US Cochlear implant test disparities risk excluding valid candidates



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Clinical testing for cochlear implant (CI) candidacy in the US is inconsistent and lacks proper guidelines, possibly filtering out valid cases, a new study has revealed.

Research led by University of Miami Assistant Professor of Otolaryngology Sandra Prentiss has looked at why so many candidates for CIs are denied surgery to implant technology that could improve their hearing and quality of life. The study, which analysed 92 surveys, found "considerable variability" in assessment practices, as well as a lack of clarity with regard to the use of HL vs SPL in testing methods.

Concluding that "indications for obtaining a CI, as provided by the FDA, Medicare, and private insurers, are ambiguous in regard to test materials, presentation level, and mode of presentation," the authors warned that this lack of consistency "has led to wide variability in reported practice methods by audiologists across the United States, which could foster confusion among referring professionals regarding CI candidacy and potentially result in fewer referrals, thus limiting access to CIs."

However, this same disparity among the testing applied in clinics across the US was seen by the authors as potentially having a positive side: "audiologists have the opportunity to use their professional judgment when making decisions about CI candidacy and may base those decisions on careful consideration of additional patient-specific factors beyond audiometric findings and aided speech recognition scores."

The full study, Audiology Practices in the Preoperative Evaluation and Management of Adult Cochlear Implant Candidates was published online on December 12 in JAMA Otolaryngology–Head & Neck Surgery.

Source: JAMA