Audiologists’ perceived value of ototoxicity management and barriers to implementation for at-risk cancer patients in VA - The OtoMIC survey

Sep 28, 2026

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Platinum-based chemotherapy can cause ototoxicity, yet ototoxicity management (OtoM) is not routinely integrated into oncology care for cancer survivors. Using a national VA survey, the study examines how audiologists perceive OtoM value and identifies gaps in implementation. Responses from 61 audiology professionals indicate strong agreement on key OtoM objectives—baseline assessment, early detection, and management during and after treatment—while highlighting disagreements about testing schedules and shared responsibilities. Barriers cluster around oncology coordination, audiology workload, and absence of protocols.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

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Implications for cancer survivors

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Audiologists’ perceived value of ototoxicity management and barriers to implementation for at‑risk cancer patients in VA: the OtoMIC survey Dawn Konrad‑Martin1,2 · Rachel Polaski1 · J. Riley DeBacker1 · Sarah M. Theodoroff1,2 · Angela Garinis1,2 · Cecilia Lacey1 · Kirsten Johansson3 · Rosemarie Mannino3 · Trisha Milnes1,4 · Michelle Hungerford1 · Khaya D. Clark1,5 Received: 14 September 2022 / Accepted: 7 December 2022 / Published online: 2 February 2023 This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023 Abstract Purpose Platinum-based chemotherapies used to treat many types of cancers are ototoxic. Ototoxicity management (OtoM) to mitigate the ototoxic outcomes of cancer survivors is recommended practice yet it is not a standard part of oncologic care. Although more than 10,000 patients each year are treated with platinum-based chemotherapies at the US Veterans Health Administration (VA), the current state of OtoM in VA is not well-defined. This study reports on a national survey of VA audiologists’ perceptions regarding OtoM in cancer patients. Methods A 26-item online survey was administered to VA audiologists and service chiefs across the VA’s 18 regional systems of care. Descriptive statistics and deductive thematic analysis were used to analyze the data. Results The 61 respondents included at least one from each VA region. All reported they felt some form of OtoM was necessary for at-risk cancer patients. A pre-treatment baseline, the ability to detect ototoxicity early, and management of ototoxic effects both during and after treatment were considered high value objectives of OtoM by respondents. Roughly half reported routinely providing these services for patients receiving cisplatin and carboplatin. Respondents disagreed regarding appropriate hearing testing schedules and how to co-manage OtoM responsibilities with oncology. They identified barriers to care that conformed to three themes: care and referral coordination with oncology, audiology workload, and lack of protocols. Conclusions Although VA audiologists value providing OtoM for cancer patients, only about half perform OtoM for highly ototoxic treatment regimens. The OtoMIC survey provides clinician perspectives to benchmark and address OtoM care gaps. Implications for cancer survivors Collaboration between oncology and audiology is needed to improve current OtoM processes, so that cancer survivors can have more control over their long term hearing health. Keywords Ototoxicity · Hearing loss · Drug-related side effects and adverse reactions · Survey · Drug monitoring · Professional practice gaps Introduction Platinum-based chemotherapeutics, such as cisplatin and carboplatin, are highly effective at treating a variety of common cancers including those of the bladder, bone, cervix, colon, * Dawn Konrad-Martin [dawn.martin@va.gov](dawn.martin@va.gov) 1 National Center for Rehabilitative Auditory Research, VA Portland Health Care System, 3710 SW US Veterans Hospital Road, P5-NCRAR, Portland, OR 97239, USA 2 Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA endometrium, esophagus, head and neck, lung, ovaries, testes, pancreas, rectum, and stomach [1] . Unfortunately, platinumbased drugs are also highly ototoxic [2–7]. According to the 2018 Ototoxicity Working Group of Pharmaceutical Interventions for Hearing Loss, ototoxicity is defined as “…damage 3 Department of Hematology/Oncology, VA Portland Health Care System, Portland, OR, USA 4 Charlie Norwood VA Medical Center, Augusta, GA, USA 5 Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA to the inner ear, targeting cochlear and vestibular structures and sensory function, due to exposure to certain pharmaceuticals, chemicals, and/or ionizing radiation” [8] . In a recent meta-analysis of da

FAQs

What prompted the OtoMIC survey in the VA context?

Ototoxicity management is recommended but not a standard part of oncologic care, and the state of OtoM in the VA had not been well defined.

What OtoM objectives did respondents rate as high value?

Respondents emphasized a pre-treatment baseline, early detection of ototoxicity, and managing ototoxic effects during and after treatment.

What barriers to implementing OtoM were identified?

Barriers aligned with three themes: coordination and referral with oncology, audiology workload, and lack of protocols.

Sep 28, 2026

Uploaded by OmBimo