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Determining electrically evoked compound action potential thresholds: a comparison of computer versus human analysis

E Katelyn Glassman1, Michelle L Hughes

  • 1Boys Town National Research Hospital, Omaha, NE, USA.

Ear and Hearing
|August 14, 2012
PubMed
Summary

Human and computer analysis of electrically evoked compound action potential (ECAP) thresholds show high agreement for Cochlear devices, but greater variability for Advanced Bionics (AB) devices. This suggests automated ECAP threshold determination is reliable for Cochlear, but requires careful consideration for AB systems.

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Area of Science:

  • Audiology
  • Biomedical Engineering
  • Neuroscience

Background:

  • Cochlear implants (CIs) utilize telemetry to measure electrically evoked compound action potentials (ECAPs).
  • ECAP amplitude growth functions are used to determine ECAP thresholds, crucial for CI programming.
  • Automated algorithms and clinician judgment are employed for ECAP threshold determination.

Purpose of the Study:

  • To assess variability between human and computer-driven peak marking (N1, P2) and threshold determination (Linear Regression Threshold - LRT, Visual Detection Threshold - VDT).
  • To compare LRT and VDT methods across human and computer decision-making processes.
  • To evaluate consistency of ECAP thresholding methods in Cochlear and Advanced Bionics (AB) CI systems.

Main Methods:

  • ECAP amplitude-growth functions were recorded from 20 ears (10 Cochlear, 10 AB devices).

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  • Computer- and human-derived LRT and VDT were calculated for each subject.
  • Specific criteria were applied for VDT in AB devices due to system characteristics.

    • Main Results:

    • High correlations (r=0.78-1.00) were found between human and computer decisions for peak marking and threshold determination for both manufacturers.
    • Cochlear devices showed excellent agreement (r=0.98-0.99) between computer and human thresholds (LRT & VDT).
    • Advanced Bionics devices exhibited weaker correlations (r=0.69-0.85) between thresholding methods, likely due to a higher noise floor.

    Conclusions:

    • Automated and human ECAP peak-picking methods demonstrate similar accuracy for both Cochlear and AB devices.
    • Both C-VDT and C-LRT can be confidently used for Cochlear 24RE/CI512 recipients due to strong correlation with human decisions.
    • Greater variability in threshold determination methods for AB devices necessitates careful consideration when using ECAP measures for CI programming.