Video game hearing tests for remote monitoring of ototoxicity
Research type
Research Study
Full title
Development and validation of the use of Video games and virtual reality to enable Autonomous Remote monitoring of OTotoxicity in high-risk population groups (VAROT).
IRAS ID
298372
Contact name
Francis Drobniewski
Contact email
Sponsor organisation
Imperial College London
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
Aminoglycoside antibiotics are widely used to treat life-threatening infections, but are associated with ear-related problems. Recent studies show that approximately 50% of cystic fibrosis patients, regularly treated with aminoglycosides, have hearing loss. Despite guidelines recommending monitoring of hearing during aminoglycoside use, there are many barriers due to inconsistent referrals and logistical limitations. Delays in screening for hearing loss lead to reduced quality of life and poorer socioeconomic implications.
Current formal hearing tests involve visiting clinical settings with integrated sound-booths which are expensive to install and require specialist staff. Tablet-based hearing tests were recently shown to effectively detect hearing loss in adult cystic fibrosis patients when compared to formal sound-booth hearing tests. Web-based hearing tests were shown not to be as effective in the same study.
The COVID-19 pandemic has highlighted the need for remote autonomous systems with reduced visits to hospital.
We propose to integrate hearing tests within videogames and virtual reality software with existing technology from the Both EARS (BEARS) project. This adaptation will be used to perform hearing tests and detect for hearing loss in patients receiving antibiotics that can cause damage to the ears. It will determine whether video game-based virtual reality hearing tests are an effective means to monitor for hearing loss remotely. Videogame-based virtual reality technology will also be used to train and potentially improve patient’s ability to locate sound in noisy environments and their clarity in speaking. We will also determine patient satisfaction and usability of the system.
The results of the study will help provide alternative options for monitoring hearing loss caused by antibiotics, using advancing mobile technology with the ability to monitor hearing remotely, autonomously with potential improvement in everyday listening experiences. This can minimise inequality of access to screening, detect hearing loss earlier, reduce healthcare costs, minimise socioeconomic impact on patients.Summary of Results
VAROT Pathway 1 (Monitoring ototoxicity):
We are not able to say whether virtual reality hearing tests were an effective means of monitoring hearing loss in patients receiving agents that can cause hearing loss as a side effect due to insufficient numbers of patients - only one patient developed an ototoxic shift. Patients preferred iPad hearing tests over virtual reality hearing tests.
VAROT Pathway 2 (tablet-based audiometry validation):
Older patients were more likely to have hearing loss. There was no difference in detecting hearing loss using either iPad or sound booth audiometers. The iPad hearing test had high likelihood of true positive (test says person has hearing loss when in fact they do have it) and true negative (test says person does not have hearing loss when they do not have it) i.e. results with good accuracy compared to the traditional sound booth hearing test. Patients rated the usability of iPad hearing test higher than sound booth hearing test indicating that they preferred iPad over sound booth hearing test.
VAROT Pathway 3 (audio-training):
There was no difference seen in changes of Virtual Reality hearing tests results between participants using audio-training and those who did not experience it. Participants preferred the audio-training sessions over the virtual reality hearing tests.REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
21/WM/0283
Date of REC Opinion
18 Nov 2021
REC opinion
Favourable Opinion