Implementation of uHear™--an iOS-based application to screen for hearing loss--in older patients with cancer undergoing a comprehensive geriatric assessment

J Geriatr Oncol. 2016 Mar;7(2):126-33. doi: 10.1016/j.jgo.2016.01.008. Epub 2016 Feb 26.

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.

Keywords: Comprehensive geriatric assessment; Hearing loss; Older cancer patients; uHear™.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Audiometry / methods*
  • Belgium
  • Female
  • Geriatric Assessment* / methods
  • Humans
  • Male
  • Mass Screening*
  • Neoplasms / complications*
  • Presbycusis / complications
  • Presbycusis / diagnosis*
  • ROC Curve
  • Software*