The use of uHear to screen for hearing loss in older patients with cancer as part of a comprehensive geriatric assessment

Objective: We previously validated uHear to screen for hearing loss in older patients with cancer without a known hearing loss, as part of a comprehensive geriatric assessment (CGA). In view of low specificity, we tested a new modified uHear scoring system as described by Handzel.Methods: Patients, aged 70years, were evaluated by uHear and conventional audiometry, which is considered the gold standard, as part of a CGA. The pass or fail screening cut-off for uHear was defined as having 2 consecutive hearing grades starting from the moderate-severe threshold zone ranging from 0.5 to 2.0kHz (modified Handzel-uHear scoring system). To accept the modified Handzel-uHear as screening tool, it was predefined that the combined sensitivity (S) and specificity (Sp) of the test (S+Sp/2) was at least 80% and that an actual combined (S+Sp)/2 of 90% would be found.Results: Ninety ears (45 subjects) were tested. Of those ears, 24.4% were identified as impaired by conventional audiometry. Modified Handzel-uHear identified 26.7% of tested ears as impaired. The combined (S+Sp)/2 of the modified Handzel-uHear was calculated as 77.5%, while in previous cohort, this was retrospectively calculated as 94.6%. A new uHear scoring system was proposed and tested in current and previous cohort. A (S+Sp)/2 of 80.2 and 78.8%, respectively, were obtained.Conclusion: uHear is a feasible tool for use within the CGA and shows promising results. However, further research is warranted to optimize the cut-off method before it could be routinely implemented within geriatric oncology.