Towards the development of a core outcome domain set for remote cochlear implant management

Remote technologies for cochlear implant (CI) service provision promises to increase access to personalised, efficient, effective, and equitable CI services. Evaluating remote services using relevant outcome measures improves evidence available to make informed decisions about patient care. The objective of this study was to identify a core outcome domain set (CODS) for remote CI services.

A three-round two-group online crossover Delphi review. Participants rated, and in the final round, ranked outcome domains (n = 57) in three supra-domains previously identified by a systematic review and three online workshops. The study is registered on the Core Outcome Measures in Effectiveness Trials website.

CI users (n = 114) and professionals (n = 77) from Australia, the UK, and the USA.

Domains identified across both groups were: Usability, Reliability, and Accessibility of the remote service to the client (Service supra-domain); Device Integrity and Status, Speech Discrimination, and Device Use (Clinical supra-domain); and Participation Restriction, Hearing-Related Quality of Life, Client Device Satisfaction, and Mental Health and Wellbeing (Patient supra-domain).

The substantial mismatch between the ranking of Clinical and Patient outcome domains between CI users and professionals suggests important differences in perspectives. Mutual education is essential to ensure needs are mutually understood and met.