Resident Physician Johns Hopkins University School of Medicine
Objective: Cochlear implant (CI) candidacy and post-operative outcomes are assessed through multiple different speech discrimination tests, limiting comparisons across time periods or institutions. The objective of this study was to investigate the extent of agreement among commonly used speech understanding scores in assessment of CI candidacy or performance in individual patients.
Study Design: Pre- and post-operative AzBio Sentence Test, Consonant-nucleus-consonant Word (CNCw), and Hearing in Noise Test (HINT) scores in quiet, collected during the same testing session, for individuals who received a CI between 1985-2018 were analyzed to derive transformation functions between test instruments. Simple linear regression with logittransformation was used to determine mean scores and variances. Bland-Altman plots were used to assess agreement between testing methods.
Setting: Single academic medical center.
Patients: 1,710 individuals with a mean age of 57.9 years (range 18-95 years) and 46% (784/1,710) male.
Interventions: N.A.
Main Outcome Measures: Mean, variance, correlation coefficients, and agreement as a function of test score.
Results: Same-session AzBio/CNCw (n=2,052), AzBio/HINT (n=525), and CNCw/HINT (n=7,187) scores were available in 1710 unique patients. Pair-wise test comparisons demonstrated score correlation between different speech tests, but also revealed large variance and limited agreement between different tests performed in the same session.
Conclusions: Transformation functions between test batteries were predictive of mean but not variance in scores, or extent of agreement between test batteries. Point-wise comparisons of scores across CI test batteries should be used with caution in clinical and research settings.
*Professional Practice Gap & Educational Need: There is a need to understand how different speech performance scores can be compared.
*Learning Objective: Understand the variability of different speech performance scores (AzBio, CNCw, HINT) recorded during the same testing session in a large cohort of cochlear implant recipients at a large academic medical center.
*Desired Result: Individuals will be able to describe the large amount of variability between different speech performance scores and that speech performance scores cannot be reliably converted.