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dc.contributor.authorvan der Straaten, Tirza FKen
dc.contributor.authorBriaire, Jeroen Jen
dc.contributor.authorVickers, Deborahen
dc.contributor.authorBoermans, Peter Paul BMen
dc.contributor.authorFrijns, Johan HMen
dc.date.accessioned2020-08-05T23:30:42Z
dc.date.available2020-08-05T23:30:42Z
dc.identifier.issn0196-0202
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/308831
dc.description.abstractOBJECTIVES: The impact of the newly introduced cochlear implantation criteria of the United Kingdom and Flanders (Dutch speaking part of Belgium) was examined in the patient population of a tertiary referral center in the Netherlands. We compared the patients who would be included/excluded under the new versus old criteria in relation to the actual improvement in speech understanding after implantation in our center. We also performed a sensitivity analysis to examine the effectiveness of the different preoperative assessment approaches used in the United Kingdom and Flanders. DESIGN: This retrospective longitudinal cohort study included 552 postlingually deafened adults with cochlear implants (CI). The selection criteria were based on preoperative pure-tone audiometry at 0.5, 1, 2, and 4 kHz and a speech perception test (SPT) with and without best-aided hearing aids. Postoperatively, the same SPT was conducted to assess the benefit in speech understanding. RESULTS: The newly introduced criteria in Flanders and the United Kingdom were less restrictive, resulting in greater percentages of patients implanted with CI (increase of 30%), and sensitivity increase of 31%. The preoperative best-aided SPT, used by both countries, had the highest diagnostic ability to indicate a postoperative improvement of speech understanding. We observed that patient selection was previously dominated by the pure-tone audiometry criteria in both countries, whereas speech understanding became more important in their new criteria. Among patients excluded by the new criteria, seven of eight (the United Kingdom and Flanders) did exhibit improved postoperative speech understanding. CONCLUSIONS: The new selection criteria of the United Kingdom and Flanders led to increased numbers of postlingually deafened adults benefitting from CI. The new British and Flemish criteria depended on the best-aided SPT with the highest diagnostic ability. Notably, the new criteria still led to the rejection of candidates who would be expected to gain considerably in speech understanding after implantation.
dc.languageengen
dc.publisherWolters Kluwer Health
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.titleSelection Criteria for Cochlear Implantation in the United Kingdom and Flanders: Toward a Less Restrictive Standard.en
dc.typeArticle
prism.publicationNameEar and Hearingen
dc.identifier.doi10.17863/CAM.55919
dcterms.dateAccepted2020-05-02en
rioxxterms.versionofrecord10.1097/AUD.0000000000000901en
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-05-02en
dc.contributor.orcidVickers, Deborah [0000-0002-7498-5637]
dc.identifier.eissn1538-4667
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMRC (MR/S002537/1)
cam.issuedOnline2020-06-22en


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International