NCT07586098

Brief Summary

Hearing loss affects approximately 11 million people in the UK, while tinnitus impacts around 7 million. Both conditions can significantly reduce quality of life and are linked to poorer mental health and employment challenges. Each year, tinnitus alone accounts for more than one million GP appointments, and patients referred to hospital ear, nose and throat (ENT) services often face long delays, sometimes exceeding a year, before their first assessment. To address this demand, the Royal Cornwall Hospitals NHS Trust has developed a virtual ENT clinic. Patients undergo a validated hearing test in person and complete online questionnaires. Clinicians then review these data to determine next steps, which may include discharge with advice, referral for imaging, or a face-to-face consultation. Initial trials demonstrated that the majority of patients could be managed virtually, substantially reducing waiting times. However, clinicians must still review every case, limiting capacity for patients who require direct care. This project builds on the virtual clinic by introducing artificial intelligence (AI) to support the assessment process. Using explainable AI methods, the system will be trained to replicate clinician-level decision-making while providing transparent reasoning for its recommendations. The study will evaluate how closely AI-generated outcomes align with clinician assessments, with all cases continuing to receive a clinician's final review. Clinicians will not be aware of the recommendations produced by the AI tool, but the study aims to measure how concordant AI recommendations are with clinician assessments. If the AI tool's clinical recommendations closely align with clinician recommendations (the gold standard for care), the AI tool could be introduced as a clinical recommendation assistant tool, streamlining the triage and management of hearing loss and tinnitus, enabling clinicians to focus on complex cases, accelerating access to care, and improving efficiency.

Trial Health

63
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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,500

participants targeted

Target at P75+ for all trials

Timeline
15mo left

Started May 2026

Geographic Reach
1 country

1 active site

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 7, 2026

Completed
7 days until next milestone

First Posted

Study publicly available on registry

May 14, 2026

Completed
16 days until next milestone

Study Start

First participant enrolled

May 30, 2026

Expected
3 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 13, 2026

1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2027

Last Updated

May 14, 2026

Status Verified

May 1, 2026

Enrollment Period

3 months

First QC Date

May 7, 2026

Last Update Submit

May 7, 2026

Conditions

Keywords

Artificial IntelligenceHearing LossTinnitusClinical Decision Support SystemsComputerizedTelemedicineOtolaryngologyPatient SatisfactionFeasibility Studies

Outcome Measures

Primary Outcomes (2)

  • MRI internal auditory meatus (IAM) referral recommendation

    Agreement between the clinical outcomes generated by the AI clinical decision support system and the clinician-derived "gold standard" outcomes within the virtual hearing loss and tinnitus clinic. Agreement will be evaluated for: MRI internal auditory meatus (IAM) referral recommendation (binary outcome: yes/no). Agreement will be quantified using sensitivity and specificity with 95% confidence intervals, derived from contingency tables and one-vs-rest analyses for categorical outcomes, as specified in the statistical analysis plan.

    March 2026 - August 2026

  • Clinical triage outcome

    Agreement between the clinical outcomes generated by the AI clinical decision support system and the clinician-derived "gold standard" outcomes within the virtual hearing loss and tinnitus clinic. Agreement will be evaluated for: Clinical triage outcome (categorical outcome: refer to face-to-face ENT clinic, refer to audiology, refer to audiology plus hearing therapy, or discharge). Agreement will be quantified using sensitivity and specificity with 95% confidence intervals, derived from contingency tables and one-vs-rest analyses for categorical outcomes, as specified in the statistical analysis plan.

    March 2026 - August 2026

Secondary Outcomes (2)

  • Patient experience and satisfaction with the AI-assisted virtual hearing loss and tinnitus clinic

    August 2026 - August 2027

  • Staff experience, usability, and acceptability of the AI-assisted clinical decision support system

    August 2026 - August 2027

Study Arms (3)

Phase 1 - Patients undergoing the standard virtual hearing loss and tinnitus clinic

Phase 1 consists of a retrospective and prospective observational evaluation of consecutive adult patients managed through the virtual hearing loss and tinnitus clinic at the Royal Cornwall Hospitals Trust, between August 2025 and August 2026. No additional interventions.

