Michelle Lycke1, Tom Boterberg2, Evi Martens3, Lore Ketelaars3, Hans Pottel4, Antoon Lambrecht5, Koen Van Eygen6, Laurence De Coster7, Ingeborg Dhooge8, Hans Wildiers9, Philip R Debruyne10. 1. Cancer Center, General Hospital Groeninge, Kortrijk, Belgium. 2. Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. 3. Department of Psychology, General Hospital Groeninge, Kortrijk, Belgium. 4. Department of Public Health and Primary Care at Kulak, Catholic University Leuven Kulak, Kortrijk, Belgium. 5. Department of Radiation Oncology, General Hospital Groeninge, Kortrijk, Belgium. 6. Cancer Center, General Hospital Groeninge, Kortrijk, Belgium; Department of Hematology, General Hospital Groeninge, Kortrijk, Belgium. 7. Department of Otolaryngology, General Hospital Groeninge, Kortrijk, Belgium. 8. Department of Otolaryngology, Ghent University Hospital, Ghent, Belgium. 9. Department of General Medical Oncology, Leuven University Hospitals, Leuven, Belgium. 10. 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.
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). MATERIALS AND 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. CONCLUSION: uHear™ can be implemented as a screening tool to detect hearing loss in older patients with cancer within a CGA.
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). MATERIALS AND 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. CONCLUSION: uHear™ can be implemented as a screening tool to detect hearing loss in older patients with cancer within a CGA.