
frequency/amplitude response of your headsets rather than changes in your hearing.
Consistency is crucial, so as soon as possible you should select a good headset and use that
for all subsequent tests.
The main Menieres Biometrics screen has five tabs: Test, Results, Events, Diary, and Trends. In normal use you would go to the
Test tab and take an audiogram on a frequent basis (daily is recommended). You can then go to the Results tab
to view the test results. On the Events tab you can enter any events you want to record, including vertigo
episodes, tinnitus changes, and medication changes. The Diary tab allows you to track symptoms, lifestyle factors, and other personal data that may help identify patterns and triggers. Lastly, on the Trends tab you can view changes in your
hearing over time, and observe correlations with logged events and diary data. If you're just getting started with Menieres Biometrics
your ability to see the functionality of the different tabs will be limited: there will be no test results or
events to view on any of the tabs. So to get started, the first thing to do is to record an audiogram. See
How to run an audiogram for a description of how to take and store an audiogram.
After completing an audiogram, you can go to the Results tab to view it. You can also start entering events
on the Events tab, but normally you would only enter events as they happen. For example you would add an event
for a vertigo attack, though presumably after the attack has passed. If you kept a record elsewhere of when you
had vertigo, or started or stopped medication, etc., you can enter those in the Events log too.
After you've taken several audiograms you can go to the Trends tab and view hearing changes over time.
This generally won't be very informative until you've been taking audiograms for an extended period, perhaps
a month or more, depending on characteristics of your particular hearing progression.
Onboarding provides a short tour of Menieres Biometrics when you first install the app. A set of cards appears on top
of the main screen, explaining what each tab does and suggesting next steps.
The onboarding cards cover the main parts of the app:
Welcome: Very short introduction to Menieres Biometrics.
Test: Explains that you take audiograms on the Test tab and provides a guided test.
Results: Describes the list of stored audiograms and how to view an individual test.
Events: Explains how to log vertigo attacks, medication changes, and other events.
Trends: Shows how to view hearing trends and overlay events on the plot.
You can move between cards using the Next button. On cards after the first, a
Back button lets you return to the previous card. The Skip button closes the
onboarding cards without affecting any of your data.
Guided test walkthrough
On the Test onboarding card there is an option to start a guided test. This switches to the Test tab and shows
a guided overlay that highlights key controls such as the Start/Stop button, volume adjustment
buttons, the Blind test button, and the Set Threshold button.
The guided test overlay uses yellow outlines around the controls and an instruction card at the top of the
screen. Use Next and Back to move between the steps, or Skip
to exit the overlay. The guided test is "live" -- you can leave the tour cards active while performing an actual test.
Upon completing the test you can save the result and continue to the other tabs, such as the Results tab, where you can
view the test results.
Showing onboarding again
After you finish or skip onboarding, Menieres Biometrics will open directly to the main screen. You can show the
onboarding cards again at any time from the menu. Tap the menu button (three horizontal lines) in the
top-right corner and choose Show Onboarding.
The only equipment required (other than an Android phone) is a good headset for playing sounds. For obvious
reasons a phone's built-in speaker is inappropriate for hearing tests. While earbuds are usable, a proper
over-the-ear headset is recommended. These are sometimes called "circumaural" or "around-ear".
Furthermore, it is best to avoid Bluetooth connections or headsets with noise-cancellation features unless the
noise cancellation can be fully disabled. The goal is to provide high quality sound and very consistent
test-to-test repeatability. Earbuds may provide high quality sound, but might be more prone to amplitude
variation based on the exact placement of the earbud in the ear. So one test may read higher or lower than
other tests simply due to minor differences in earbud placement. Some Bluetooth earbuds or headsets may
be perfectly adequate, but a little extra caution may be necessary. Bluetooth audio equipment often includes
additional processing that could degrade accuracy in a pure-tone test such as an audiogram. Menieres Biometrics
will issue a warning when a test is started with Bluetooth (unwired) audio. This warning message can be suppressed in
app settings.
Philips SHP 9600 headphones are an example over-the-ear design (this isn't an endorsement and we
don't receive a commission for this mention). This headset uses an "open back" design, which doesn't isolate
external sounds,
so a quiet environment is necessary. A "closed-back" design would be more appropriate if you don't have a quiet
place to take audiograms. Furthermore, if one ear is far better than the other, an open back design may allow your
good ear to hear the tones intended for your other ear, making proper threshold determination difficult. Audiologists
often use noise masking for this (playing noise in the opposite ear). Menieres Biometrics doesn't currently have the
capability to apply noise masking. In short, an open back design may provide better sound quality but allows
external noise. A closed-back design provides better isolation from external sounds. Depending on design,
earbuds may also offer good isolation.