Device: Artificial Intelligence (AI) Assisted Clinical Decision Support Tool for managing Hearing Loss and Tinnitus

Phase 2 - Patients undergoing the AI-assisted virtual hearing loss and tinnitus clinic

Phase 2 consists of a prospective observational evaluation of consecutive adult patients managed through the AI-assisted virtual hearing loss and tinnitus clinic at the Royal Cornwall Hospitals Trust, between August 2026 and August 2027. The AI-assisted clinic is the intervention.

Device: Artificial Intelligence (AI) Assisted Clinical Decision Support Tool for managing Hearing Loss and Tinnitus

Phase 2 - Staff involved in providing an AI-assisted virtual hearing loss and tinnitus clinic

Staff involved in running the artificial intelligence-assisted virtual hearing loss and tinnitus clinic at the Royal Cornwall Hospitals Trust from August 2026 to August 2027. They include doctors, healthcare assistants, administrative staff and nurses. The AI-assisted clinic is the intervention.

Device: Artificial Intelligence (AI) Assisted Clinical Decision Support Tool for managing Hearing Loss and Tinnitus

Interventions

An explainable AI-based clinical decision support tool within an existing virtual hearing loss and tinnitus clinic. The tool provides non-binding triage and investigation recommendations based on routinely collected patient data, with all final clinical decisions remaining the responsibility of the clinician and no change to standard care pathways

Phase 1 - Patients undergoing the standard virtual hearing loss and tinnitus clinicPhase 2 - Patients undergoing the AI-assisted virtual hearing loss and tinnitus clinicPhase 2 - Staff involved in providing an AI-assisted virtual hearing loss and tinnitus clinic

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

The study population comprises adult patients managed through the virtual hearing loss and tinnitus clinic, in the Ear, Nose and Throat Department at the Royal Cornwall Hospitals Trust. Patients included are seen in the virtual clinic during the study period, as well as clinical staff involved in reviewing and making decisions within the service. Patient data are analysed observationally, and a subset of patients and clinicians may be invited to provide questionnaire or interview data to explore experiences of the AI-assisted clinic. Patients will comprise of those living in the county of Cornwall and considered under the care of the Royal Cornwall Hospitals Trust.

You may qualify if:

  • Patients assessed in the RCHT virtual hearing loss and tinnitus clinic.
  • Presenting symptoms of hearing loss and/or tinnitus.
  • Ability to provide informed consent to participate in the study.

You may not qualify if:

  • Individuals under 18 years of age.
  • Patients unable to provide informed consent.
  • Patients without sufficient English proficiency where translation services cannot be arranged.
  • Cases where data quality is insufficient for analysis.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Treliske Hospital

Truro, Cornwall, TR1 1LJ, United Kingdom

Location

Related Publications (1)

  • Baron T, Whinney D, Reddy V. Virtual clinic for hearing loss and non-pulsatile tinnitus: initial experience of 210 cases. J Laryngol Otol. 2024 Jan;138(1):38-42. doi: 10.1017/S0022215123000518. Epub 2023 Mar 20.

MeSH Terms

Conditions

Hearing LossTinnitusPatient Satisfaction

Condition Hierarchy (Ancestors)

Hearing DisordersEar DiseasesOtorhinolaryngologic DiseasesSensation DisordersNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsTreatment Adherence and ComplianceHealth BehaviorBehavior

Central Study Contacts

Neil C Tan, MEd PhD FRCS(ORL-HNS)

CONTACT

Christian JW Grimes, BMBS MRCS (ENT) PGCert ClinEd

CONTACT

Study Design

Study Type
observational
Observational Model
OTHER
Time Perspective
OTHER
Target Duration
1 Year
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 7, 2026

First Posted

May 14, 2026

Study Start (Estimated)

May 30, 2026

Primary Completion (Estimated)

August 13, 2026

Study Completion (Estimated)

August 31, 2027

Last Updated

May 14, 2026

Record last verified: 2026-05

Locations