CEDRA: A Tool to Help Consumers Assess Risk for Ear Disease

Abstract

This article introduces the Consumer Ear Disease Risk Assessment (CEDRA) tool. CEDRA is a brief questionnaire designed to screen for targeted ear diseases. It offers an opportunity for consumers to self-screen for disease before seeking a hearing device and may be used by clinicians to help their patients decide the appropriate path to follow in hearing healthcare. Here we provide highlights of previously published validation in the context of a more thorough description of CEDRA’s development and implementation. CEDRA’s sensitivity and specificity, using a cut-off score of 4 or higher, was 90% and 72%, respectively, relative to neurotologist diagnoses in the initial training sample used to create the scoring algorithm (n = 246). On a smaller independent test sample (n = 61), CEDRA’s sensitivity and specificity were 76% and 80%, respectively. CEDRA has readability levels similar to many other patient-oriented questionnaires in hearing healthcare, and informal reports from pilot CEDRA-providers indicate that the majority of patients can complete it in less than 10 min. As the hearing healthcare landscape changes and provider intercession is no longer mandated, CEDRA provides a measure of safety without creating a barrier to access.

Consensus on connected hearing health technologies and service delivery models in the UK: a Delphi review

“…This is a short 10-minute questionnaire with strong psychometric properties that has the potential to help an adult appropriately identify a pathway for hearing healthcare. While we failed to achieve consensus regarding whether this method would be a suitable means of assessing the risk of medical contraindications, this may have reflected an overall lack awareness of the CEDRA tool amongst our UK-based expert panel, as well as awareness about the evidence demonstrating its reliability and validity (Klyn et al, 2019). In relation, while adults in the UK may be aware about the signs and symptoms of hearing loss, they have less knowledge about how to address their condition.…”

“…Consumer Ear Disease Risk Assessment (CEDRA) tool could be used by patients to selfassess their individual risks of ear disease (Klyn et al, 2019). This is a short 10-minute questionnaire with strong psychometric properties that has the potential to help an adult appropriately identify a pathway for hearing healthcare.…”

Using Machine Learning and the National Health and Nutrition Examination Survey to Classify Individuals With Hearing Loss

“…As a caution, if in-home testing becomes a broadly accepted option in the future, careful steps will need to be taken to make sure that patients have a pathway for follow-up likely including a full audiogram, medical care, and that treatable audiologic disorders are not missed. One questionnaire, the Consumer Ear Disease Risk Assessment (CEDRA), effectively screens for serious audiologic disorders ( 22 ). CEDRA or a similar questionnaire could be used as a supplement during at-home hearing screening.…”

The role of hearing professionals for over-the-counter hearing aids

“…These criteria were made to screen for potential secondary causes of hearing loss before a patient purchases a hearing aid (Kuhn et al, 2011;Lee and Bance, 2019). For patients still unsure if they require medical evaluation before obtaining a hearing aid, the Consumer Ear Disease Risk Assessment (CEDRA) provides a more in-depth analysis to determine risk for ear disease before obtaining a hearing aid (Klyn et al, 2019). When a prospective hearing aid user does visit their primary care physician, the physician is able to assess for risk of secondary causes of their hearing and determine if they need referral to hearing specialists.…”