For best results you should use headphones with a flat frequency response. This means that all frequencies
are played with approximately equal amplitude. So you should avoid headphones that have features such
as "bass boost" or other sound modifications. In general, headphones that are labelled "studio monitor"
or "studio reference" will have a flatter response.
If you wear hearing aids, remove them prior to taking a hearing test. Do not use the hearing aids in place of
a good headset, even if your aids link to your phone: the aids will vary in volume and frequency response such that
results will vary with hearing aid settings, making analysis of hearing trends difficult or impossible.
Note that the standard 3.5mm headphone jack is becoming much less common on phones, but is still common on
headsets, so you will likely need to use a USB-C to 3.5mm converter. This of course won't be needed if your
headset has a USB connector, or other connector that fits your phone.
One last concern: very high quality headsets often have lower sensitivity, or higher impedance, than lower
quality headsets. This means they require more
signal amplification to produce a given sound level. The result is that some headsets would have trouble
producing sounds loud enough to measure higher levels of hearing loss. For example, if you have substantial
hearing loss, perhaps 60 to 80 dB or more, at a given frequency a high impedance / low sensitivity
headset may be unable to
produce a sound loud enough for you to hear, rendering the audiogram invalid at that frequency. So it is
advisable to test a headset before purchase, or to buy a headset that can be returned if it proves to be
inadequate. As a general rule, if a headset can play music on your phone at a level that a listener with normal
hearing would consider to be fairly loud, the headset is likely to be usable for audiograms.
Results: Provides a list of stored audiograms; plots selected results.
Events: Provides a way to log vertigo attacks, medication changes, and other relevant events.
Diary: Track symptoms, lifestyle factors, and other subjective data that may correlate with your condition.
Trends: Provides a plot summarizing hearing levels and events.
Test Tab
The test tab is where you generate audiograms. Audiograms are self-administered: upon starting an audiogram you will step
through the different frequencies, adjusting the volume and hitting
Set Threshold at the minimum detectable volume. After finding the threshold for all frequencies and both ears
you will normally save the results and perhaps create a backup copy.
Taking an audiogram, short description
Click Start audiogram, and respond to any messages that appear. Then adjust the volume using the
+ and - buttons
until the sound is just
barely audible. Do not adjust the sound using your phone's volume control. You may want to hit +10
or -10 for
more rapid adjustment. In particular, your first test will start at a very low volume, possibly requiring
multiple +10 presses to get to an audible level. When the signal is just barely audible, hit
Set Threshold,
which will store that threshold and advance to the next frequency and ear. Upon setting the threshold for
the last test (10 kHz, right ear) you'll be prompted to save the results. Save the results, and you should then
be able to switch to the results tab and view the audiogram.
Taking an audiogram, detailed description
To start a new audiogram, press the Start audiogram button. This will usually produce a popup screen
requesting that the phone's
audio volume
be set to its maximum. This is necessary to provide consistent sound levels from one test to the next.
The app adjusts the sound level during a test by varying the tone amplitude, not by adjusting the system volume.
After a test is complete the system volume will be set to its prior level. The popup screen can set the
volume to the maximum level for you. You may also get a warning message if you're using a headset that may be
deficient, for example if you're using the system speaker. You can continue the test, but accuracy may be poor.
Once you've set the volume, you can continue with the test. For each frequency and ear you should adjust the sound level
by hitting the + and - buttons. The goal is to adjust the volume so that the given tone is
just barely audible.
When you have adjusted the volume to the just-audible level, press Set Threshold.
To avoid sudden loud sounds, for the very first test the volume will be set to a
low level. You will likely need to hit the +10 button several times before hearing any sound. In subsequent tests,
the volume automatically starts 10-20 dB below your last threshold for that frequency and ear. This random offset
prevents you from being biased by previous tests.
Pressing Set Threshold sets the threshold for the given ear and frequency. Later you can view audiogram
results on the
Results tab, but data for a test won't be available until an audiogram is completed and saved. Upon hitting
Set Threshold the test will advance to the next ear or frequency. You may notice that after pressing
Set Threshold
the button is immediately disabled. This prevents an inadvertent double-press, which would set the
threshold for both the intended ear/frequency and for the subsequent (unintended) one. Hitting any of the volume
adjustment buttons will re-enable the Set Threshold button.
If you mistakenly hit Set Threshold before intending to, you can use the arrow buttons to the right of the
frequency
list to move back to the erroneous test. You can then continue as before: adjust the volume and tap Set Threshold.
Upon hitting Start audiogram you'll see that the Start tone button is now labeled
Stop tone. This button turns
on and off the tone temporarily -- it doesn't halt a test. It is common to press Start and Stop multiple times
during a test, to help you determine if you're actually hearing the test tone, rather than mistaking tinnitus for
the tone. When in the stopped state the volume buttons are disabled.
