title: Implementation of uHear™--an iOS-based application to screen for hearing loss--in older patients with cancer undergoing a comprehensive geriatric assessment.
abstract: OBJECTIVE
  Validation of uHear™ as a screening tool to detect hearing loss in older patients with cancer without a known diagnosis of presbycusis, as part of a Comprehensive Geriatric Assessment (CGA).
  
  
  METHODS
  Patients (≥70 years) with a histologically confirmed diagnosis of cancer, were enrolled at the time of CGA screening. Patients were evaluated by uHear™, which was compared to conventional audiometry as gold standard. We defined a pure-tone average (PTA) of ≥40dB HL as the pass or fail screening cut-off. Validation of uHear™ was defined in terms of diagnostic accuracy through Receiver Operating Characteristics (ROC)-analysis. To accept uHear™, we estimated that the Area Under the ROC-curve (AUC) had to differ significantly from 0.50 with an AUC of at least 0.70. The Whispered Voice Test and Hearing Handicap Inventory for the Elderly were also administered.
  
  
  RESULTS
  Thirty-three patients consented for participation. In one patient, the results of one ear were excluded from the analysis as the patient was documented with a known hearing disorder in that ear. Significant hearing loss, defined by a PTA of ≥40dB HL calculated from the air conduction thresholds at 0.5, 1.0 and 2.0kHz, was found in 15.4% of tested ears. uHear™ showed excellent diagnostic accuracy with an AUC±SE of 0.98±0.14. It provided maximum sensitivity (100.0%) but poor specificity (36.4%) at our predefined cut-off score of ≥40dB HL.
  
  
  CONCLUSIONS
  uHear™ can be implemented as a screening tool to detect hearing loss in older patients with cancer within a CGA.
authors.affiliation: Cancer Center, General Hospital Groeninge, Kortrijk, Belgium.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lycke
authors.affiliation: Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Boterberg
authors.affiliation: Department of Psychology, General Hospital Groeninge, Kortrijk, Belgium.
authors.forename: Evi
authors.initials: E
authors.lastname: Martens
authors.affiliation: Department of Psychology, General Hospital Groeninge, Kortrijk, Belgium.
authors.forename: Lore
authors.initials: L
authors.lastname: Ketelaars
authors.affiliation: Department of Public Health and Primary Care at Kulak, Catholic University Leuven Kulak, Kortrijk, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Pottel
authors.affiliation: Department of Radiation Oncology, General Hospital Groeninge, Kortrijk, Belgium.
authors.forename: Antoon
authors.initials: A
authors.lastname: Lambrecht
authors.affiliation: Cancer Center, General Hospital Groeninge, Kortrijk, Belgium; Department of Hematology, General Hospital Groeninge, Kortrijk, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Van Eygen
authors.affiliation: Department of Otolaryngology, General Hospital Groeninge, Kortrijk, Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: De Coster
authors.affiliation: Department of Otolaryngology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Dhooge
authors.affiliation: Department of General Medical Oncology, Leuven University Hospitals, Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Wildiers
authors.affiliation: Cancer Center, General Hospital Groeninge, Kortrijk, Belgium; Centre for Positive Ageing, University of Greenwich, London, UK; Faculty of Health, Social Care & Education, Anglia Ruskin University, Chelmsford, UK. Electronic address: Philip.Debruyne@azgroeninge.be.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Debruyne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry / Q000379:methods*; D001530:Belgium; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening; D009369:Neoplasms / Q000150:complications*; D011304:Presbycusis / Q000150:complications / Q000175:diagnosis*; D012372:ROC Curve; D012984:Software
keywords: Comprehensive geriatric assessment; Hearing loss; Older cancer patients; uHear™