Dille Marilyn F, McMillan Garnett P, Helt Wendy J, Konrad-Martin Dawn, Jacobs Peter
National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Healthcare System (VAPORHCS), Portland, OR.
Department of Otolaryngology/HNS, Oregon Health & Science University, Portland, OR.
J Am Acad Audiol. 2015 Oct;26(9):750-60. doi: 10.3766/jaaa.15028.
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.
The purpose of this article is to present the efficacy and effectiveness of the OtoID hearing screener.
A repeated measures design was used in this study.
Twenty-one veterans undergoing cisplatin chemotherapy were recruited in this study.
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.
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.
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.
远程听力诊断改善了医疗服务的可及性，控制了成本，并提高了医疗保健诸多方面的效率。我们研发并验证了一种设备，即耳毒性识别设备（OtoID），它能使患者在化疗期间进行远程听力监测。该设备的设计特点，如患者自我检测以及将结果发送短信至听力诊所，是其重要特性。
本文旨在介绍OtoID听力筛查仪的有效性。
本研究采用重复测量设计。
本研究招募了21名接受顺铂化疗的退伍军人。
在每次顺铂治疗时，听力学家使用手动测试模式，参与者使用自动测试模式，用OtoID对参与者进行测试。根据美国言语语言听力协会（ASHA）听力变化的检测结果（是/否）得出测试灵敏度和特异性。
OtoID的测试灵敏度为80.6%，特异性为85.3%。对自动OtoID识别出的ASHA变化概率进行了逻辑回归模型分析。建立了单独的模型来确定年龄、耳毒性敏感范围内的平均基线阈值（SRO）和顺铂剂量对听力变化阳性结果概率的影响。还纳入了交互作用来评估这些因素对自动测试的灵敏度和假阳性率的影响。结果表明，年龄、SRO频率的基线听力或顺铂剂量均无统计学显著影响。
推荐使用OtoID自动测试。自动测试显著提高了人员效率。最近该设备新增的具有简单短信功能的调制解调器进一步提高了这些效率。