The Blind test button allows you to do a blind test of the current tone and volume. It will randomly turn the
tone on or off and ask you to indicate whether or not you think the tone is on. It then shows if you correctly detected
the on/off state. The test repeats automatically until you hit Close.
If you are often incorrect, then you may have the volume below your true hearing threshold. If it's
extremely easy to tell if the sound is on or off, then you probably have the volume too high. Note that this
is just to help you set the threshold for the current frequency and ear. It doesn't change the tone volume or adjust thresholds,
and it doesn't affect the general test process.
Furthermore it isn't a required part of testing -- you can run a full test without ever using the blind test.
As you proceed through the individual frequencies the "L" and "R" markers for the completed frequencies will be marked
and the current frequency will be highlighted.
Between the - and + buttons there is a volume indicator displayed as a simple
red shaded box, where the intensity changes with changes in volume. This should give you some indication of the varying
volume without biasing your threshold determination.
At the end of each audiogram, i.e. after all frequency/ear combination thresholds have been set, you will be prompted
to save the results. In almost all cases you would save the result. The only time you wouldn't would be if for
some reason you know the test to have been bad. If you know that a single threshold had been improperly set you
could go back to that frequency/ear combination and set the threshold properly. At that point you won't be
automatically prompted to save the test, but can manually hit the Save result button at the top right of the
screen.
Once you have saved an audiogram there is no way to edit it. You can delete it and re-run an entire audiogram,
but there's no way to edit just a frequency or two. Normally there should be no need to edit audiograms. As
mentioned above, if you know an individual threshold was improperly set, you can modify it prior to saving the
audiogram. Once you've saved it, editing is no longer possible.
After saving the audiogram you may be prompted to save a complete backup (of all tests and events) based on the backup
setting you've selected in the Settings screen. If the backup location you specify is on your
device, you'll get a warning message that reminds you that off-device (i.e. cloud) storage is generally wiser,
providing a backup in case your device is lost, stolen, or disabled. Note that off-device storage security is
up to you: only back your data up to storage that includes security you're comfortable with.
The Save result button will be disabled until a test is complete. As mentioned above, you'll be prompted to save
audiograms immediately upon completion. Clicking "Yes" on the prompt saves the result, so you don't
need to manually use the Save result button unless you've chosen not to save a test upon completion. Again,
this is an unusual case, so normally you won't need to use the Save result button.
Results Tab
The results tab allows you to view stored audiograms. After you've recorded one or more audiograms you'll see
a list of past results, ordered by date and organized by month. Tapping an item in this list will produce a plot
of the corresponding audiogram. Following standard audiogram convention, the left ear threshold is plotted in
blue and the right ear is plotted in red. Note that the scale of the plot -- i.e. the minimum and maximum
hearing thresholds plotted -- will be fairly large by default. Double-tapping the plot produces a dialog that allows
you to specify a desired y-axis range.
If you've entered any events on the events tab, you may see small circle indicators next to some of the results
on the results tab. These markers correspond to events, and are color-coded to match the event colors used in
the trends tab. Markers will appear next to the first audiogram following an event. This allows you to see
the first audiogram after vertigo or other logged events. A long-press on the colored circles will
produce a pop-up description of the corresponding events.
The number in parentheses after the "Hearing Test Results" title is the total number of stored audiograms.
Events Tab
The Events tab provides a log where you can record events that may be relevant to your disease progression.
These events can later be displayed in the Trends plot. The following event types are supported:
Vertigo
Roaring sounds
Medication change
Symptom flareup
Illness/Allergies
Equipment change
Doctor visit
Drop attack
Headache
Trigger
Other
Events screen, with selected event.
Events screen, adding an event.
To add an event, press the + button at the bottom of the screen. You can then indicate the date of the event
by pressing the date and time button. Then indicate the event type by pressing the corresponding event button.
This will produce additional input fields based on the selected event type. For example, if Vertigo is selected
you'll be prompted to enter the severity and duration of the vertigo. For most event types you'll also have
a comment field where you can include any additional information you want to record with the event. Comments
are limited to 400 characters. After setting the event information, tapping Add event to list will store that event.
Note that Add event to list will be disabled until all necessary fields have been filled in. After tapping
Add event to list the event should be visible in
the events list. Selecting the event in the list will allow you to edit or delete the event.
There is a subjective aspect to defining the events, particularly those related to symptoms. For most of these
events the precise definition is up to you: enter events under whatever label you feel is most appropriate.
