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  • 1
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    Online Resource
    Assessment of Electrode Placement and Audiological Outcomes in Bilateral Cochlear Implantation
    Ovid Technologies (Wolters Kluwer Health) ; 2011
    In:  Otology & Neurotology Vol. 32, No. 3 ( 2011-04), p. 428-432
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 3 ( 2011-04), p. 428-432
    Type of Medium: Online Resource
    ISSN: 1531-7129
    URL: Article
    DOI: 10.1097/MAO.0b013e3182096dc2
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2011
    detail.hit.zdb_id: 2058738-7
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  • 2
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    Patient-Related Factors Do Not Predict Use of Computer-Based Auditory Training by New Adult Cochlear Implant Recipients
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Otology & Neurotology Vol. 44, No. 2 ( 2023-2), p. e81-e87
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 2 ( 2023-2), p. e81-e87
    Abstract: The use of computer-based auditory training (CBAT) after cochlear implantation is associated with improved speech recognition and real-world functional abilities. However, patient-related factors associated with CBAT use remain unknown. This study seeks to identify such factors and recognize those at risk for not implementing CBAT. Study Design Prospective natural experiment. Setting Tertiary academic center. Patients A total of 117 new adult cochlear implant (CI) recipients with bilateral moderate-to-profound hearing loss. Interventions/Main Outcome Measures Patient demographic and lifestyle information, preimplantation aided speech recognition scores, Cochlear Implant Quality of Life (CIQOL) domain and global scores, CIQOL-Expectations scores, and CBAT use in the first 3 months after activation. Patient-related variables included age, sex, race, duration of hearing loss before implantation, hours of CI use per day, hearing-aid use before implantation, living arrangements/marital status, annual household income, employment, technology use, and education. Results Overall, 33 new CI users (28.2%) used CBAT in the first 3 months after activation. On bivariate analysis of the pre-CI CIQOL scores, CIQOL-Expectations score, aided speech recognition scores, and demographic/lifestyle factors examined, regular use of smartphone, tablet, or computer technology was significantly associated with an increased likelihood of CBAT use (odds ratio, 9.354 [1.198-73.020]), whereas higher CIQOL-Expectations emotional domain scores were associated with a lower likelihood of CBAT use ( d = −0.69 [−1.34 to −0.05]). However, using multivariable analysis to control for potential confounding factors revealed no significant associations between CBAT use in the first 3 months after cochlear implantation and any examined factor. Conclusions No associations between patient demographic, lifestyle, or pre-CI speech recognition and patient-reported outcome measures and CBAT use were identified. Therefore, discussions with all patients after implantation on the availability of CBAT and its potential benefits are warranted. In addition, given the limited overall use of CBAT and its association with improved CI outcomes, future studies are needed to investigate facilitators and barriers to CBAT use.
    Type of Medium: Online Resource
    ISSN: 1537-4505 , 1531-7129
    URL: Article
    DOI: 10.1097/MAO.0000000000003764
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 3
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    Factors Influencing Time to Cochlear Implantation
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Otology & Neurotology Vol. 41, No. 2 ( 2020-02), p. 173-177
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 41, No. 2 ( 2020-02), p. 173-177
    Abstract: To determine demographic and audiologic factors associated with time to treatment with cochlear implantation. Methods: Retrospective review of a prospectively maintained adult cochlear implant database. A total of 492 patients were implanted from 2012 to 2017. Time to implantation, preimplantation audiologic outcomes, and demographic data were collected. Multivariate analysis was undertaken to establish demographic/audiologic factors that predict time to cochlear implantation. Results: Using multivariate analysis, nonwhite race (hazard ratio 0.157, p  = 0.038) and increased age (hazard ratio 0.970, p  = 0.038) were associated with increased time to cochlear implantation. Nonwhite patients had significantly higher pure-tone averages and lower speech recognition scores (consonant–nucleus–consonant words and AzBio sentences in quiet) and were less likely to use hearing aids as compared with white patients (all p   〈  0.001). Sex ( p  = 0.188), health insurance type ( p  = 0.255), preoperative hearing aid use ( p  = 0.174), and audiologic outcomes were not significant predictors of time to implantation. Conclusion: Nonwhite patients have poorer preoperative hearing and speech recognition and lower hearing aid use and are at risk for delay in referral and treatment for severe to profound sensorineural hearing loss. Other demographic factors, notably health insurance status, did not significantly predict time to cochlear implantation. Given the observed hearing healthcare disparities, special outreach programs may be needed to ensure timely cochlear implantation and effective hearing screening and rehabilitation.
