Sensorineural Hearing Loss: A Changing Paradigm for Its Evaluation

Asitha D L Jayawardena; A Eliot Shearer; Richard J H Smith

doi:10.1177/0194599815596727

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Sensorineural Hearing Loss: A Changing Paradigm for Its Evaluation

Journal article

Open access

Peer reviewed

Sensorineural Hearing Loss: A Changing Paradigm for Its Evaluation

Asitha D L Jayawardena, A Eliot Shearer and Richard J H Smith

Otolaryngology--head and neck surgery, Vol.153(5), pp.843-850

11/2015

DOI: 10.1177/0194599815596727

PMCID: PMC4730883

PMID: 26216887

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https://www.ncbi.nlm.nih.gov/pmc/articles/4730883View

Open Access

Abstract

To determine how practicing clinicians evaluate patients with sensorineural hearing loss (SNHL) and to analyze the cost-effectiveness of current algorithms in the evaluation of these patients. An interactive online survey allowing respondents to order diagnostic testing in the evaluation of 4 simulated patients with SNHL across 2 testing encounters per patient. The survey was distributed to clinician members of the American Society of Pediatric Otolaryngology and the American Society of Human Genetics between May and August 2014. Statistical tests included chi-square and nonparametric testing with Mann-Whitney U test. Otolaryngologists were significantly more likely than other clinicians to order repeat audiometric testing and significantly less likely to order genetic testing. Respondents who completed training more recently were significantly more likely to order magnetic resonance imaging and electrocardiogram. On average, respondents spent $4756 in the evaluation of a single patient, with otolaryngologists spending significantly more than other clinicians. Computed tomography of the temporal bone (40%), ophthalmology consultation (39%), and genetics consultation (37%) were ordered most frequently in the first encounter. Comprehensive genetic testing was ordered least frequently on the first encounter (20%) but was the most frequently ordered test on the second encounter (30%). Recent guidelines advocate comprehensive genetic testing in the evaluation of patients with SNHL, as early genetic testing can prevent uninformative additional tests that otherwise increase health care expenditures. Results from this survey indicate that comprehensive genetic testing is now frequently but not uniformly included in evaluation of patients with SNHL.

Audiometry - methods

Temporal Bone - diagnostic imaging

Humans

Magnetic Resonance Imaging - methods

Tomography, X-Ray Computed - methods

Infant

Male

Genetic Testing - methods

Hearing Loss, Sensorineural - diagnosis

Algorithms

Adult

Female

Referral and Consultation

Child

Hearing Loss, Sensorineural - physiopathology

Details

Title: Subtitle: Sensorineural Hearing Loss: A Changing Paradigm for Its Evaluation
Creators: Asitha D L Jayawardena - Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
A Eliot Shearer - Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
Richard J H Smith - Department of Molecular Physiology & Biophysics, University of Iowa College of Medicine, Iowa City, Iowa, USA
Resource Type: Journal article
Publication Details: Otolaryngology--head and neck surgery, Vol.153(5), pp.843-850
DOI: 10.1177/0194599815596727
PMID: 26216887
PMCID: PMC4730883
NLM abbreviation: Otolaryngol Head Neck Surg
ISSN: 0194-5998
eISSN: 1097-6817
Publisher: England
Grant note: R01 DC003544 / NIDCD NIH HHS R01 DC012049 / NIDCD NIH HHS R01 DC002842 / NIDCD NIH HHS
Language: English
Date published: 11/2015
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Otolaryngology; Internal Medicine
Record Identifier: 9984006493702771

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