Note that there is no separate event for tinnitus. For most Meniere's patients tinnitus never goes away, so there
is no discrete event that needs to be recorded. Tinnitus does sometimes change substantially, for example it
may at times become much louder than normal. This could be recorded as a Roaring event, or a
Symptom flareup event,
based on your preference. Hint: in the Events tab you can filter events based on event comments. So, for example,
you could enter a tinnitus change as a Symptom flareup event and include a comment with the event such as
Unusual tinnitus. Then when displaying the trends plot you could filter on tinnitus to see only the events
that mention tinnitus.
Diary Tab
The Diary tab provides a way to track symptoms, lifestyle factors, and other subjective data that may correlate with your Meniere's condition. This data can help identify patterns and triggers that affect your symptoms, complementing the objective hearing measurements from audiograms. You can also enter a simple text description to keep a record of anything you think is notable for the day.
Use the Diary tab to log daily information such as:
Exercise: Physical activity that might affect your symptoms
Hydration: Indicate daily water intake
To add a new diary entry, tap the + button and adjust the sliders to indicate (on a scale of
0-10) the level you want to assign to each item. You don't need to enter values for all items.
Adjusting the slider to the far left value indicates "no entry" for that item.
Each entry is stored with a timestamp so it can be correlated with your hearing test results and events in the Trends tab.
The Diary tab displays your entries in chronological order. Adjust the slider at the top to scroll to different
saved entries. The date and time of the selected entry will be shown, and the various sliders (tinnitus, ear fullness,
etc.) will be adjusted to their corresponding values. At the bottom of the screen there are buttons to let you edit or
delete entries.
There is some overlap between the diary items on this tab and the events on the Events tab. For example a vertigo
attack could be entered as an event on the Events tab or as a high value for "Balance Trouble" on the Diary tab.
In general, "Events" are intended for discrete events such as a vertigo attacks, and "Diary" items are intended for
things that are more nearly always present, just in varying degrees. So a full vertigo attack would be an "Event", and
a general long-term feeling of imbalance would be a "Diary" item.
Like events, diary entries can be displayed on the Trends plot to help you visualize correlations between your diary data and hearing levels.
The Trends tab summarizes hearing levels over time and overlays annotations for key events. This helps visualize
correlations
between hearing level changes and events such as vertigo, medication changes, or symptom changes. There are no
universally correct settings to use here. To some extent you need to be your own analyst, looking at
different frequencies and different events, and seeing when useful patterns emerge. "Useful", in this context,
means something that you can use to predict vertigo or to identify medication or other treatment that is effective.
In the plot shown below, for example, the average of the 200, 300, and 500 Hz hearing thresholds is shown,
giving a measure of low-frequency hearing loss variation over time.
There is a clear relationship between the left ear hearing (blue line) level and the occurrence of vertigo (as indicated by
the vertical green lines). There is no correlation between the right ear (red line) and vertigo, so we know the vertigo is
caused by the left ear. Furthermore, variations in the left ear hearing level give a prediction of when vertigo is likely:
a decline in hearing to 70 dB is a clear sign of impending vertigo.
The several jumps from roughly 70 dB to 50 dB coincide with a temporary cessation of vertigo. While not shown
here, if the Roaring event is selected, it is clear that those jumps are always accompanied by a large increase
in tinnitus, i.e. a roaring sound. Note that detecting patterns is a long-term process. If you took any one-week
section of this plot it would be unlikely to tell you anything at all. You need to collect data long enough to
observe any patterns your symptoms may follow.
The red caret under the plot and the corresponding line through the plot area provide hearing data and weather
data at a particular time. Moving the caret to a desired point in the plot timeline will produce a text description
just above the plot showing results closest in time to the selected point. To move the caret drag it left and right
across the bottom of the plot.
Your hearing progression will almost certainly look quite different from the example shown here. One of the main purposes of
Menieres Biometrics is to help you determine your progression. Low frequency hearing fluctuation is a key symptom
of Meniere's, so you might start by looking at low frequencies as shown below. But your hearing may fluctuate at different
frequencies, so selecting different frequencies for the trends plot could be informative. If you have enabled weather
data collection you could compare your hearing progression to atmospheric pressure to see if they are related. For all
such variations on the trends plot you can select vertigo or other events to see if they are related to hearing fluctuations.
As always, don't make any important health decisions based on what you see in Menieres Biometrics. Errors
in data collection or in understanding or interpreting the trends plot could lead to poor choices in
disease management. Consult with a health professional before using Menieres Biometrics to make substantial
changes in how you manage your disease.
Trends screen.
Plot Settings
Under Plot Settings you have the option of displaying individual or averaged data. If you select individual,
then each of the frequencies you select (in the Frequency selection section) will be plotted as separate lines.
