A Scoping Review and Meta-Analysis of the Relations Between Cognition and Cochlear Implant Outcomes and the Effect of Quiet Versus Noise Testing Conditions.
Andrew E Amini, James G Naples, Luis Cortina and 4 others
PMID 38953851WHAT IT FOUND
Cognitive screening and attention tasks correlate with how well adults understand speech after cochlear implantation, especially in quiet.
However, results vary widely across studies, and noise testing is underpowered. Do not use these scores alone to predict outcomes or select candidates.
Key findings
01Global cognition scores were significantly correlated with speech recognition overall (r = 0.37), with a stronger correlation in quiet (r = 0.43) than in noise (r = 0.23, non-significant).
02Inhibition-concentration was the only cognitive domain where the majority of studies reported a significant correlation with speech recognition (62% in quiet, 43% in noise).
03Verbal working memory correlations were inconsistent and non-significant in both quiet (r = 0.30) and noise (r = -0.06) conditions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only ~30% of studies evaluated speech recognition in noise, limiting comparisons between quiet and noise conditions. There was significant variation in cognitive tests used (over thirty different tests), and only three domains had enough data for meta-analysis. The meta-analysis included studies with moderate and serious risk of bias according to ROBINS-I. Most studies tested speech recognition in either quiet or noise, but not both in the same patients, preventing direct within-subject comparisons. Publication bias may have distorted findings because some studies reported null results without providing correlation coefficients for pooling.
The easy way to misread this
Do not use global cognition or attention scores to definitively predict cochlear implant outcomes or exclude candidates. The correlations are moderate, inconsistent across studies, and the evidence base has moderate to serious risk of bias.