Cochlear Implants
by Cochlear Guest Author

Why Upgrading a Sound Processor Matters: A Summary of Peer-Reviewed, Published Research

October 5, 2022
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When new sound processors become available, professionals want to understand the benefits to them and their patients. Evidence-based medicine (EBM), with its capacity to improve patient outcomes, has grown prominent throughout the medical field.1 EBM describes the process in which medical literature is critically assessed to define the value of different therapeutic interventions with the goal to improve clinical decision making and patient outcomes.2 Cochlear recognizes the importance of data mining, clinical research, and medical literature to make clinical decisions and optimize care models.   

Compiling the Evidence

Cochlear has reviewed the literature and compiled a clinical evidence summary of peer-reviewed publications that demonstrate how historically, upgrading to the latest sound processor technology has been beneficial for patients, clinics, and society.3-18

The journal articles are categorized into four main areas: Hearing outcomes, Patient outcomes, Patient Satisfaction and Health Economic Benefits.

Learn Why

This clinical evidence summary, along with the meaningful innovation of next-generation sound processors designed to deliver improved hearing performance, new connectivity and capabilities, and compatibility with existing implants, provide the “why” behind upgrading to the latest generation sound processor.  To learn more about how to facilitate a sound processor upgrade for your patients, watch this series of five professional-facing short videos that provide an outline of the process, resources, and support available to you and your patients to make the upgrade process for a CochlearTM next-generation sound processor as seamless as possible. 

Click here to read the Clinical Evidence Summary.

To learn more about upgrade resources available for your patients visit: click here.

References:

  1. Shin JJ, Randolph GW, Rauch SD. Evidence-based medicine in otolaryngology, part 1: the multiple faces of evidence-based medicine. Otolaryngol Head Neck Surg. 2010;142(5):637-646. doi:10.1016/j.otohns.2010.01.018
  2. Goodin DS. Evidence-based medicine. Int MS J. 2005;12(3):94-95.
  3. Hey M, Böhnke B, Mewes A, Munder P, Mauger SJ, Hocke T. Speech comprehension across multiple CI processor generations: Scene dependent signal processing. Laryngoscope Investigative Otolaryngology. 2021 Aug;6(4):807-15.
  4. 2. Go­ -Gomez MV, Muniz L, Wiemes G, Onuki LC, Calonga L, Osterne FJ, Kós MI, Caldas FF, Cardoso C, Cagnacci B. Contribution of noise reduction pre-processing and microphone directionality strategies in the speech recognition in noise in adult cochlear implant users. European Archives of Oto-Rhino-Laryngology. 2021 Aug;278(8):2823-8.
  5. Mauger SJ, Warren CD, Knight MR, Goorevich M, Nel E. Clinical evaluation of the Nucleus® 6 cochlear implant system: Performance improvements with SmartSound iQ. International Journal of Audiology. 2014 Aug 1;53(8):564-76.
  6. Mosnier I, Sterkers O, Nguyen Y, Lahlou G. Benefits in noise from sound processor upgrade in thirty-three cochlear implant users for more than 20 years. European Archives of Oto-Rhino-Laryngology. 2021 Mar;278(3):827-31.
  7. Pinheiro MM, Mancini PC, Soares AD, Ribas Â, Lima DP, Cavadas M, Banhara MR, da Silva Carvalho SA, Buzo BC. Comparison of Speech Recognition in Cochlear Implant Users with Different Speech Processors. Journal of the American Academy of Audiology. 2021 Jul;32(07):469-76.
  8. Plasmans A, Rushbrooke E, Moran M, Spence C, Theuwis L, Zarowski A, Oeciers E, Atkinson B, McGovern J, Dornan D, Leigh J. A multi-center clinical evaluation of pediatric cochlear implant users upgrading to the Nucleus® 6 system. International Journal of Pediatric Otorhinolaryngology. 2016 Apr 1;83:193-9.
  9. Biever A, Gilden J, Zwolan T, Mears M, Beiter A. Upgrade to Nucleus® 6 in Previous Generation Cochlear™ sound processor patients. Journal of the American Academy of Audiology. 2018 Oct;29(09):802-13.
  10. Mauger SJ, Jones M, Nel E, Del Dot J. Clinical outcomes with the Kanso™ off-the-ear cochlear implant sound processor. International Journal of Audiology. 2017 Apr 3;56(4):267-76.
  11. Mosnier I, Marx M, Venail F, Loundon N, Roux-Vaillard S, Sterkers O. Bene‑ ts from upgrade to the CP810™ sound processor for Nucleus® 24 cochlear implant patients. Eur Arch Otorhinolaryngol 2014; 271:49–57.
  12. Warren CD, Nel E, Boyd PJ. Controlled comparative clinical trial of hearing bene‑ t outcomes for users of the Cochlear™ Nucleus® 7 Sound Processor with mobile connectivity. Cochlear Implants International. 2019 May 4;20(3):116-26.
  13. Maruthurkkara S, Allen A, Cullington H, MuJ, Arora K, Johnson S. Remote check test battery for cochlear implant patients: proof of concept study. International Journal of Audiology. 2021 Aug 24:1-0.
  14. Maruthurkkara S, Case S, Rottier R. Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant Patients. Ear and Hearing. 2022 Mar 1;43(2):495-506.
  15. Neve OM, Boerman JA, van den Hout WB, Briaire JJ, van Benthem PP, Frijns JH. Cost-bene‑ t analysis of cochlear implants: A societal perspective. Ear and Hearing. 2021 Sep;42(5):1338.
  16. FoteC, Kennedy S, Milton AH, Deger M, Payk F, Sanderson G. Cost–utility analysis of cochlear implantation in Australian adults. Otology & Neurotology. 2016 Jun 1;37(5):454-61.
  17. Cutler H, Gumbie M, Olin E, Parkinson B, Bowman R, Quadri H, Mann T. The cost-effectiveness of unilateral cochlear implants in UK adults. The European Journal of Health Economics. 2021 Nov 2:1-7.
  18. Gumbie M, Olin E, Parkinson B, Bowman R, Cutler H. The cost-effectiveness of Cochlear implants in Swedish adults. BMC health services research. 2021 Dec;21(1):1-4.
Author

Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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Yellow ear

What is Normal Hearing? Why a simple and consistent answer is needed

October 29, 2020

By Patti Trautwein, MA, AuD, Vice President, Product Management & Marketing, Cochlear Americas

Less than 25% of people get their hearing screened annually and more than 37 million (15%) Americans have hearing loss.1-2  Less than 30% of people who can benefit from hearing aids1, 2 and approximately 8% from cochlear implants have them.3 

As an audiologist, this data can be frustrating. There have been tremendous advancements in technology in the last few decades, including more treatment options with devices that are smaller, smarter and deliver better outcomes. Despite these advances, why haven’t the growing number of people with hearing loss accessed treatment?  Recent clinical and market investigations have identified awareness, acceptance, cost and stigma as primary obstacles to adopting hearing devices.4

A recent article by Christopher Spankovich reviewed the history of defining hearing loss using the audiogram versus other measures such as speech or objective measures, explaining how the past five decades encapsulated the rationale for 15- 25 dB HL as the limit for normal hearing.5 Importantly, the author noted strong correlation between pure tone average and perceived hearing difficulty. Most interesting, Spankovich reported that when asking audiologists what normal hearing is, “not surprisingly, you get a variety of responses.” 

How does the variability across clinicians transcend to the general population’s understanding of normal hearing? 

For example, Cochlear’s industry research highlights how people described hearing and noted the variability. Some used words such as mild, moderately severe, significant or deaf, while others used percentages of loss or percentages of hearing remaining.

So, do people know what is normal hearing? The team decided to go out on the street to find out:

Raising awareness of a simple metric, such as 20 dB PTA, for normal hearing may help the general population understand hearing health. Further, it may provide guidance on when to seek clinical evaluation, treatment and even what type of treatments to consider. This becomes increasingly important as the options expand to include over-the-counter devices in addition to hearing aids or hearing implants, making it more important for consumers to get the support of an audiologist or ENT. A simple and consistent metric streamlines to the process for consumers and allied health providers to monitor and act on hearing health, as they are likely to do with other health considerations such as vision or cholesterol.  

Is this a call to action for hearing health care providers to align on the simple answer that the general public can understand?  Please share the video with your colleagues and start the conversation so we can work together to improve access to appropriate hearing healthcare.

To learn more, subscribe to Cochlear ProNews.

About the author: Patricia’s 25 years in the hearing healthcare industry includes roles in research and clinical studies, product management, education and training, sales and marketing. As Cochlear America’s VP of Marketing, Patricia is responsible for the marketing strategy, communications and public relations, brand ambassador program and product management. Her organization is responsible for positioning Cochlear Americas growth strategy, cultivating opportunities in new and existing customer markets and growing demand for Cochlear’s hearing solutions in the region.

References:

1. Abrahms, H and Kihm, J (2015) MT9 reveals renewed encouragement as well as obstacles for consumers with hearing loss. Hearing Review https://www.hearingreview.com/practice-building/marketing/introduction-marketrak-ix-new-baseline-hearing-aid-market (accessed on Sept 14, 2020)  

2. Quick Statistics About Hearing. (2020, October 2). NIDCD. https://www.nidcd.nih.gov/health/statistics/quick-statisticshearing#:~:text=One%20in%20eight%20people%20in,based%20on%20standard%20hearing%20examinations.&text=About%202%20percent%20of%20adults,54%20have%20disabling%20hearing%20loss.