If you select Average, then the dB values of the selected frequencies are averaged together. This is generally
more useful.
The Adjust for equipment change checkbox directs the app to attempt to smooth transitions due to equipment
changes. If you've changed the headset you use, and have included that change in the events tab, then the app
will try to adjust prior measurements to make them more consistent with current measurements. The
Adjust for equipment change checkbox only adjusts prior measurements (and only on the plot -- the actual stored audiograms
are never modified) so selecting or deselecting this feature will only change the display of old
measurements -- the current measurements will be unaffected. Note that the adjustment this makes is very inexact,
and is intended to improve the data slightly. As mentioned elsewhere, it is best to use a good headset and
stay with that headset for all tests.
Setting the minimum and maximum hearing loss values sets the Y-Axis range on the trends plot.
The default values are initialized after your first audiogram and should be be appropriate for your
data. After you've performed several tests you can adjust the values to better fit
your particular loss levels.
The "Auto-set Y Axis Limits" button will read through your test results and automatically set the Plot Y-Axis Range values to
reasonable levels. You may then choose to adjust the levels further.
Select ear
You can select either or both ears for display on the trends plot. Right ear results will be plotted in red,
and left ear results will be plotted in blue.
Frequency selection
You can select any frequencies for display. If under Plot settings you've selected individual, then each of
the selected frequencies will be plotted as an individual line. If Average is selected, you'll get a single
plotted line (per selected ear) representing the average of the selected frequencies.
Events
Checkboxes are included for each of the event types that may be entered on the Events tab. Selecting any of those
will add annotations to the plot indicating the date and time of any events of that type. Event annotations are
displayed as vertical lines on the plot. The color of the lines matches the text color of the different events.
If you haven't entered any events of the selected
type, checking the checkbox will have no effect. Perhaps the most common selection is to show vertigo events.
This allows you to observe how hearing levels and vertigo attacks are related. Other events are likely also of
interest. For example, if you've entered events for when you started a particular medication or treatment and
select the Medication checkbox, you may be able to observe any improvements, or lack of improvements,
provided by that medication.
Trends screen.
You can also filter events by text. This limits the annotations to only those that have comment fields containing
the entered search term. This lets you, for example, filter on "Betahistine" to see annotations only pertaining
to betahistine. This assumes you've included comments containing that term in the corresponding events, e.g.
"Started betahistine".
Several of the event types include a duration and severity. For such events the width of the annotation line
corresponds to the duration of the event, and the shade of the line indicates severity.
Diary items
Similar to events, the Trends tab can also show items entered on the Diary tab. Select any items you
want to add to the trends plot. If you haven't entered any data for the item, selecting it won't affect the plot.
Diary items are plotted on a scale of 0 to 10, irrespective of the Y axis numbering. The bottom of the
trends plot corresponds to a diary value of 0, and the top of the plot corresponds to a value of 10.
Weather overlay
The Trends tab can also show local weather data, including temperature, relative humidity,
and barometric pressure, as separate lines on the plot.
Weather data is optional and is only collected when you enable the weather setting in the
Settings screen. When enabled, Menieres Biometrics periodically fetches local weather using
approximate (coarse) location. Weather forecasts from the Norwegian Meteorological Institute
(MET Norway). If you havent enabled weather alerts, forecasts are only obtained while Menieres
Biometrics is in use, so if you only open
Menieres Biometrics occasionally the weather predictions will be sparse and therefore less accurate
than if you use the app more frequently. If you have enabled weather alerts, Menieres Biometrics
will check for weather updates even if the app is not actively in use, so that you don't need
to open the app to receive alerts.
The app only updates location information while
the app is in use. If you travel, but don't open the app, it will continue to fetch weather data
for the location of the phone the last time the app was used. Note that since there are safeguards in
place to prevent excessive weather fetches, there can be a substantial delay between travel and when
weather data corresponding to your new location is obtained.
Existing weather samples remain in your data even if you later turn weather collection off.
Turning the weather setting off stops new downloads but does not delete past weather data or
affect hearing test results.
On the Trends tab you can choose to show or hide temperature, humidity, and pressure using
separate checkboxes. These curves are plotted on their own scale. The data cursor can be used
to obtain values at selected points in time. You can also choose to display weather alerts on
the plot. In the figure below these are the red points in the green line for atmospheric
pressure. The marked points correspond to weather predictions that exceed the thresholds
you've set in weather alerts. The Include past alerts option controls
whether alerts from past forecasts are shown or only upcoming alerts. If you are certain that
your symptoms are affected by atmospheric pressure, displaying alerts on the trends plot can
help you anticipate future symptom flareups. If you are uncertain about the link between weather
and symptoms, viewing past alerts and symtoms may help you identify (or rule out) correlations
between pressure and symptoms.
