External Validation of Cochlear Implant Screening Tools Demonstrates Modest Generalizability.

Area of Science:

• Audiology
• Otolaryngology
• Medical Devices

Background:

• Cochlear implantation is a complex procedure requiring careful patient selection.
• Standardized screening tools are needed to efficiently identify potential cochlear implant candidates.
• Existing screening tools for cochlear implant candidacy evaluation (CICE) vary in their criteria and effectiveness.

Purpose of the Study:

• To externally validate five recently published CICE referral screening tools.
• To assess the clinical applicability of these tools in identifying patients who meet established CI candidacy criteria.

Main Methods:

• A retrospective cohort study was conducted in a tertiary otology/neurotology practice.
• Adult patients undergoing CICE between December 2020 and September 2021 were included.
• The performance of five CICE referral screening tools was evaluated against traditional and Medicare-eligible CI candidacy criteria.

Main Results:

• Screening tool performance varied, with sensitivities ranging from 40-77% and specificities from 22-86% for traditional criteria.
• For Medicare-eligible criteria, sensitivities ranged from 41-81% and specificities from 24-91%.
• The Zwolan et al. screening tool demonstrated the highest overall performance but all tools underperformed compared to their development cohorts.

Conclusions:

• Current CICE referral tools utilize diverse screening criteria with modest success in identifying potential cochlear implant candidates.
• External validation revealed performance limitations of existing screening tools.
• Further refinement of CICE referral screening tools is warranted to improve candidate identification accuracy.