Auditory Insight, a consultancy for the hearing healthcare industry, analyzes patients’ concerns with cochlear implants and identifies three causative barriers in its Q1 2022 Research Note. 

To download the Research Note, please click here.

Cochlear implants (CIs) are indicated for about two million people with severe or profound hearing loss who no longer obtain sufficient benefit from hearing aids. Yet from 2000 to 2019, only 100,000 total CIs were implanted in that population, according to the report.

“Instead of undergoing CI surgery, many patients contrive a workaround of hearing aids, lipreading, captioning apps, and sign language. But often they still struggle to hear and communicate,” said Nancy M. Williams, president of Auditory Insight. “We wanted to understand patient barriers to cochlear implantation.” 

Auditory Insight curated, analyzed, and synthesized six recent studies in peer-reviewed medical research on patient adoption of cochlear implants. The company partnered with professor Erin Schafer, PhD, an audiologist and researcher in assessment and habilitation of hearing loss whose experience includes mining a multi-institutional database of CI outcomes. Schafer’s research revealed that patients’ 12-month post-operative speech perception ranges from 0% to 100%, with the median at 56%. 

As a result, patients considering a CI face significant outcome uncertainty. “There’s a gap in the industry dialog on how outcome uncertainty impacts patient adoption,” said Williams. “That’s what Dr Schafer and I set out to address.” 

Auditory Insight’s analysis reveals that three of the top five patient-reported CI concerns, in a recent study, are linked to hearing outcomes: 

  • “A cochlear implant would not significantly improve my ability to communicate.” 
  • “I did not want to risk losing my appreciation for music.” (Due to CI’s technological limitations, some people lose music appreciation.) 
  • “My current hearing aids are satisfactory for my needs.” 

Auditory Insight concluded that patients question whether a CI would improve communication ability and music appreciation better than hearing aids because of their difficulty predicting  their outcome based on their unique profile. “We believe that outcome uncertainty is the primary causative patient barrier to cochlear implantation,” Williams said. 

The research note identifies three causative barriers that are driving patient concerns: 

  1. Outcome uncertainty is the primary driver; 
  2. Lack of CI standards and clinical guidelines create variability in the patient experience, exacerbating patient concerns with outcome uncertainty;
  3. The general public perceives that the risks of CIs outweigh the benefits, reinforcing patient concerns about uncertain outcomes. 

Source: Auditory Insight

Image: Auditory Insight