Hearing Loss Clinical Trial
Official title:
Comprehensive Ototoxicity Monitoring Program for VA: A Randomized Trial
This study involves research. Some chemotherapeutic drugs that can permanently reduce hearing are termed "ototoxic". One such drug is the chemotherapy called cisplatin. Currently, if a patient is receiving cisplatin, hearing is tested in the Audiology Clinic using lengthy protocols and may be retested only when it is requested by their oncologist and when the Veteran can arrange an appointment. Researchers think that hearing testing prior to every treatment of cisplatin may reduce the number of Veterans who get disabling hearing loss from treatment. The purpose of this study is to compare the current method of monitoring hearing (audiology clinic protocols termed "usual care") with a new portable hearing monitoring program (a comprehensive program of ototoxicity monitoring termed "COMP-VA") that tests hearing using a portable hearing testing audiometer and a variety of efficient tools and techniques so that testing can occur prior to each cisplatin treatment at any quiet location in the hospital.
Research objectives are to compare the effectiveness of ototoxicity monitoring implemented
using Comp-VA or usual care with regard to (1) improving Veterans' hearing and quality of
life outcomes, (2) assisting oncologists in pre-treatment counseling and therapeutic planning
and (3) increasing use of post-treatment rehabilitative services.
The investigators plan to recruit a total of 320 Veterans undergoing cisplatin
chemotherapeutic treatment over 4 years and 120 control subjects.
Program Evaluation: Hearing testing prior to treatment will be done in order to establish
eligibility, enroll and randomize each subject into one of two study arms. At 5 weeks and at
one year post-randomization hearing will be re-tested in order to obtain an estimate of
longitudinal trends in hearing and quality of life assessment. Use of audiological services
following treatment from the randomized subjects will be tracked. Finally, data will also be
collected at each treatment interval to track use of counseling tools and oncology personnel
treatment decisions.
Serial measurements from subjects receiving cisplatin prior to treatment who are randomized
to:
Comp-VA group will get a screening hearing test prior to treatment, at each treatment
interval and at one-month post-treatment. Auditory testing will be done on or near the Chemo
Unit and will include otoscopy, immittance testing, and a hearing testing done by the Veteran
using a self-testing procedure, and may be tested using distortion product otoacoustic
emissions (DPOAEs), if they cannot take a reliable hearing test.
Usual care group will receive a full audiometric evaluation (otoscopy, immittance testing,
air conduction and bone conduction hearing testing, speech audiometry, and distortion product
otoacoustic emissions, DPOAEs) scheduled in the audiology clinic sound booth according to
Audiology Service ototoxicity monitoring protocols. Testing will be arranged according to
availability of appointments and patient convenience.
Additionally data will also be collected from control subjects who are similar in age and are
tested at intervals similar to the chemotherapy subjects.
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