Patient-Related Factors Do Not Predict Use of Computer-Based Auditory Training by New Adult Cochlear Implant Recipients

Abstract

Objective: 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.

Computer-based Auditory Training by New Adult Cochlear Implant Recipients Is Associated With Durable Improvements in Cochlear Implant Quality of Life

“…Finally, unmeasurable patient factors such as motivation may play a large role in outcomes and confound results, particularly considering quality-of-life scores, as a motivated patient may be simultaneously more likely to use training, such as CBAT, and to report better CIQOL scores. That said, previous analysis did not show any link between various patient factors, including pre-CI CIQOL, scores and use of CBAT in new, adult CI recipients (Dornhoffer et al 2023).…”

Predicting Early Cochlear Implant Performance: Can Cognitive Testing Help?

“…Our group has also shown correlations of working memory with long-term CI performance ( 22 ). Additionally, prior studies have described up to 1–2 years for peak performance with a CI ( 27 – 29 ). It is known that soon after CI activation, the new signals received via the implant provide degraded sensory input to the listener.…”