    Type of Medium: Online Resource
    ISSN: 1531-7129 , 1537-4505
    URL: Article
    DOI: 10.1097/MAO.0000000000002449
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 4
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    Use of Adult Patient Focus Groups to Develop the Initial Item Bank for a Cochlear Implant Quality-of-Life Instrument
    American Medical Association (AMA) ; 2017
    In:  JAMA Otolaryngology–Head & Neck Surgery Vol. 143, No. 10 ( 2017-10-01), p. 975-
    Details
    In: JAMA Otolaryngology–Head & Neck Surgery, American Medical Association (AMA), Vol. 143, No. 10 ( 2017-10-01), p. 975-
    Type of Medium: Online Resource
    ISSN: 2168-6181
    URL: Article
    DOI: 10.1001/jamaoto.2017.1182
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2017
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  • 5
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    Using Clinical Audiologic Measures to Determine Cochlear Implant Candidacy
    S. Karger AG ; 2022
    In:  Audiology and Neurotology Vol. 27, No. 3 ( 2022), p. 235-242
    Details
    In: Audiology and Neurotology, S. Karger AG, Vol. 27, No. 3 ( 2022), p. 235-242
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Only a small percentage (6–10%) of patients who are candidates receive cochlear implants (CIs). One potential reason contributing to low usage rates may be confusion regarding which patients to refer for CI evaluation. The extent to which information provided by standard clinical audiologic assessments is sufficient for selecting appropriate CI evaluation referrals is uncertain. The objective of this study is to evaluate the capacity of standard clinical audiologic measures to differentiate CI candidates from noncandidates. 〈 b 〉 〈 i 〉 Method: 〈 /i 〉 〈 /b 〉 The study design is a retrospective review of a prospectively maintained CI database from a university-based tertiary medical center of 518 patients undergoing CI evaluations from 2012 to 2020. Each ear of each patient was treated as an independent value. Receiver operating characteristic (ROCs) curves were constructed using aided AzBio sentence recognition scores in quiet and aided AzBio +10 dB signal-to-noise ratio scores & #x3c;60% as binary classifiers for CI candidacy. For each ROC, we examined the capacity of multiple pure-tone thresholds, pure-tone average (PTA), and CNC word recognition scores (WRSs) measured under earphones to determine CI candidacy. Area under the curve ROC (AUC-ROC) values were calculated to demonstrate the capacity of each model to differentiate CI candidates from noncandidates. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Variables with the greatest capacity to accurately differentiate CI candidates from noncandidates using aided AzBio in quiet scores were earphone CNC WRS, earphone pure-tone threshold at 1,000 Hz, and earphone PTA (AUC-ROC values = 0.86–0.88). Using aided AzBio +10 scores as the measure for candidacy, only CNC word recognition had a fair capacity to identify candidates (AUC-ROC value = 0.73). Based on the ROCs, a 1,000 Hz pure-tone threshold & #x3e;50 dB HL, PTA & #x3e;57 dB HL, and a monosyllabic WRS & #x3c;60% can each serve as individual indicators for referral for CI evaluations. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The current study provides initial indicators for referral and a first step at developing evidence-based criteria for CI evaluation referral using standard audiologic assessments.
