The purpose of this study was to evaluate the speci city and sensitivity of two red ag protocols in detecting ear diseases associated with changes in hearing. The presence of red- ag symptoms was determined in a chart review of 307 adult patients from the Mayo Clinic Florida Departments of Otorhinolaryngology and Audiology. Participants formed a convenience sample recruited for a separate study. Neurotologist diagnosis was the criterion for comparisons. Of the 251 patient les retained for analysis, 191 had one or more targeted diseases and 60 had age- or noise-related hearing loss. Food and Drug Administration red ags sensitivity was 91% (con- dence interval [CI], 86 to 95%) and speci city was 72% (CI, 59 to 83%). American Academy of Otolaryngology-Head and Neck Surgery red ags sensitivity was 98% (CI, 95 to 99%) and speci city was 20% (CI, 11 to 32%). Stakeholders must determine which diseases are mean- ingful contraindications for hearing aid use and whether these red- ag protocols have acceptable levels of sensitivity and speci city. As direct- to-consumer models of hearing devices increase, a disease detection method that does not require provider intercession would be useful.