Cochlear implant telemedicine: Remote fitting based on psychoacoustic self-tests and artificial intelligence

Abstract

Objective: This study aims to assess the feasibility of autonomous cochlear implant (CI) fitting by adult CI recipients based on psychoacoustic self-testing and artificial intelligence (AI).

Design: A feasibility study was performed on six adult CI recipients implanted with a Nucleus device. Two weeks after processor activation in the clinic, a ‘self-fitting’ session was organized in a supervised simulated home environment. The CI recipient performed pure tone audiometry and spectral discrimination tests as self-tests. The AI application FOX analysed the results and recommended a new map. The participants filled out a questionnaire and were tested again after 2 months of take-home experience.

Results: Four out of six patients performed the self-tests without any help from the audiologist and four were fitted by FOX without any manual intervention. All patients were comfortable with the concept of self-testing and automated fitting. Patients acknowledged that at this stage the remote supervision of an audiologist remains essential.

Conclusions: The study showed that audiological self-assessment and remote CI fitting with AI under the supervision of an audiologist is feasible, at least in a number of CI recipients. Currently, there are still some technical and regulatory challenges to be addressed before this can become routine practice.

Keywords:

• Telemedicine
• Remote fitting
• Artificial Intelligence
• Cochlear implant fitting
• Self-test
• Audiometry

Supplemental data

Supplemental data for this article can be accessed 10.1080/14670100.2020.1757840.

Notes on contributors

Matthias Meeuws is clinical physicist and audiologist at the Eargroup.

David Pascoal is clinical audiologist at the Eargroup.

Sebastien Janssens de Varebeke is ENT surgeon at Jessa Hospital.

Geert de Ceulaer is engineer and audiologist at the Eargroup.

Paul J. Govaerts is Head of the Eargroup and of the FOX A.I. project.