Trends screen weather options.
Trend plot tips
The trend plot can be panned or zoomed using standard gestures: pinch to zoom, swipe to pan.
Double-tap to zoom out to view all data.
Double-tap the right-hand quarter to zoom to the last month.
Long-press a point to open the corresponding audiogram in Results.
Tap an event annotation to see event details.
The plot Y axis range is defined on the Settings screen.
Settings
The Settings screen lets you set various parameters affecting app behavior.
Warning messages
This section lets you enable or disable the warnings normally generated at the start of a test -- one for
setting the system volume and one for using sub-optimal equipment (non-wired headphones).
The app adjusts the tone volume during a test by adjusting the volume of the sound sent to your audio device,
not by adjusting the system volume. For consistency from one test to the next, the volume should be set to
its maximum value. If the volume is not already at its maximum a warning box will be produced, allowing you
to set the volume to the maximum value, or continuing to take the test with the current volume (not
recommended). Volume warning setting allows you to override the default behavior, having the app always
adjust the volume to maximum without warning, or using the volume as it is.
As described in the section on equipment, it is best to use wired headphones
for taking tests. If you are
using wireless headphones or ear buds, you may find them to be adequate and not want to be questioned about
their use each time you take a test. The "Warn if equipment is not wired" checkbox lets you enable or
disable the warning.
Appearance
You can select the light/dark mode for the app. Selecting "Use device theme" will set the app mode to match the phone's theme.
Selecting "Light mode" or "Dark mode" will override the system setting.
In landscape mode (holding the phone horizontally) the contents of the Test, Results, and Trends screens are organized
in two columns. Options are provided to swap the left and right columns, letting you choose whichever arrangement is more
convenient.
Horizontal layout.
Weather
Menieres Biometrics can optionally collect local weather data (temperature, humidity, and pressure)
and overlay it on the Trends tab. This can help you see whether symptoms correlate with
weather changes.
The Settings screen includes a "Collect local weather data for Trends tab" checkbox. When
you turn this on, the app requests approximate (coarse) location permission and periodically
downloads weather forecasts from the Norwegian Meteorological Institute (MET Norway).
Weather samples are stored locally with your other data and are used only for plotting on
the Trends tab and for CSV export. You can turn the weather checkbox off at any time to
stop new weather downloads; existing weather data will remain available.
MET Norway provides public forecast data and asks apps to avoid unnecessary or excessive
requests. Menieres Biometrics respects this by caching each forecast until the service reports
that it will expire and by limiting how many times per day it will contact MET Norway.
These limits help protect MET Norway's infrastructure and also benefit you by reducing
battery usage and network data consumption. Only approximate location and weather
requests are sent; your hearing test data is never transmitted to MET Norway.
Weather alerts
Weather alerts let you define thresholds for barometric pressure conditions.
When weather forecasts exceed these thresholds, the app notifies you and can highlight
those points on the Trends plot so you can see at a glance when weather conditions may
be triggering symptoms.
Configuring alerts
To configure weather alerts, go to Settings
and scroll to the Weather section. You must first enable weather collection to use alerts.
Four types of pressure alerts are available:
Pressure is above: Triggers when the forecast pressure exceeds your threshold.
Pressure is below: Triggers when the forecast pressure drops below your threshold.
Pressure increases by: Triggers when pressure is forecast to rise by the specified amount per hour.
Pressure drops by: Triggers when pressure is forecast to fall by the specified amount per hour.
Pressure thresholds can be entered in either inHg (inches of mercury), mmHg (mm of mercury), or
millibars (which is the same as hectopascals -- hPa),
depending on your selected pressure unit in Settings. Typical sea-level atmoshpheric pressure is around
30.0 inHg (1013 hPa).
Alert notifications
When an enabled alert threshold is met, the app issues a system notification. Depending on your phone
and Android version this will give a summary in the system Notification Shade, as seen in the figure below.
If you tap that system notification it will display a complete list of notifications and the
conditions that caused them as seen in the screenshot below. Each alert shows the
condition that was met, the date and time of the forecast, and the predicted value.
The app requires notification permission (Android 13+) to display these alerts. You can also view this
list of notification using the "Show current weather alerts" menu item.
Weather alerts appearing in system.
Weather alerts notification showing forecast conditions that match configured thresholds.
