Statistical model for prediction of hearing loss in patients receiving cisplatin chemotherapy. JAMA Otolaryngol Head Neck Surg 2013 Mar;139(3):256-64
Date
02/23/2013Pubmed ID
23429908DOI
10.1001/jamaoto.2013.1713Scopus ID
2-s2.0-84875829521 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
IMPORTANCE: This statistical model might be used to predict cisplatin-induced hearing loss, particularly in patients undergoing concomitant radiotherapy.
OBJECTIVE: To create a statistical model based on pretreatment hearing thresholds to provide an individual probability for hearing loss from cisplatin therapy and, secondarily, to investigate the use of hearing classification schemes as predictive tools for hearing loss.
DESIGN: Retrospective case-control study.
SETTING: Tertiary care medical center.
PARTICIPANTS: A total of 112 subjects receiving chemotherapy and audiometric evaluation were evaluated for the study. Of these subjects, 31 met inclusion criteria for analysis.
MAIN OUTCOME MEASURES: The primary outcome measurement was a statistical model providing the probability of hearing loss following the use of cisplatin chemotherapy.
RESULTS: Fifteen of the 31 subjects had significant hearing loss following cisplatin chemotherapy. American Academy of Otolaryngology-Head and Neck Society and Gardner-Robertson hearing classification schemes revealed little change in hearing grades between pretreatment and posttreatment evaluations for subjects with or without hearing loss. The Chang hearing classification scheme could effectively be used as a predictive tool in determining hearing loss with a sensitivity of 73.33%. Pretreatment hearing thresholds were used to generate a statistical model, based on quadratic approximation, to predict hearing loss (C statistic = 0.842, cross-validated = 0.835). The validity of the model improved when only subjects who received concurrent head and neck irradiation were included in the analysis (C statistic = 0.91). A calculated cutoff of 0.45 for predicted probability has a cross-validated sensitivity and specificity of 80%.
CONCLUSIONS AND RELEVANCE: Pretreatment hearing thresholds can be used as a predictive tool for cisplatin-induced hearing loss, particularly with concomitant radiotherapy.
Author List
Johnson A, Tarima S, Wong S, Friedland DR, Runge CLAuthors
David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of WisconsinChristina Runge PhD Associate Provost, Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Stuart J. Wong MD Center Director, Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Antineoplastic Agents
Audiometry
Case-Control Studies
Cisplatin
Female
Hearing Loss
Humans
Male
Middle Aged
Models, Statistical
Neoplasms
Predictive Value of Tests
Retrospective Studies