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Prospective Comparison Between Manual and Computer-Assisted (FOX) Cochlear Implant Fitting in Newly Implanted

Justine Wathour1, Paul J Govaerts2,3, Lucie Derue1

  • 1Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Ear and Hearing
|January 6, 2023
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Summary

Artificial intelligence (AI)-based cochlear implant (CI) fitting using the Fitting to Outcome eXpert (FOX) system demonstrated superior speech intelligibility and patient satisfaction compared to manual fitting. This AI approach offers a promising advancement for CI users, potentially improving hearing outcomes and comfort.

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Area of Science:

  • Audiology and hearing science
  • Biomedical engineering
  • Artificial intelligence in healthcare

Background:

  • Traditional manual fitting of cochlear implants (CIs) is time-consuming and may not always yield optimal auditory outcomes.
  • The development of AI-driven tools aims to enhance the efficiency and effectiveness of CI programming.
  • The Fitting to Outcome eXpert (FOX) system represents an AI-based approach to CI fitting.

Purpose of the Study:

  • To compare the efficacy of manual CI fitting versus AI-based fitting (FOX system) in newly implanted patients.
  • To evaluate auditory outcomes, patient-reported comfort, and resource utilization between the two fitting methods.
  • To assess long-term patient preference and performance with AI-optimized versus manually programmed CI maps.

Main Methods:

  • A 1-year prospective, longitudinal, randomized controlled trial with a crossover design was conducted.
  • Twenty-four first-time CI patients were randomized to either manual or FOX fitting, then crossed over after 1 year.
  • Auditory outcomes (speech intelligibility, pure-tone thresholds, etc.), patient questionnaires, and CI parameters were compared.

Main Results:

  • The AI-FOX group showed significantly better speech intelligibility in quiet and noise at 3 and 12 months postactivation (p < 0.05).
  • In the manual group, 100% chose to keep the FOX map, with 82% showing improved performance.
  • In the FOX group, 63% preferred the manual map for comfort, despite better objective outcomes with the FOX map.

Conclusions:

  • The AI-FOX approach is equivalent or superior to manual fitting in hearing performance, comfort, and resource efficiency.
  • The AI-FOX system demonstrates continuous learning capabilities, suggesting significant future advancements in CI fitting.
  • AI-driven fitting holds promise for improving CI patient outcomes and optimizing clinical workflows.