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

Background/Objectives: Uptake of remote cochlear implant (CI) services is feasible in clinical studies, but implementation into regular clinical practice is limited. Effective implementation requires demonstration of at least equivalent outcomes to in-person care. Use of outcome measures (e.g., specific tools such as speech tests or surveys) that are relevant and sensitive to both modes of service facilitates evidence-based provision of CI services. Following our previous study, which developed a core outcome domain set (CODS) (i.e., a set of CI outcome areas important to measure), this study aimed to (1) review current awareness and use of outcome measures implemented clinically, in-person, or remotely; and (2) provide recommendations for a pragmatic core outcome set (COS) to assess remote technologies for CI users. Methods: Expert Australian/New Zealand clinical CI professionals (n = 20) completed an online survey regarding use of, and familiarity with, pre-identified outcome measures mapping to the previously identified CODS. Respondents rated the outcomes' usefulness, ease of use, trustworthiness, and recommendation for future use. Stakeholder workshops (clinician, n = 3, CI users n = 4) finalised recommendations. Results: Four of the six most regularly used and familiar measures were speech perception tests: BKB-A sentences, CNC words, CUNY sentences, and AB words. The long- and short-form Speech, Spatial, and Qualities of Hearing Scales (SSQ/SSQ-12) were the top-ranked patient-reported outcome measures (PROMs). These outcome measures were also perceived as the most trustworthy, easy to use, and likely to be used if recommended. Conclusions: A pragmatic COS, relevant to both remote and in-person delivery of CI services, including recommendations for measurement of service, clinician-measured and patient-reported outcomes, and how these might be developed in future, is recommended.