Remote Monitoring of Adult Cochlear Implant Recipients Using Digits-in-Noise Self-Testing

Abstract

Purpose: The COVID-19 pandemic has accelerated the uptake and scope of telehealth. This study determined the accuracy and reliability of a smartphone digits-in-noise (DIN) test when conducted by adult cochlear implant (CI) recipients in a simulated home environment compared with a clinic setup. Perceptions of remote monitoring using speech-in-noise (SIN) testing were also explored. Method: Thirty-three adult CI recipients between 18 and 78 years of age ( M = 46.7, SD = ±20.4) conducted the DIN test in a simulated home environment and a clinic setup. Test–retest reliability across the two environments and comparisons between test settings were evaluated. A survey explored the perceptions of adult CI recipients regarding remote monitoring and use of the DIN self-test. Results: Mean-aided speech reception thresholds (SRTs) in the clinic and simulated home environment test conditions and clinic and simulated home environment retest conditions did not differ significantly. Mean test–retest SRTs in the clinic and simulated home environment were significantly different ( p < .05). High intraclass correlation coefficient and low standard error of measurement scores reflected good and excellent reliability between test–retest measures and between clinic and simulated home environment measures. Most participants were positive about the possibility of using the DIN test at home to self-assess speech perception, although some test adjustments such as including training items and a less adverse starting signal-to-noise ratio may be required. Conclusion: Adult CI recipients can use the smartphone DIN test to self-assess aided SIN performance in a home environment with accuracy and reliability relatively similar to clinic testing. Supplemental Material: https://doi.org/10.23641/asha.20044418

Comparison of Psychometric Functions Measured Using Remote Testing and Laboratory Testing

“…Accurately measuring psychoacoustic thresholds outside the confines of specialized laboratories could initiate important changes in how data is collected and would increase accessibility for basic and translational research [ 4 ]. Previous studies have shown success in comparing equivalent data collected in the lab versus remotely with acoustic hearing [ 5 , 6 , 7 , 8 , 9 ] as well as with electric hearing [ 10 , 11 , 12 , 13 ]. For instance, Lelo de Larrea-Mancera et al (2022) [ 5 ] measured performance on a battery of psychoacoustic experiments in tasks involving audibility, temporal fine structure sensitivity, spectro-temproal modulation sensitivity, and spatial release from masking from a large group of young normal-hearing listeners.…”