Attrition in Cochlear Implant Research: Sociodemographic, Audiologic, and Performance Variables.

Area of Science:

• Audiology and Hearing Research
• Clinical Research Methodology
• Biomedical Engineering

Background:

• Participant attrition is a significant challenge in long-term clinical research, potentially compromising study generalizability.
• Understanding factors influencing withdrawal is crucial for improving participant retention in cochlear implant (CI) studies.

Purpose of the Study:

• To identify sociodemographic, audiologic, and performance variables associated with participant attrition in a long-term, repeated-measures CI clinical trial.
• To inform strategies for enhancing participant enrollment and retention in similar research.

Main Methods:

• Retrospective review of 118 adult CI recipients in a 12-month study comparing two mapping procedures.
• Comparison of sociodemographic, cognitive, and audiologic variables between completers and those who withdrew.
• Analysis of early word recognition performance (CNC) between groups.

Main Results:

• The overall attrition rate was 21%, with no significant sociodemographic differences between completers and withdrawers.
• Withdrawal was associated with poorer low-frequency hearing thresholds, less use of electric-acoustic stimulation, and greater tonotopic mismatch.
• The group that completed the study demonstrated significantly better early word recognition scores.

Conclusions:

• Audiologic factors and early performance, rather than sociodemographics, appear to influence attrition in CI research.
• Study designs should incorporate criteria and procedures to actively support the enrollment and retention of diverse participant samples.