TY - JOUR
T1 - A randomized controlled trial using automated technology for improving ototoxicity monitoring in va oncology patients
AU - Konrad-Martin, Dawn
AU - Bennett, Keri O’Connell
AU - Garinis, Angela
AU - McMillan, Garnett P.
N1 - Publisher Copyright:
© 2021, American Speech-Language-Hearing Association. All rights reserved.
PY - 2021/10
Y1 - 2021/10
N2 - Purpose: 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. Method: Participants were patients (n = 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 (n = 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 (n = 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. Results: 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. Conclusions: Auditory impairment was anactionableconcern 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.
AB - Purpose: 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. Method: Participants were patients (n = 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 (n = 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 (n = 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. Results: 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. Conclusions: Auditory impairment was anactionableconcern 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.
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U2 - 10.1044/2021_AJA-21-00032
DO - 10.1044/2021_AJA-21-00032
M3 - Article
C2 - 34582263
AN - SCOPUS:85117301255
SN - 1059-0889
VL - 30
SP - 870
EP - 886
JO - American journal of audiology
JF - American journal of audiology
IS - 3S
ER -