title: A Store-and-Forward Tele-Audiology Solution to Promote Efficient Screenings for Ototoxicity during Cisplatin Cancer Treatment.
abstract: BACKGROUND
  Tele-audiology improves access, controls cost, and improves efficiency of many aspects within health care. We have developed and validated a device, the ototoxicity identification device (OtoID), which enables remote hearing monitoring by a patient during chemotherapy treatment. Aspects of the design such as patient self-testing and texting of results to the audiology clinic are important features of this device.
  
  
  OBJECTIVE
  The purpose of this article is to present the efficacy and effectiveness of the OtoID hearing screener.
  
  
  METHODS
  A repeated measures design was used in this study.
  
  
  METHODS
  Twenty-one veterans undergoing cisplatin chemotherapy were recruited in this study.
  
  
  METHODS
  Participants were tested using the OtoID at each cisplatin treatment by an audiologist using the manual mode of test and the participant using the automated mode of test. Test sensitivity and specificity were developed from the detection (yes/no) of an American Speech-Language-Hearing Association (ASHA) change in hearing.
  
  
  RESULTS
  The OtoID had a test sensitivity of 80.6% and specificity of 85.3%. A logistic regression model analysis of the probability of an ASHA shift identified by the automated OtoID was conducted. Separate models were fit to establish effects of age, average baseline thresholds in the sensitive range for ototoxicity (SRO), and dose of cisplatin on the probability of a positive hearing change result. Interactions were also included to evaluate these effects on the sensitivity and false-positive rates of the automated test. Results indicated no statistically significant effects of age, of baseline hearing in the SRO frequencies, or of cisplatin dose.
  
  
  CONCLUSIONS
  The OtoID automated test can be recommended for use. The automated test provides significant personnel efficiencies. The modem with simple text messaging function recently added to the device improves on these efficiencies.
authors.affiliation: National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Healthcare System (VAPORHCS), Portland, OR.|Department of Otolaryngology/HNS, Oregon Health & Science University, Portland, OR.
authors.forename: Marilyn F
authors.initials: MF
authors.lastname: Dille
authors.affiliation: National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Healthcare System (VAPORHCS), Portland, OR.|Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR.
authors.forename: Garnett P
authors.initials: GP
authors.lastname: McMillan
authors.affiliation: National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Healthcare System (VAPORHCS), Portland, OR.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Helt
authors.affiliation: National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Healthcare System (VAPORHCS), Portland, OR.|Department of Otolaryngology/HNS, Oregon Health & Science University, Portland, OR.
authors.forename: Dawn
authors.initials: D
authors.lastname: Konrad-Martin
authors.affiliation: National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Healthcare System (VAPORHCS), Portland, OR.|Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR.
authors.forename: Peter
authors.initials: P
authors.lastname: Jacobs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001299:Audiometry; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D034381:Hearing Loss / Q000139:chemically induced* / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D012680:Sensitivity and Specificity; D017216:Telemedicine
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin