Ototoxicity monitoring through the eyes of the treating physician: Perspectives from pulmonology and medical oncology.
Angela C Garinis, Alexandra Cornell, Gopal Allada and 3 others
PMID 28978238WHAT IT FOUND
Physicians who referred patients receiving ototoxic drugs for hearing checks described inconsistent monitoring.
They relied on patient reports and audiologist interpretation, wanted simple flags for changes affecting speech, but had no agreed thresholds.
Key findings
01Monitoring practices varied from routine referrals for high-risk regimens to referral only when patients reported hearing complaints.
02Hearing changes were often noticed by patients or audiologists, and the physicians wanted audiologists to judge whether changes affected speech understanding.
03Time, cost, clinic space and lack of consensus thresholds were given as reasons standard monitoring was not used.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only four physicians were included, and they were known to the authors as people who already referred patients for ototoxicity monitoring, so their views may not represent others. The survey was modified from a non-validated questionnaire, and the authors selected the questions to include, so the findings depend on those choices. No patients were interviewed and no hearing or treatment outcomes were measured, so the paper cannot show whether monitoring helps or harms patients. The sample was chosen to span different ototoxicity risks, not to estimate how common any practice is.
Declared interests
The work was supported by NIH intramural and U.S. government non-PHS research support. Dawn Konrad-Martin is listed as a coinventor on patents for a hearing test and mobile device, and these patents generate no revenue. No other potential conflicts of interest were reported.
The easy way to misread this
Do not read this as evidence that ototoxicity monitoring improves outcomes or that a standard schedule works. It reports only physicians' views, and they were chosen because they already referred patients for monitoring.