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Statistical model for prediction of hearing loss in patients receiving cisplatin chemotherapy. JAMA Otolaryngol Head Neck Surg 2013 Mar;139(3):256-64

Date

02/23/2013

Pubmed ID

23429908

DOI

10.1001/jamaoto.2013.1713

Scopus ID

2-s2.0-84875829521   7 Citations

Abstract

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 CL

Authors

David R. Friedland MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
Christina 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 Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Agents
Audiometry
Case-Control Studies
Cisplatin
Female
Hearing Loss
Humans
Male
Middle Aged
Models, Statistical
Neoplasms
Predictive Value of Tests
Retrospective Studies
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0