Patient-Reported Measures of Hearing Loss and Tinnitus in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review

Abstract

Purpose We identified studies that described use of any patient-reported outcome scale for hearing loss or tinnitus among children and adolescents and young adults (AYAs) with cancer or hematopoietic stem cell transplantation (HSCT) recipients. Method In this systematic review, we performed electronic searches of OvidSP MEDLINE, EMBASE, and PsycINFO to August 2015. We included studies if they used any patient-reported scale of hearing loss or tinnitus among children and AYAs with cancer or HSCT recipients. Only English language publications were included. Two reviewers identified studies and abstracted data. Results There were 953 studies screened; 6 met eligibility criteria. All studies administered hearing patient-reported outcomes only once, after therapy completion. None of the studies described the psychometric properties of the hearing-specific component. Three instruments (among 6 studies) were used: Health Utilities Index (Barr et al., 2000; Fu et al., 2006; Kennedy et al., 2014), Hearing Measurement Scales (Einar-Jon et al., 2011; Einarsson et al., 2011), and the Tinnitus Questionnaire for Auditory Brainstem Implant (Soussi & Otto, 1994). All had limitations, precluding routine use for hearing assessment in this population. Conclusions We identified few studies that included hearing patient-reported measures for children and AYA cancer and HSCT patients. None are ideal to take forward into future studies. Future work should focus on the creation of a new psychometrically sound instrument for hearing outcomes in this population.

Provider Documentation of Tinnitus in Childhood Cancer Survivors

“…31 However, no validated PRO instrument exists for tinnitus in pediatric patients despite multiple calls for their development. 25,26,[32][33][34] Until such an instrument is available, other changes in practice, such as a checklist system for symptoms related to treatment exposures or obtaining the review of systems through a patient-completed questionnaire, might improve screening and earlier detection of tinnitus in CCS without requiring the additional health care costs more frequent audiologic evaluation would entail. 35,36 In summary, documented screening and detection of tinnitus by survivorship providers is inadequate, even among high-risk CCS.…”

Validation of questionnaire-reported hearing with medical records: A report from the Swiss Childhood Cancer Survivor Study

“…They have shown that single questions such as “Do you have a problem with your hearing?” are less able to detect mild hearing loss than more comprehensive instruments like the Hearing Handicap Inventory for the Elderly—Screening Version (HHIE-S) [30]. A recent systematic review that described patient-reported measures for hearing loss identified only two instruments, the Health Utilities Index (HUI) [31] and the Hearing Measurement Scale (HMS) [32] that are used with childhood cancer patients [33]. The HUI includes six questions, the HMS 44 questions, and both return hearing-specific summary scores.…”

“…The HUI includes six questions, the HMS 44 questions, and both return hearing-specific summary scores. Researchers reported that none of the questionnaires appeared ideal based upon the number of questions, and wording for children or adolescents, and psychometric properties were never tested in this population [33]. …”

Introductory Chapter - Genealogy of Audiology

“…Important aspects of novel hearing restoration strategies including gene therapy [3], stem cells [4,5], and related intracochlear distribution nanotechnologies [6,7] are still at best in a preclinical phase.…”