PP807 - Quiet-to-Noise Shift in Speech Perception and Quality-of-Life Measures in Cochlear Implant Users

Abstract: Previous research has indicated inconsistent relationships between quality-of-life (QoL) questionnaires and clinical measures of CI speech outcomes. Here, in addition to assessing the relationship between QoL measures and CI speech in quiet and noise conditions, we also generated a quiet-to-noise shift. This score quantifies the degree of change in CI speech perception with the addition of background noise. Greater speech-in-noise perception, as well as smaller shifts in performance when background noise was added, was significantly related to self-reported CI benefit as measured by the Glasgow Benefit Inventory (GBI) Total and General scores.

Summary: Authors: Alexandra Parbery-Clark, Chantel Hazlewood*, Dylan Severson, Jake Hillyer, Nadav Brumer & Elizabeth Elkins

Background: Cochlear implant (CI) care has traditionally focused on assessing CI outcome measures with clinical measures of speech perception. Recently, there is a growing shift toward providing greater holistic care, which translates into assessing a patient’s subjective insight of CI benefit using quality-of-life (QoL) questionnaires. However, the relationship between QoL metrics and commonly used clinical CI speech tests has been inconsistently demonstrated. To address this, we compared QoL metrics to CI speech understanding in both quiet and noise conditions in addition to calculating a quiet-to-noise shift score which quantifies the degree of change in CI speech perception an individual demonstrated with the addition of background noise.
 

Methods: Speech perception abilities for twenty-eight adult CI users (20 bimodal and 8 bilateral) were assessed using the AzBio sentence test in quiet and in noise. The AzBio quiet-to-noise shift was calculated by subtracting the AzBio noise scores from the AzBio quiet scores for each participant. The Glasgow Benefit Inventory (GBI), Nijmegen Cochlear Implant Questionnaire (NCIQ), and Hearing Handicap Inventory for Adults (HHIA) were used to measure QoL benefit following cochlear implantation. All participants were post-lingually deafened and had normal IQ as indicated by the Test of Nonverbal Intelligence (TONI).
 

Results: Higher speech-in-noise (SIN) performance was related to higher self-report of CI benefit on the GBI General subscore. Conversely, a smaller quiet-to-noise shift in AzBio scores was related to higher GBI Total and General scores. Speech perception did not relate to either Social Support or Physical Health subscores of the GBI, nor to the NCIQ or HHIA.
 

Conclusion: Greater SIN perception, as well as smaller shifts in performance when background noise was added, was significantly related to self-reported CI benefit as measured by the GBI Total and General; no relationships were observed for the NCIQ nor HHIA. Our results indicate that the quiet-to-noise shift significantly relates with subjective perception of CI benefit. Future work is needed to determine the extent of the clinical benefit of the AzBio quiet-to-noise shift and whether this would be a meaningful clinical metric to track for CI recipients over time.