    Type of Medium: Online Resource
    ISSN: 1420-3030 , 1421-9700
    URL: Article
    DOI: 10.1159/000520077
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1481979-X
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  • 6
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    Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures
    S. Karger AG ; 2020
    In:  Audiology and Neurotology Vol. 25, No. 4 ( 2020), p. 215-223
    Details
    In: Audiology and Neurotology, S. Karger AG, Vol. 25, No. 4 ( 2020), p. 215-223
    Abstract: 〈 b 〉 〈 i 〉 Purpose: 〈 /i 〉 〈 /b 〉 To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all 〈 i 〉 p 〈 /i 〉 & #x3e; 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations ( 〈 i 〉 r 〈 /i 〉 = 0.37, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; 〈 i 〉 r 〈 /i 〉 = 0.28, 〈 i 〉 p 〈 /i 〉 = 0.005, respectively) and ease of communication APHAB subscale scores ( 〈 i 〉 r 〈 /i 〉 = 0.32, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; 〈 i 〉 r 〈 /i 〉 = 0.33, 〈 i 〉 p 〈 /i 〉 = 0.001, respectively). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.
    Type of Medium: Online Resource
    ISSN: 1420-3030 , 1421-9700
    URL: Article
    DOI: 10.1159/000506666
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1481979-X
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  • 7
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    Use of Auditory Training and Its Influence on Early Cochlear Implant Outcomes in Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Otology & Neurotology Vol. 43, No. 2 ( 2022-02), p. e165-e173
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 2 ( 2022-02), p. e165-e173
    Abstract: Assess associations between postcochlear implant (CI) auditory training and early outcomes related to speech recognition and CI quality of life (CIQOL). Study Design: Longitudinal, prospective cohort. Setting: Tertiary academic center. Patients: Seventy-two adults undergoing cochlear implantation for bilateral severe-to-profound hearing loss. Interventions: Self-reported use of three categories of auditory training post-CI activation: (1) face-to-face training (e.g., speech pathologist), (2) passive home-based training (e.g., listening to audiobooks), and (3) computer-based training (e.g., interactive software). Main Outcome Measures: Change in Consonant-Nucleus-Consonant phoneme (CNCp), CNC word (CNCw), AzBio sentences in quiet, and CIQOL-35 Profile global and domain scores from pre-CI to 3-month post-CI. Results: Of 72 patients, 52 (72.2%) used an auditory training resource. Of all patients, 18.4% used face-to-face training, 58.3% passive home-based training, and 33.3% computer-based training. At 3 months post-CI, use of any training was associated with greater improvement in speech recognition ( d- range = 0.57–0.85) and global and domain-specific CIQOL scores, except entertainment ( d- range = −0.33 to 0.77). Use of computer-based training demonstrated the greatest effect, with larger improvements in speech recognition (CNCp: d  = 0.69[0.03,1.35]; CNCw: d  = 0.80[0.14,1.46]; AzBio: d  = 1.11[0.44,1.77]) and global and all domain-specific CIQOL scores ( d- range  =  0.05–1.35). Controlling for age, sex, household income, and use of multiple training resources, computer-based training remained the strongest positive predictor of speech recognition and CIQOL improvement, with significant associations with CNCp (ß = 33.07[1,43,64.719]), AzBio (ß = 33.03[5.71,60.35] ), and CIQOL-global (ß = 10.92[1.15,20.70]) score improvement. Conclusions: Our findings provide preliminary evidence-based recommendations for use of specific auditory training resources for new adult CI recipients. Auditory training, especially self-directed computer software, resulted in improved speech recognition and CIQOL outcomes after 3 months and are widely available for CI users.