Approximate Calibration
The hearing levels recorded by Menieres Biometrics will depend greatly on the headset being used and on your phone's
audio output level. Unfortunately there's no way for Menieres Biometrics to know the sound levels your phone and
headset will produce. You can determine a reasonable calibration offset two ways:
Compare audiograms produced by Menieres Biometrics to audiograms you have from an audiologist. The Calibration Offset
you enter in the Settings screen should be based on the difference between Menieres Biometrics audiograms and
professional audiograms. So, for example, if a professional audiogram gives a general hearing level of 25 dB
and Menieres Biometrics reported 45 dB, you would set the Calibration Offset to the difference between the two,
i.e. 20 dB. Note that even with a good calibration offset value you shouldn't expect perfect agreement between
Menieres Biometrics and a professional audiogram. The point of the calibration offset is to bring the two into closer
agreement, though perfect agreement is unlikely.
Ask someone with normal hearing to take an audiogram with Menieres Biometrics. View the result on the Results tab.
If their hearing is, for example, typically around 20 dB, then add 20 to the Calibration offset on the Settings
screen. Then go back to the results tab and view the result. It should now be near 0 dB. Note that few headsets have
perfectly flat frequency response, so you won't see 0 dB hearing loss for all frequencies even if the person
you asked to perform a test has perfect hearing.
If neither of these approaches is convenient, you can simply leave the calibration offset set to 0. You will still
be able to observe hearing level changes over time, but the absolute hearing level will be uncalibrated and therefore
incorrect.
If you use method 2 above, after determining a reasonable calibration offset you will probably want to delete
that audiogram from your results list since it measured someone else's hearing, not your own.
Note that even with a good calibration value the results won't be fully "calibrated" in a technical sense.
All the Calibration Offset does is display your Menieres Biometrics results in a manner that more closely matches your
true hearing loss. This is imprecise, but as stated elsewhere Menieres Biometrics can't provide highly accurate
hearing loss levels. The main information provided by Menieres Biometrics is the change in your hearing levels
over time. This is unaffected by the calibration level, and is also unaffected by imperfections in the
frequency response of your phone and headset (within reason). So don't be overly concerned about entering a
precise calibration offset term.
After saving an audiogram you may get a reminder to back up your data. This setting allows you to specify
how often you will be reminded to make a backup. See Saving, exporting, and backing up data
for further details.
Menieres Biometrics can collect anonymous indicators of app usage through Google Analytics. This allows us to see, for example,
how many users are using the app, how often audiograms are taken, etc. No test results or events are included in Analytics. Furthermore,
the information provided by Analytics is anonymous. So for example, on a given day we would see how many audiograms were recorded, but
wouldn't know if you were one of those who did or did not record an audiogram. We ask to collect this data because seeing minimal
details regarding app usage could help us improve Menieres Biometrics in the future.
Deselecting the checkbox will remove your usage statistics from the reports we see regarding user engagement. The app features and
behavior are unaffected by your selection.
All of your data is stored within the app. To create a backup use the "Create data
backup" menu item. This creates a comma-separated-variable (CSV) file that contains
your audiogram results, any stored weather samples, and your events. CSV files are simple
text files that can be read by spreadsheets and other programs.
The backup CSV is divided into sections for audiogram test results, events, diary entries, and
weather data. Any comments you enter in event descriptions and diary entries are included in the CSV
file. The CSV file does not include anything you entered on the Settings screen.
The "Load data from backup" menu item can read a previously exported backup
CSV file. If you had to reinstall Menieres Biometrics or have otherwise lost your data, importing
the saved CSV file will restore your audiograms, any backed-up weather samples, and your
event log. After a full reinstall, any settings you made on the Settings screen will be
lost and will need to be re-entered (the CSV file will not restore settings). If you import
a file to a fresh Menieres Biometrics install, i.e. one without any data, then all data
in the CSV file will be imported. If you import a file to a device with pre-existing data,
then the data in the imported file will be merged with the existing data. In such cases the two devices
may not have identical data after the import.
The Settings screen allows you to specify how often you should be prompted to create a backup file. This prompt will
appear after you've saved an audiogram. The prompt will include a button that exports the data, so you may
not need to use the "Create data backup" menu item on a regular basis.
However often you create backups, it would be wise to ensure that the backup is actually being created. The location
in which you store the file is up to you. Navigate to that location on your phone, and check that the CSV file is
there and not empty. Clicking on it will generally let you view the contents, though this is dependent on
apps that your phone may or may not have.
If you save backups to a local folder, i.e. one on your phone, a message will appear advising you to use off-device
backup instead, for example a Google Drive folder. That way if your phone is lost, stolen, or disabled, you would
still have a backup available. If all backups are on your phone, then loss of your phone means loss of your data.
Backup files created by "Create data backup" store the raw values collected
during hearing tests plus any corresponding weather samples. These raw values are not
hearing level values; calibration is applied only when graphs are drawn or when you export
data for analysis.
