Automated technology for ototoxicity monitoring (Konrad-Martin et al., 2021)
Creators: name: Konrad-Martin, Dawn
name: Bennett, Keri O’Connell
name: Garinis, Angela C.
name: McMillan, Garnett P.
Publisher: name: ASHA journals
Year: 2021
Subjects: subject: Health Care
subject: 111709 Health Care Administration
subject: FOS: Health sciences

description: <b>Purpose:</b> Determine the efficacy of ototoxicity monitoring (OM) administered as automated protocols with the Oto-ID mobile audiometer (automated ototoxicity monitoring [A-OM]), compared with usual care (UC) OM in cancer patients receiving cisplatin.<b>Method: </b>Participants were patients (<i>n</i> = 46, mean age 64.7 years; range: 30–78 years) receiving cisplatin-based chemotherapy at the Department of Veterans Affairs Portland Health Care System. A randomized controlled trial contrasted A-OM and UC at up to three program evaluations (PEs) conducted by the study audiologist who was blinded to arm through PE1. PE1 occurred before randomization or oncology treatment; PE2 and PE3 occurred during and/or after treatment at 35 and 365 days postrandomization. The A-OM group (<i>n</i> = 24) used Oto-ID to screen their hearing before each cisplatin dose. Oto-ID results were sent to the study audiologist for interpretation, follow-up, and care coordination. The UC group (<i>n</i> = 22) received a consult for OM services through the audiology clinic. Outcomes included hearing shift near each patient’s high-frequency hearing limit, revised hearing-handicap inventory score, and survival time from the start of treatment. Adherence to OM protocols, patients’ use of aural rehabilitation services, and oncologists’ treatment decisions were also examined.<b>Results: </b>Ototoxicity was identified at a high overall rate (46% and 76% at 35 and 365 days, respectively, postrandomization). Adherence to monitoring prior to each cisplatin dose was 83.3% for those randomized to A-OM compared with 4.5% for UC. Randomization to A-OM was not associated with reduced ototoxic hearing shifts or self-reported hearing handicap relative to UC; neither did it compromise participants’ survival. Half of participants in each arm accessed aural rehabilitation services. One in each arm had a documented ototoxicity-related cisplatin dose reduction.<b>Conclusions:</b> Auditory impairment was an actionable concern for the participants and their oncology providers. A dedicated surveillance program using the Oto-ID’s automated protocols improved adherence to OM recommendations over a traditional UC service delivery model.<br><b>Supplemental Material S1.</b> Patient demographics, clinical aspects of diagnosed cancer and hearing characteristics by treatment arm and primary tumor location.<br><b>Supplemental Material S2. </b>Audiograms comparing those with and without an ototoxic hearing shift.<br><b>Supplemental Material S3. </b>The numbers and types of chemotherapy treatment modifications by study arm and participant.<br>Konrad-Martin, D., Bennett, K. O., Garinis, A.. &amp; McMillan, G. P. (2021). A randomized controlled trial using automated technology for improving ototoxicity monitoring in VA oncology patients. <i>American Journal of Audiology</i>. Advance online publication. https://doi.org/10.1044/2021_AJA-21-00032<br><b>Publisher Note: </b>This article is part of the Special Issue: Selected Papers From the 9th Biennial National Center for Rehabilitative Auditory Research Conference.