A device-independent approach to cochlear-implant telehealth.

Objective

Commercial cochlear-implant (CI) telehealth is manufacturer-specific and generally does not replicate standard sound-field tests. This study developed and tested a manufacturer-independent CI telehealth system designed to replace a standard clinic visit.

Design

The system comprised a laptop, a sound card, headphones (placed over the CI sound processor), manufacturer's programming software and cables, and custom software for aided speech-recognition and warble-tone detection-threshold assessment. Phase 1 compared telehealth-system aided assessment to standard sound-field testing. In Phase 2, participants completed at-home remote audiological follow-up visits. STUDY SAMPLE N = 15 (Phase 1) and N = 13 (Phase 2) adult CI users.

Results

Mean absolute differences between telehealth-system and sound-field warble-tone detection thresholds were 5 dB, with 96% of 0.5-4 kHz telehealth-system thresholds within the sound-field 95% confidence interval (95ci). Consonant-nucleus-consonant word and AzBio sentence identification in quiet showed no significant differences between modes, with high intraclass correlations (ICC = 0.94-0.97) and 80-93% of telehealth-system scores within the sound-field 95ci. Bamford-Kowal-Bench sentence-in-noise scores showed larger deviations. Telehealth-survey responses indicated high patient satisfaction, improved convenience and access to care, and only minor challenges.

Conclusions

Combining a manufacturer-independent headphones-based alternative to sound-field testing with manufacturer's programming software in a remotely controlled laptop system replicates sound-field outcome scores and produces high patient satisfaction.