Audiologists’ preferences in programming cochlear implants: A preliminary report

Browning, Leanne; Nie, Yingjiu; Rout, Ayasakanta; Heiner, Meredith

doi:10.1080/14670100.2019.1708553

Cited by 16 publications

(14 citation statements)

References 28 publications

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“…MCLs are set with a minimal amount of current stimulation and gradually increased until the patient reports the sound is "loud but comfortable", thereby creating an electrical dynamic range (DR) for each CI electrode [3]. However, this programming method is not standardized, with techniques varying widely both between individual clinicians and between CI clinics [4,5]. Vaerenberg et al, 2014 demonstrated that 31% of clinics around the world measured Ts only, and that 24% of clinics measured MCLs only, while 45% of clinics measured both Ts and MCLs.…”

Section: Introductionmentioning

confidence: 99%

Cortical auditory evoked potential in cochlear implant users: An objective method to improve speech perception

Távora-Vieira

Wedekind²,

Ffoulkes³

et al. 2022

PLoS ONE

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Objective To investigate if cortical auditory evoked potential (CAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve CI outcomes in adults with bilateral hearing loss. Design CAEPs were measured in CI recipients using the speech tokens /m/, /g/, /t/ and /s/. If CAEP responses were present for all speech tokens, the participant’s map was considered “satisfactory”. If CAEP responses were absent, the CI map was considered “unsatisfactory” and therefore adjusted and CAEP measures repeated. This was repeated until auditory potentials were seen in response to all four speech tokens. Speech testing was conducted pre-CI, as well as before and after CAEP-guided map adjustments. Results 108 adult unilateral CI users participated, whose sound processors were previously programmed using subjective methods. 42 CI users elicited a CAEP response to all four speech tokens and therefore no further mapping adjustments were made. 66 subjected lacked a CAEP response to at least one speech token and had their CI map adjusted accordingly. Of those, 31 showed a CAEP response to all four speech tokens, and the average speech score significantly improved after CI map adjustments based on CAEP responses. Conclusion CAEP’s are an objective tool that can be used to guide and verify CI mapping in adults CI users. Significant improvement in speech scores was observed in participants who had their CI map adjusted based on CAEP responses.

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Section: Introductionmentioning

confidence: 99%

Cortical auditory evoked potential in cochlear implant users: An objective method to improve speech perception

Távora-Vieira

Wedekind²,

Ffoulkes³

et al. 2022

PLoS ONE

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“…This indicates that a moderately high rate of cochlear implant users with indiscriminate electrodes which can be identified using a clinical task. Despite the moderately high prevalence of poorly encoding electrodes and potential for individual improvement following deactivation, clinical audiologists do not commonly practice electrode deactivation ( Vaerenberg et al, 2014 ; Browning et al, 2020 ; Sander et al, 2023 ). This is likely due to audiologists’ lack of access to a clinically feasible, evidence-based approach to electrode identification and deactivation ( Sander et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…While evidence of the benefits of electrode deactivation in some CI users have been established for decades, this practice is not widely adopted by clinical audiologists ( Vaerenberg et al, 2014 ; Browning et al, 2020 ; Sander et al, 2023 ). Clinical audiologists reportedly deactivate electrodes in the case of abnormal telemetry measures, evidence of extracochlear electrodes, or facial stimulation ( Vaerenberg et al, 2014 ; Hemmingson and Messersmith, 2018 ), however, this practice is not carried over to measures of pitch ranking or electrode discrimination.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a clinical method for selective electrode deactivation in cochlear implant programming

Warren

Atcherson

2023

Front. Hum. Neurosci.

