{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:27:04Z","timestamp":1792502824465,"version":"4.5.0"},"reference-count":0,"publisher":"American Academy of Audiology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2010,5,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold>There is disagreement about ototoxicity monitoring methods. Controversy exists about what audiometric threshold shift criteria should be used, which frequencies should be tested, and with what step size. An evaluation of the test performance achieved using various\n criteria and methods for ototoxicity monitoring may help resolve these issues.<jats:bold>Purpose:<\/jats:bold>(1) Evaluate test performance achieved using various significant threshold shift (STS) definitions for ototoxicity monitoring in a predominately veteran population; and (2) determine whether testing\n in \u2159- or \u2153-octave steps improves test performance compared to \u00bd-octave steps.<jats:bold>Research Design:<\/jats:bold>A prospective, observational study design was used in which STSs were evaluated at frequencies within an octave of each subject's high-frequency hearing limit at two time\n points, an early monitoring test and the final monitoring test.<jats:bold>Study Sample:<\/jats:bold>Data were analyzed from 78 ears of 41 patients receiving cisplatin and from 53 ears of 28 hospitalized patients receiving nonototoxic antibiotics. Cisplatin-treated subjects received a cumulative dosage \u2265350\u2005mg\n by the final monitoring test. Testing schedule, age, and pre-exposure hearing characteristics were similar between the subject groups.<jats:bold>Data Collection and Analysis:<\/jats:bold>Threshold shifts relative to baseline were examined to determine whether they met criteria based on magnitudes of positive\n STS (shifts of \u22655, 10, 15, or 20\u2005dB) and numbers of frequencies affected (shifts at \u22651, 2, or 3 adjacent frequencies) for data collected using approximately \u2159-, \u2153-, or \u00bd-octave steps. Thresholds were confirmed during monitoring sessions in which shifts were\n identified. Test performance was evaluated with receiver operating characteristic (ROC) curves developed using a surrogate \u201cgold standard\u201d; true positive (TP) rates were derived from the cisplatin-exposed group and false positive (FP) rates from the nonexposed, control group. Best\n STS definitions were identified that achieved the greatest areas under ROC curves or resulted in the highest TP rates for a fixed FP rate near 5%, chosen to minimize the number of patients incorrectly diagnosed with ototoxic hearing loss.<jats:bold>Results:<\/jats:bold>At the early monitoring test, average\n threshold shifts differed only slightly across groups. Test-frequency step size did not affect performance, and changes at one or more frequencies yielded the best test performance. At the final monitoring test, average threshold shifts were +10.5\u2005dB for the cisplatin group, compared\n with \u22120.2\u2005dB for the control group. Compared with the \u00bd-octave step size used clinically, use of smaller frequency steps improved test performance for threshold shifts at \u22652 or \u22653 adjacent frequencies. Best overall test performance was achieved using a criterion cutoff\n of \u226510\u2005dB threshold shift at \u22652 adjacent frequencies tested in \u2159-octave steps. Best test performance for the \u00bd-octave step size was achieved for shifts \u226515\u2005dB at one or more frequencies.<jats:bold>Conclusions:<\/jats:bold>An ototoxicity monitoring protocol that uses an individualized,\n one-octave range of frequencies tested in \u2159-octave steps is quick to administer and has an acceptable FP rate. Similar test performance can be achieved using \u2153-octave test frequencies, which further reduces monitoring test time.<\/jats:p>","DOI":"10.3766\/jaaa.21.5.3","type":"journal-article","created":{"date-parts":[[2011,4,14]],"date-time":"2011-04-14T09:52:33Z","timestamp":1302774753000},"page":"301-314","source":"Crossref","is-referenced-by-count":20,"title":["Evaluation of Audiometric Threshold Shift Criteria for Ototoxicity Monitoring"],"prefix":"10.3766","volume":"21","author":[{"given":"Dawn","family":"Konrad-Martin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth E.","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M.","family":"Reavis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene W.","family":"Bratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Fausti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2087","container-title":["Journal of the American Academy of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/aaa\/jaaa\/2010\/00000021\/00000005\/art00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:59:35Z","timestamp":1738828775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.3766\/jaaa.21.5.3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,5,1]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2010,5,1]]}},"alternative-id":["1050-0545(20100501)21:5L.301;1-"],"URL":"https:\/\/doi.org\/10.3766\/jaaa.21.5.3","relation":{},"ISSN":["1050-0545"],"issn-type":[{"value":"1050-0545","type":"print"}],"subject":[],"published":{"date-parts":[[2010,5,1]]}}}