Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 1, 2014
   Pages 81 — 100

Abstract — Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA)

Dawn Konrad-Martin, PhD;1* Kelly M. Reavis, MPH;1 Garnett McMillan, PhD;2 Wendy J. Helt, MA;1 Marilyn Dille, PhD1,3

1National Center for Rehabilitative Auditory Research, Portland Department of Veterans Affairs Medical Center, Portland, OR; Departments of 2Public Health and Preventive Medicine and 3Otolaryngology/HNS, Oregon Health & Science University, Portland, OR

Abstract — Prevention and rehabilitation of hearing loss and tinnitus, the two most commonly awarded service-connected disabilities, are high priority initiatives in the Department of Veterans Affairs (VA). At least 4,000 Veterans, most with significant hearing loss, will receive cisplatin this year, with more than half sustaining permanent hearing shift and nearly 40% developing new tinnitus. With improved survivability following cancer treatment, Veterans treated with cisplatin are approached with the dual goals of effective treatment and preserved quality of life. This article describes COMP-VA, a comprehensive ototoxicity monitoring program developed for VA patients receiving cisplatin. The program includes an individualized pretreatment prediction model that identifies the likelihood of hearing shift given cisplatin dose and patient factors. It supports both manual and automated hearing testing with a newly developed portable audiometer capable of performing the recommended procedures on the chemotherapy unit during treatment. It also includes objective methods for identifying outer hair cell changes and predicting audiogram changes using distortion-product otoacoustic emissions. We describe this program of evidence-based ototoxicity monitoring protocols using a case example to give the reader an understanding of how this program would be applied, along with a plan for future work to accomplish the final stages of program development.

Key words:aural rehabilitation, chemotherapy, cisplatin, COMP-VA, distortion-product otoacoustic emissions, DPOAE, hearing, OtoID, ototoxicity monitoring, sensitive range for ototoxicity.

View HTML ¦ View PDF ¦ Contents Vol. 51, No.1
This article and any supplementary material should be cited as follows:
Konrad-Martin D, Reavis KM, McMillan G, Helt WJ, Dille M. Proposed comprehensive ototoxicity monitoring program for VA healthcare (COMP-VA). J Rehabil Res Dev. 2014;51(1):81–100.

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Last Reviewed or Updated  Wednesday, April 9, 2014 9:57 AM

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