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

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 ≥ 40 dB 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 ≥ 40 dB HL calculated from the air conduction thresholds at 0.5, 1.0 and 2.0 kHz, 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 ≥ 40 dB HL. Conclusion uHear™ can be implemented as a screening tool to detect hearing loss in older patients with cancer within a CGA.