Person-centred cochlear implant care: Assessing the need for clinic intervention in adults with cochlear implants using a dual approach of an online speech recognition test and a questionnaire

Abstract

Objectives: To evaluate the feasibility of adults with cochlear implants using an online speech recognition test and questionnaire at home to assess whether they need to come to the clinic or not.

Methods: A prospective single-centre feasibility study evaluating

• An online speech recognition test (digit triplet test (DTT)).

• A long-term follow-up questionnaire to assess aspects that a clinician would ask in a face-to-face appointment.

• A satisfaction questionnaire to assess patient perception of remote speech recognition testing.

• Seventeen people using cochlear implants aged from 34 to 84 years took part.

Results:

• The majority of adults were able and willing to use tools at home to assess if they need to come to the centre.

• The DTT speech reception threshold was repeatable on three occasions within 3 weeks.

• The majority of adults felt positive about testing their own hearing using the DTT at home. However, only a minority (two out of 17) felt they preferred remote testing to clinic testing (the majority was undecided).

Conclusion: The concept of a dual approach of online speech recognition test and questionnaire both done at home has potential to identify which adults with cochlear implants require clinic intervention, although sensitivity and specificity measures are unknown. A clinic visit remains the gold standard of care, but remote care may supplement traditional care pathways.

Keywords:

• Cochlear implant
• Speech perception
• Telemedicine
• Person-centred care

Acknowledgements

The authors thank the people with cochlear implants who give so freely of their time and experience in order to further cochlear implant research. Thanks are also expressed to Action on Hearing Loss; Thomas Fiddian and Darren Dignam worked hard to set up the customized Action on Hearing Loss online speech recognition test that was used for this study

Disclaimer statements

Contributors Helen Cullington and Akosua Agyemang-Prempeh worked together on the study design and analysis.

Funding None.

Conflict of interest Helen Cullington performs private consultancy work for Cochlear Europe.

Ethics approval The study received approval from the University of Southampton Institute of Sound and Vibration Research Safety and Ethics Committee (ref 1218) on 20/07/2011. The study also received National Research Ethics Service approval (NRES Committee South West – Exeter 11/SW/0162) on 11 August 2011.

ORCID

Helen E. Cullington http://orcid.org/0000-0002-5093-2020

Notes

1 In clinical practice it is likely that remote care would only be offered to patients with long-term implant use (perhaps greater than one year). As this was only a study, those with shorter periods of cochlear implant use were also recruited.