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BackgroundCochlear implants are a neural prosthesis used to restore the perception of hearing in individuals with severe-to-profound hearing loss by stimulating the auditory nerve with electrical current through a surgically implanted electrode array. The integrity of the interface between the implanted electrode array and the auditory nerve contributes to the variability in outcomes experienced by cochlear implant users. Strategies to identify and eliminate poorly encoding electrodes have been found to be effective in improving outcomes with the device, but application is limited in a clinical setting.ObjectiveThe purpose of this study was to evaluate a clinical method used to identify and selectively deactivate cochlear implants (CI) electrodes related to poor electrode-neural interface.MethodsThirteen adult CI users participated in a pitch ranking task to identify indiscriminate electrode pairs. Electrodes associated with indiscriminate pairs were selectively deactivated, creating an individualized experimental program. Speech perception was evaluated in the baseline condition and with the experimental program before and after an acclimation period. Participant preference responses were recorded at each visit.ResultsStatistically significant improvements using the experimental program were found in at least one measure of speech perception at the individual level in four out of 13 participants when tested before acclimation. Following an acclimation period, ten out of 13 participants demonstrated statistically significant improvements in at least one measure of speech perception. Statistically significant improvements were found with the experimental program at the group level for both monosyllabic words (p = 0.006) and sentences in noise (p = 0.020). Additionally, ten participants preferred the experimental program prior to the acclimation period and eleven preferred the experimental program following the acclimation period.ConclusionResults from this study suggest that electrode deactivation may yield improvement in speech perception following an acclimation period. A majority of CI users in our study reported a preference for the experimental program. This method proved to be a suitable clinical strategy for identifying and deactivating poorly encoding electrodes in adult CI users.

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“…In fact, previous studies reported 59.8%–72.1% of adult CI recipients have aidable hearing in the non-implanted ear that could be used for a bimodal configuration (Dorman & Gifford 2010; Holder et al 2018). Results from Browning et al (2020) stated most audiologists frequently recommend bimodal fitting with 81% always or almost always recommending the partner manufacturer’s HA when available since such devices enable certain features, such as bilateral streaming and communication between the 2 devices. Consequently, there is a growing trend for CI audiologists to manage the HA for bimodal patients, making it necessary for clinicians to utilize more consistent bimodal billing practices.…”

Section: Discussionmentioning

confidence: 99%

Decoding Billing Practices in Cochlear Implant Programs

et al. 2021

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Objectives: The purpose of this study was to examine current cochlear implant (CI) billing practices across CI audiologists in the United States, to determine if CI audiologists are following the National Correct Coding Initiative (NCCI) edits, and to assess the CI audiologist’s exposure to billing education. Design: A 48-question survey was electronically distributed to and completed by audiologists who bill for CI services. Demographic data including work setting, population served, years of experience, number of CI patients managed per week, and exposure to billing education were collected. Data were analyzed to identify codes and modifiers used to bill for commonly performed CI procedures such as unilateral and bilateral CI programming, preoperative and postoperative testing, and objective measures. Results: Data were obtained from 96 audiologists. The majority (86.3%, n = 82) of respondents agreed or strongly agreed they understand billing and coding practices for cochlear implants and 94.7% (n = 89) rated themselves as somewhat to highly efficient when performing these practices. Only 16.8% (n = 16) of respondents reported receiving formal training for practice management, and half of the respondents (51.1%, n = 48) reported unfamiliarity with national billing guidelines. Those who received formal training reported higher billing efficiency. Wide variability was seen for various billing scenarios. Billing questions were presented, and answers were coded as correct or incorrect based on the NCCI edits. Respondents who reported higher agreement with understanding billing and who received formal training scored better on common billing questions related to the NCCI edits. Conclusions: Most CI audiologists rated themselves as efficient in billing; however, wide variance in billing practices was observed. Incorporating practice management and current billing education into daily practice and into audiology training programs is essential to clinic efficiency, practice management, and CI program viability. CI audiologists should be knowledgeable about appropriate billing practices to ensure long-term sustainability of programs.

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Audiologists’ preferences in programming cochlear implants: A preliminary report

Cited by 16 publications

References 28 publications

Cortical auditory evoked potential in cochlear implant users: An objective method to improve speech perception

Cortical auditory evoked potential in cochlear implant users: An objective method to improve speech perception

Evaluation of a clinical method for selective electrode deactivation in cochlear implant programming

Decoding Billing Practices in Cochlear Implant Programs

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