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早期数据记录可预测人工耳蜗植入效果:建立日常设备使用建议。

Early Datalogging Predicts Cochlear Implant Performance: Building a Recommendation for Daily Device Usage.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Vanderbilt University Schools of Medicine (Biostatistics, VICC, Psychiatry) and Nursing, Nashville, Tennessee.

出版信息

Otol Neurotol. 2023 Aug 1;44(7):e479-e485. doi: 10.1097/MAO.0000000000003917.

Abstract

OBJECTIVE

To quantify the effect of datalogging on speech recognition scores and time to achievement for a "benchmark" level of performance within the first year, and to provide a data-driven recommendation for minimum daily cochlear implant (CI) device usage to better guide patient counseling and future outcomes.

STUDY DESIGN

Retrospective cohort.

SETTING

Tertiary referral center.

PATIENTS

Three hundred thirty-seven adult CI patients with data logging and speech recognition outcome data who were implanted between August 2015 and August 2020.

MAIN OUTCOME MEASURES

Processor datalogging, speech recognition scores, achievement of "benchmark speech recognition performance" defined as 80% of the median score for speech recognition outcomes at our institution.

RESULTS

The 1-month datalogging measure correlated positively with word and sentences scores at 1, 3, 6, and 12 months postactivation. Compared with age, sex, and preoperative performance, datalogging was the largest predictive factor of benchmark achievement on multivariate analysis. Each hour/day increase of device usage at 1 month resulted in a higher likelihood of achieving benchmark consonant-nucleus-consonant and AzBio scores within the first year (odds ratio = 1.21, p < 0.001) as well as earlier benchmark achievement. Receiver operating characteristic curve analysis identified the optimal data logging threshold at an average of 12 hours/day.

CONCLUSIONS

Early CI device usage, as measured by 1-month datalogging, predicts benchmark speech recognition achievement in adults. Datalogging is an important predictor of CI performance within the first year postimplantation. These data support the recommended daily CI processor utilization of at least 12 hours/day to achieve optimal speech recognition performance for most patients.

摘要

目的

量化数据记录对第一年达到“基准”水平的言语识别得分和时间的影响,并提供数据驱动的建议,以指导患者咨询和未来结果,确定最低每日人工耳蜗(CI)设备使用量。

研究设计

回顾性队列研究。

地点

三级转诊中心。

患者

2015 年 8 月至 2020 年 8 月期间接受数据记录和言语识别结果数据的 337 名成年 CI 患者。

主要观察指标

处理器数据记录、言语识别得分、达到我们机构言语识别结果中位数 80%的“基准言语识别性能”。

结果

1 个月的数据记录与激活后 1、3、6 和 12 个月的单词和句子得分呈正相关。与年龄、性别和术前表现相比,数据记录是多变量分析中基准达成的最大预测因素。与 1 个月时设备使用时间增加 1 小时/天相比,设备使用时间每增加 1 小时/天,第一年达到基准辅音-核-辅音和 AzBio 得分的可能性就越高(优势比=1.21,p<0.001),而且基准达成时间更早。受试者工作特征曲线分析确定了平均每天 12 小时的最佳数据记录阈值。

结论

1 个月的数据记录,即早期 CI 设备使用情况,可预测成人的基准言语识别成绩。数据记录是植入后第一年 CI 性能的重要预测因素。这些数据支持推荐的每日 CI 处理器利用率至少为 12 小时/天,以实现大多数患者的最佳言语识别性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d492/10361622/3a9786c0cb8e/nihms-1893706-f0001.jpg

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