Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting

Objective. The paper aims to demonstrate the feasibility of defining a substantial set of psychoacoustic outcome measures with preset targets and to adopt a systematic methodology for reaching these targets in a large group of subjects, by more than one clinical centre. Design. Retrospective data an...

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Main Authors: Bart Vaerenberg, Geert De Ceulaer, Zoltán Szlávik, Patrizia Mancini, Andreas Buechner, Paul J. Govaerts
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2014/646590
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author Bart Vaerenberg
Geert De Ceulaer
Zoltán Szlávik
Patrizia Mancini
Andreas Buechner
Paul J. Govaerts
author_facet Bart Vaerenberg
Geert De Ceulaer
Zoltán Szlávik
Patrizia Mancini
Andreas Buechner
Paul J. Govaerts
author_sort Bart Vaerenberg
collection DOAJ
description Objective. The paper aims to demonstrate the feasibility of defining a substantial set of psychoacoustic outcome measures with preset targets and to adopt a systematic methodology for reaching these targets in a large group of subjects, by more than one clinical centre. Design. Retrospective data analysis. Setting. Multicentre with 14 participating centres. Patients. 255 adults and children using the Advanced Bionics HiRes90k cochlear implant. Intervention. Target driven fitting with the fitting to outcomes expert (FOX) system. Main Outcome Measures. For each patient, 66 measurable psychoacoustical outcomes were recorded several times after cochlear implantation: free field audiometry (6 measures) and speech audiometry (4), spectral discrimination (20), and loudness growth (36), defined from the A§E test battery. These outcomes were reduced to 22 summary variables. The initial results were compared with the latest results. Results. The state of the fitting process could be well monitored by means of the measured variables. The use of the FOX computer assisted CI-programming significantly improved the proportion of the 22 variables on target. When recipients used the automated MAPs provided at switch-on, more than half (57%) of the 22 targets were already achieved before any further optimisation took place. Once the FOX system was applied there was a significant 24% (P<0.001) increase in the number of targets achieved. Conclusions. This study demonstrates that it is feasible to set targets and to report on the effectiveness of a fitting strategy in terms of these targets. FOX provides an effective tool for achieving a systematic approach to programming, allowing for better optimisation of recipients' MAPs. The setting of well-defined outcome targets allowed a range of different centres to successfully apply a systematic methodology to monitoring the quality of the programming provided.
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spelling doaj-art-6cd1bdd403224d749206ca489abd8a292025-02-03T01:11:24ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/646590646590Setting and Reaching Targets with Computer-Assisted Cochlear Implant FittingBart Vaerenberg0Geert De Ceulaer1Zoltán Szlávik2Patrizia Mancini3Andreas Buechner4Paul J. Govaerts5The Eargroup, Herentalsebaan 75, B-2100 Antwerp-Deurne, BelgiumThe Eargroup, Herentalsebaan 75, B-2100 Antwerp-Deurne, BelgiumDepartment of Computer Science, VU University Amsterdam, The NetherlandsDepartment of Sense Organs, University Sapienza, Rome, ItalyDepartment Otolaryngol, Medizinische Hochschule Hannover, GermanyThe Eargroup, Herentalsebaan 75, B-2100 Antwerp-Deurne, BelgiumObjective. The paper aims to demonstrate the feasibility of defining a substantial set of psychoacoustic outcome measures with preset targets and to adopt a systematic methodology for reaching these targets in a large group of subjects, by more than one clinical centre. Design. Retrospective data analysis. Setting. Multicentre with 14 participating centres. Patients. 255 adults and children using the Advanced Bionics HiRes90k cochlear implant. Intervention. Target driven fitting with the fitting to outcomes expert (FOX) system. Main Outcome Measures. For each patient, 66 measurable psychoacoustical outcomes were recorded several times after cochlear implantation: free field audiometry (6 measures) and speech audiometry (4), spectral discrimination (20), and loudness growth (36), defined from the A§E test battery. These outcomes were reduced to 22 summary variables. The initial results were compared with the latest results. Results. The state of the fitting process could be well monitored by means of the measured variables. The use of the FOX computer assisted CI-programming significantly improved the proportion of the 22 variables on target. When recipients used the automated MAPs provided at switch-on, more than half (57%) of the 22 targets were already achieved before any further optimisation took place. Once the FOX system was applied there was a significant 24% (P<0.001) increase in the number of targets achieved. Conclusions. This study demonstrates that it is feasible to set targets and to report on the effectiveness of a fitting strategy in terms of these targets. FOX provides an effective tool for achieving a systematic approach to programming, allowing for better optimisation of recipients' MAPs. The setting of well-defined outcome targets allowed a range of different centres to successfully apply a systematic methodology to monitoring the quality of the programming provided.http://dx.doi.org/10.1155/2014/646590
spellingShingle Bart Vaerenberg
Geert De Ceulaer
Zoltán Szlávik
Patrizia Mancini
Andreas Buechner
Paul J. Govaerts
Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting
The Scientific World Journal
title Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting
title_full Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting
title_fullStr Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting
title_full_unstemmed Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting
title_short Setting and Reaching Targets with Computer-Assisted Cochlear Implant Fitting
title_sort setting and reaching targets with computer assisted cochlear implant fitting
url http://dx.doi.org/10.1155/2014/646590
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AT patriziamancini settingandreachingtargetswithcomputerassistedcochlearimplantfitting
AT andreasbuechner settingandreachingtargetswithcomputerassistedcochlearimplantfitting
AT pauljgovaerts settingandreachingtargetswithcomputerassistedcochlearimplantfitting