Mobile Audiometry for Use in Ototoxicity Monitoring Programs: A Scoping Review.

Abstract

Ototoxicity monitoring programs (OMPs) for cisplatin-induced hearing loss have not been widely adopted in clinical practice for various reasons. Mobile audiometry (MA) offers cost and convenience advantages over conventional pure-tone audiometry (CA) and it is currently used in hearing screening. However, there is no consensus on whether MA can replace CA for measuring hearing thresholds in OMPs. This scoping review examines the challenges of OMPs and evaluates the diagnostic accuracy of MA for hearing thresholds. A comprehensive search was conducted in four databases from their inception to December 2024. Data on study characteristics, reported OMP challenges, MA specifications, test settings, and performance measures were extracted. Nine studies on OMP challenges were reviewed. Identified barriers were inconsistent referrals, resource constraints, low awareness of ototoxicity monitoring, and patient-related factors. Twenty-three studies reporting on three portable audiometers, and 14 app-based hearing tests were evaluated for the diagnostic accuracy of MA for hearing thresholds. Only two studies involved testing at extended high frequencies. Studies used measures including MA-CA threshold differences, sensitivity/specificity, and test-retest reliability. App-based MA represents an accessible and scalable solution to the resource constraints faced by OMPs. However, its diagnostic accuracy remains uncertain given the substantial methodological variability across studies. OMPs using MAs should consider clinically validated modalities.