Remote Monitoring of Adult Cochlear Implant Recipients Using Digits-in-Noise Self-Testing

Purpose: The COVID-19 pandemic has accelerated the uptake and scope of telehealth. This study determined the accuracy and reliability of a smartphone digits-in-noise (DIN) test when conducted by adult cochlear implant (CI) recipients in a simulated home environment compared with a clinic setup. Perceptions of remote monitoring using speech-in-noise (SIN) testing were also explored. Method: Thirty-three adult CI recipients between 18 and 78 years of age ( M = 46.7, SD = ±20.4) conducted the DIN test in a simulated home environment and a clinic setup. Test–retest reliability across the two environments and comparisons between test settings were evaluated. A survey explored the perceptions of adult CI recipients regarding remote monitoring and use of the DIN self-test. Results: Mean-aided speech reception thresholds (SRTs) in the clinic and simulated home environment test conditions and clinic and simulated home environment retest conditions did not differ significantly. Mean test–retest SRTs in the clinic and simulated home environment were significantly different ( p < .05). High intraclass correlation coefficient and low standard error of measurement scores reflected good and excellent reliability between test–retest measures and between clinic and simulated home environment measures. Most participants were positive about the possibility of using the DIN test at home to self-assess speech perception, although some test adjustments such as including training items and a less adverse starting signal-to-noise ratio may be required. Conclusion: Adult CI recipients can use the smartphone DIN test to self-assess aided SIN performance in a home environment with accuracy and reliability relatively similar to clinic testing. Supplemental Material: https://doi.org/10.23641/asha.20044418