If you want to analyze your data in another program (for example, a spreadsheet), use the
"Export data for analysis" menu item. This creates a CSV file that is similar to the backup
file but uses dB hearing levels rather than the raw measurements included in the backup CSV. The
analysis CSV is for external analysis only and cannot be loaded back into Menieres Biometrics.
The analysis CSV will contain all of the audiogram data, all events (including any comments), all
diary subjective values, and weather data. It does not include diary text entries.
Note that analysis exports are unadjusted for equipment. If your data spans multiple
headsets, the values will include shifts caused by those equipment changes.
All CSV files are simple text files that can be viewed directly on most phones. Before sharing a CSV file with anyone
you should review the contents of the file to make sure you are comfortable sharing the contents.
On most devices, Android can automatically restore Menieres Biometrics data (audiograms, events, and settings) to a new
phone when you sign in with the same Google account, provided that system backups are enabled. The backup and
restore process is handled by Android/Google and may occur during device setup or shortly after installation.
Even if automatic restoration is expected, making a backup of your data is highly
recommended.
If you prefer a manual transfer, or if automatic restore is not available on your device, you can export a CSV
backup from your old phone and import it on your new phone:
On the old phone, use the menu to Create data backup and save to cloud storage
Install Menieres Biometrics on the new phone
Use the menu to Load data from backup and select the exported CSV
After switching, verify your audiograms and events are present on your new phone before disposing of or
resetting your old phone.
The "Generate Printable PDF" menu item will produce a PDF file with your latest audiogram and a copy of the
trends plot. The trends plot in the PDF will match the trends plot within the app. This includes ear selection,
frequencies, zoom/pan, and events. The menu item will be disabled until you've viewed the Trends tab.
The "Generate Trends Plot File" menu item will create a PNG graphic file with the trends plot. As with the
"Generate Printable PDF" menu item, the trends plot in the PNG will include ear selection,
frequencies, zoom/pan, and events. The resulting PNG may be useful if you want to include your trends plot
in an email or other document, or share it with others.
Menieres Biometrics includes a simple way to send feedback about the app. This can be used to report bugs, suggest
improvements, or share general comments about your experience.
How to open the feedback screen
From the main screen, tap the menu button (three horizontal lines) in the top-right corner. In the menu that
appears, choose Send Feedback. A dialog will open with a text box where you can type your
message.
What you can send
You can enter up to 4000 characters of text. A small counter under the text box shows how many characters are
remaining. You can send up to 10 feedback messages per day from a given device. If you reach this limit, the app
will let you know and you can try again the next day.
Privacy and limitations
Feedback is stored securely using Google's Firebase services and is associated with an anonymous identifier for
your device. Feedback is used only to help improve the app. Please do not include names, locations, or detailed
medical information in feedback messages. Menieres Biometrics cannot provide medical advice or emergency support via
feedback.
Since feedback is anonymous we are unable to respond individually to feedback submissions.
Menieres Biometrics includes open-source components. These are used under their respective licenses. The main
components and licenses are listed below:
AndroidX and Jetpack Compose — Apache License 2.0
Room (AndroidX Room) — Apache License 2.0
DataStore (AndroidX) — Apache License 2.0
Google Material Components — Apache License 2.0
Accompanist System UI Controller — Apache License 2.0
desugar_jdk_libs — Apache License 2.0
License texts and more information can be found on the respective project pages.
The main menu (hamburger icon in the top bar) provides access to the following functions:
Show onboarding: Replays the introductory onboarding screens that appear when you first use the app.
Show current weather alerts: Displays any weather conditions that match your configured alert thresholds.
Load data from backup: Imports previously saved data from a CSV backup file, restoring audiograms, events, diary entries, and weather data.
Create data backup: Exports all your data (audiograms, events, diary entries, and weather) to a CSV file for safekeeping.
Export data for analysis: Creates a CSV file formatted for external analysis tools or spreadsheets.
Generate printable PDF: Creates a PDF document containing your trends plot and summary data suitable for printing or sharing with healthcare providers. Requires viewing the Trends tab first.
Generate trends plot file: Saves the trends plot as a PNG image file. Requires viewing the Trends tab first.
Create Diary PDF: Generates a PDF document containing your diary entries.
Send feedback: Opens a dialog to send comments, suggestions, or bug reports to the developer.
Menieres Biometrics helps you measure and track hearing thresholds over time. It was designed with Meniere's
disease patients in mind, and supports logging events such as vertigo and tinnitus changes to help
visualize correlations with hearing trends.
Version: 1.0.0
Privacy: All data is stored locally on your device unless you choose to export it. See
Privacy for details.
Disclaimer: This app is not a substitute for professional medical diagnosis or treatment. See the
Disclaimer.