3. Holder, J., Reynolds, S., Sunderhaus, L., Gifford, R. (2018) Current Profile of Adults Presenting for Preoperative Cochlear Implant Evaluation Trends in Hearing Jan-Dec.

4. Kochin, S. (2007) MarkeTrak VII: Obstacles to adult non-user adoption of hearing aids, he Hearing Journal: April 2007 – Volume 60 – Issue 4 – p 24-51

5. Spankovich, C. (2020) Some observations on normal hearing and hearing loss.  Audiology Today Sep/Oct 2020 pgs. 32-41.

woman with cochlear implant on run with phone

Understanding reliability and why it matters

November 29, 2018

Nucleus System

Guest author: Wade Colburn

Wade Colburn

 

 

Of all the different factors in counseling your patient on a cochlear implant, the reliability of the implant is likely one factor that comes to mind. Once a patient commits to a cochlear implant, it is important to know that a reliable and properly functioning implant is the basis for hearing. Furthermore, a reliable implant can reduce the need for a possible revision in the future. All manufacturers claim to have the most reliable 1,2,3 implants, but this can’t be the case.

Let’s take a closer look at what goes in to reliability reporting.  Reliability is measured as Cumulative Survival Percentage (CSP), which is the probability of survival of a device within a given time period, and Cumulative Failure Percentage (CFP), which is the probability of failure of a device within a given time period.

Reliability reporting is done each and every year and should be reported according to the European and Global Consensus Statement on Cochlear Implant Failures and Explantations1. This consensus detailed how device failures and reliability should be reported and established the seven principles of best practice reporting.

In the latest reports of each cochlear implant manufacturer, the CSP was reported as follows: Cochlear TM Profile Series – 99.82% within 4 years 2, Med-El Synchrony Series – 98.16% within 3 years 3, Advanced Bionics HiRes 90K Advantage – 99.29% within 5 years 4. While this may seem like a small percentage difference, the fact is these numbers result in the following likelihood of failure:

  • Cochlear Profile: 1 in 556 devices fail within 4 years.
  • Advanced Bionic HiRes 90K Advantage: 1 in 141 devices fail within 5 years
  • MED-EL Synchrony: 1 in 55 devices fail within 3 years

This way of looking at reliability is powerful and the reason Cochlear stands behind having the best reliability in the industry establishing itself as the most chosen manufacturer in the world.

Reliability Graph

The difference in CSP seems very small (<1%), but it can translate to a big difference with tremendous impact to patients. To establish this evidence supporting Cochlear as #1 in implant reliability, the following calculations were made:

  • Convert failure rate (CFP) based on Cumulative Survival Percentage (CSP)
  1. Cochlear Profile (4 Years)  99.82% (CSP) = 0.18% failure rate
  2. AB HiRes 90K (5 Years) 99.29% (CSP) = 0.71% Failure Rate
  3. MedEl Synchrony (3 Years)  98.16% (CSP) = 1.84% Failure Rate
  • Based on this failure rate, we establish how many will have failed after 1000 implantations (1000 implants x failure rate):
  1. Cochlear Profile (4 Years) = 1000*.0018 = 1.8 Failures in 1000 Implants
  2. AB HiRes 90K (5 Years)= 1000*.0071 = 7.1 Failures in 1000 Implants
  3. MedEl Synchrony (3 Years) = 1000*.0184 = 18.4 Failures in 1000 Implants
  • Last we establish the number of implants for every failure: 1000/ # of Failures per 1000
  1. Cochlear Profile (4 Years) = 1000/ 1.8 = 1 in 556 within 4 years
  2. AB HiRes 90K= 1000/7.1 = 1 in 141 within 5 years
  3. MedEl Synchrony = 1000/18.4 = 1 in 55 within 3 years

Understanding reliability is essential to making the best decision for your patients. To learn more about reliability reporting at Cochlear and see the full Reliability report.

About our guest author:

Wade is the Product Manager for Cochlear Implant product portfolio within Cochlear Americas.  Wade’s responsibilities include product positioning and messaging, life-cycle management, new product launches and surgical support and training. Wade has recently joined Cochlear, but comes from an engineering background with the medical device field, including previous otology experience.

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References:
  1. European Consensus Statement on Cochlear Implant Failures and Explantations. Otol Neurotol. 26: 1097-1099, 2005.
  2. Cochlear Nucleus Implant Reliability Report. Volume 16 | December 2017. D1335113. Cochlear Ltd; 2018
  3. Hearing Implant Reliability Reporting | MED-EL [Internet]. Medel.com 2018 [cited 15 Oct 2018] Available from: https://www.medel.com/us/reliability-reporting/
  4. 2018 Global Implant Reliability Report. 027-N025-02 Rev B. Advanced Bionics AG and affiliates; 2018.
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This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

 

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