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 - Funding Information:
This work was supported in part by a VA Rehabilitative Research & Development (RR&D) Services Merit Review Award (Grant C0239R) and with resources and the use of facilities at the NCRAR (RR&D Center Award #C2361-C). These contents are the opinions of the authors and do not represent the views of the VA or the United States Government. This work was prepared as part of official duties as U.S. Government employees, and therefore, is defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105; copyright protection is not available for any work of the U.S. Government. Aspects of this work have been presented at the 2019 NCRAR Biennial Conference in Portland, Oregon; and in the International Journal of Audiology (Brungart et al., 2018; Konrad-Martin et al., 2018).
Funding Information:
This work was supported in part by a VA Rehabilitative Research & Development (RR&D) Services Merit Review Award (Grant C0239R) and with resources and the use of facilities at the NCRAR (RR&D Center Award #C2361-C). These contents are the opinions of the authors and do not represent the views of the VA or the United States Government. This work was prepared as part of official duties as U.S. Government employees, and there-fore, is defined as U.S. Government work under Title 17 U.S.C.?101. Per Title 17 U.S.C.?105; copyright protection is not available for any work of the U.S. Government. Aspects of this work have been presented at the 2019 NCRAR Biennial Conference in Portland, Oregon; and in the International Journal of Audiology (Brungart et al., 2018; Konrad-Martin et al., 2018). Marilyn Dille was the PI for this study with Dawn Konrad-Martin as co-PI. The authors thank her for her leadership with the design and execution of this study. The authors thank Ronald Maggiore, currently at the University of Rochester, Department of Medicine, Division of Hematology/Oncology in Rochester, NY, for his assistance with this project including many discussions of ototoxicity from the perspective of the treating physician. They thank Suzanne ?Windy? Lyle and Phan Dang, the VAPORHCS oncology nurses for their service to their patients and enthusiasm for OM. They also appreciate contributions from their colleagues Kelly Reavis, MS, MPH and Amy Custer, AuD. Finally, Trisha Milnes, Chief of Audiology and Speech Pathology Services at the Charlie Norwood VA, GA, provided invaluable insights regarding the interpretation of results for clinical application. She is currently designing a learning module on how to implement a Proactive OM Surveillance Program in VA.
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
VL - 30
SP - 870
EP - 886
JO - American Journal of Audiology
JF - American Journal of Audiology
SN - 1059-0889
IS - 3S
ER -