    Type of Medium: Online Resource
    ISSN: 1531-7129 , 1537-4505
    URL: Article
    DOI: 10.1097/MAO.0000000000003417
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 8
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    Association of Patient-Related Factors With Adult Cochlear Implant Speech Recognition Outcomes : A Meta-analysis
    American Medical Association (AMA) ; 2020
    In:  JAMA Otolaryngology–Head & Neck Surgery Vol. 146, No. 7 ( 2020-07-01), p. 613-
    Details
    In: JAMA Otolaryngology–Head & Neck Surgery, American Medical Association (AMA), Vol. 146, No. 7 ( 2020-07-01), p. 613-
    Type of Medium: Online Resource
    ISSN: 2168-6181
    URL: Article
    DOI: 10.1001/jamaoto.2020.0662
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2020
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  • 9
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    Individual Differences in Speech Recognition Changes After Cochlear Implantation
    American Medical Association (AMA) ; 2021
    In:  JAMA Otolaryngology–Head & Neck Surgery Vol. 147, No. 3 ( 2021-03-01), p. 280-
    Details
    In: JAMA Otolaryngology–Head & Neck Surgery, American Medical Association (AMA), Vol. 147, No. 3 ( 2021-03-01), p. 280-
    Type of Medium: Online Resource
    ISSN: 2168-6181
    URL: Article
    DOI: 10.1001/jamaoto.2020.5094
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2021
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  • 10
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    Computer-based Auditory Training by New Adult Cochlear Implant Recipients Is Associated With Durable Improvements in Cochlear Implant Quality of Life
    Ovid Technologies (Wolters Kluwer Health) ; 2024
    In:  Ear & Hearing
    Details
    In: Ear & Hearing, Ovid Technologies (Wolters Kluwer Health)
    Abstract: The process of adapting to communicate with a cochlear implant (CI) is complex. The use of auditory training after cochlear implantation may help to facilitate improvements in postoperative speech recognition and quality-of-life outcomes in new adult CI recipients. However, the effectiveness of auditory training remains uncertain and long-term effects have not been examined in a large sample of new adult CI users. As such, the objective of this study was to examine the influence of common forms of auditory training on speech recognition and CI-related quality-of-life (CI-related QOL) outcomes at 1 year after cochlear implantation. We hypothesized that patients who reported use of computer-based auditory training (CBAT) would show improved speech and CIQOL-35 Profile scores at 1 year after activation of their implant, compared with their peers. Design: This study was designed as a prospective study and was undertaken at a tertiary academic CI center. Participants included 114 adults undergoing cochlear implantation for bilateral hearing loss. Patients serially self-reported use of the following types of post-CI auditory training over their first-year postactivation: (1) face-to-face training (e.g., speech-language pathologist), (2) passive home-based training (e.g., listening to audiobooks), and (3) CBAT (e.g., self-directed software). Outcomes measures for this study included change in Consonant-Nucleus-Consonant phoneme (CNCp), CNC word (CNCw), AzBio sentences in quiet, and CIQOL-35 Profile global and domain scores from pre-CI to 12-mo post-CI. Results: Of 114 patients, 94 (82.5%) used one or more auditory training resources. Of these, 19.3% used face-to-face training, 67.5% passive home-based training, and 46.5% CBAT. Of 114 patients, 73 had complete CIQOL data. At 12 mo, only CBAT use was associated with significantly greater improvements in global and all domain-specific CIQOL scores ( d -range = 0.72–0.87), compared with those not using CBAT. Controlling for demographics and use of multiple training resources, CBAT remained the strongest positive predictor of CIQOL improvement, with significant associations with global score (ß = 12.019[4.127,19.9]) and all domain scores at 12-mo post-CI: communication (ß = 11.937[2.456,21.318), emotional (ß = 12.293[1.827,22.759), entertainment (ß = 17.014[5.434,28.774), environment (ß = 13.771[1.814,25.727]), listening effort (ß = 12.523[2.798,22.248]), and social (ß = 18.114[7.403,28.826]). No significant benefits were noted with use of CBAT or any other form of auditory training and speech recognition scores at 12-mo post-CI ( d -range = –0.12–0.22). Conclusions: Auditory training with CBAT was associated with improved CI-related QOL outcomes at 12-mo post-CI. Given its availability and low cost, this study provides evidence to support using CBAT to improve real-world functional abilities in new adult CI recipients.
    Type of Medium: Online Resource
    ISSN: 1538-4667
    URL: Article
    DOI: 10.1097/AUD.0000000000001486
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
    detail.hit.zdb_id: 2081799-X
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