What to Measure? Development of a Core Outcome Set to Assess Remote Technologies for Cochlear Implant Users.

Area of Science:

• Audiology
• Rehabilitation Medicine
• Health Services Research

Background:

• Remote cochlear implant (CI) services show promise in clinical trials but face barriers to widespread adoption.
• Successful implementation hinges on demonstrating outcomes comparable to traditional in-person care.
• Standardized, sensitive outcome measures are crucial for evidence-based remote CI service delivery.

Purpose of the Study:

• To assess current awareness and utilization of outcome measures in clinical CI practice, both in-person and remotely.
• To propose recommendations for a practical core outcome set (COS) tailored for evaluating remote CI technologies.
• To build upon a previously established core outcome domain set (CODS) for CI services.

Main Methods:

• An online survey was administered to 20 expert Australian/New Zealand clinical CI professionals.
• Participants evaluated pre-identified outcome measures against the CODS, rating usefulness, ease of use, trustworthiness, and recommendability.
• Stakeholder workshops involving clinicians and CI users finalized recommendations for the COS.

Main Results:

• Speech perception tests (e.g., BKB-A, CNC, CUNY, AB words) were among the most frequently used and recognized measures.
• The Speech, Spatial, and Qualities of Hearing Scales (SSQ/SSQ-12) emerged as top-ranked patient-reported outcome measures (PROMs).
• These selected outcome measures were highly regarded for trustworthiness, usability, and potential for future adoption.

Conclusions:

• A pragmatic core outcome set (COS) is recommended for CI services, applicable to both remote and in-person delivery models.
• The COS includes recommendations for measuring service delivery, clinician-assessed outcomes, and patient-reported outcomes.
• Future development pathways for these outcome measures are also outlined.