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Assessing Cochlear Implant Performance in Older Adults Using a Single, Universal Outcome Measure Created With Imputation in HERMES

Sharma, Rahul K.*; Chen, Stephanie Y.*,†; Grisel, Jedidiah‡,§; Golub, Justin S.*

doi: 10.1097/MAO.0000000000001907
COCHLEAR IMPLANTS
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Objective: In the era of big data, it is critical to aggregate results across different institutions. This is a major challenge for cochlear implant (CI) research given multiple, incompatible outcome measures. We use a large, national CI database to develop a formula to convert between the two most common measures: Consonant-Nucleus-Consonant word (CNCw) and Arizona Biomedical (AzBio). We then use this tool to analyze hearing outcomes in older adults with a single, universal outcome measure.

Study Design: Analysis of a prospective, national cochlear implant database (HERMES).

Setting: Multicentered, 32 US private practice and academic medical centers.

Patients: CI subjects (n = 386, n = 430 ears; 10–102 years old; mean: 65).

Main Outcome Measure(s): CNCw, AzBio.

Results: Univariable linear regression equations were generated relating CNCw and AzBio scores at each time-point. Correlation (R2) was 0.71 (3 mo), 0.69 (6 mo), 0.63 (12 mo), and 0.56 (24 mo) (all p < 0.01). Using these equations, missing outcomes (CNCw, n = 83 or AZBio, n = 96) were imputed (calculated). The average absolute difference between observed and imputed CNCw (when both present) was 10.5% (95% CI = 9.8–11.3). On multivariable regression, age was not a significant predictor of CNCw (p = 0.38) after controlling for sex, hearing loss duration, use, and postoperative follow-up duration.

Conclusions: We generated simple linear regression equations to calculate CNCw scores from AzBio, and vice versa, with good accuracy. This allowed one of the largest analyses of CI performance in older adults to date. We confirm that older age is not a significant predictor of performance when controlling for confounders.

*Department of Otolaryngology—Head and Neck Surgery, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Medical Center, New York

Departments of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine, Saint Louis, Missouri

Head & Neck Surgical Associates

§Auditory Implant Initiative, Wichita Falls, Texas

Address correspondence and reprint requests to Justin S. Golub, M.D., M.S., Assistant Professor, Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology—Head and Neck Surgery, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Medical Center, 180 Fort Washington Ave, HP8-845, New York, NY 10032; E-mail: justin.golub@columbia.edu

Meeting Information: Presented at American Otological Society and American Neurotology Society, April 2018, National Harbor, MD.

Travel expenses for industry conference by Cochlear, AII/HERMES data-entry grant, AII/HERMES data-use committee (Golub); AII-HERMES founder, AII/HERMES grants from Cochlear, Advanced Bionics (Grisel).

The authors disclose no conflicts of interest.

Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company