Changes in Outcomes Expectations During the Cochlear Implant Evaluation Process.
Joshua E Fabie, Christian M Shannon, Shreya Chidarala and 4 others
PMID 39360792WHAT IT FOUND
Average expectations did not significantly change across the cochlear implant evaluation period.
People who started with high expectations lowered them, while people with low expectations mostly stayed the same or increased.
Key findings
01For the overall cohort, CIQOL-Expectations global and domain scores did not significantly change between any of the three timepoints.
02In the high-expectations group, global and all domain scores except social decreased significantly from pre-evaluation to surgery day, with effect sizes from d=0.55 to d=1.14.
03The CIQOL functional staging system was the most preferred format for discussing potential outcomes, chosen by 14 participants, or 73.6%.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was done at one institution and had a small sample, so it may not generalize. Counseling was usual clinical care, not a standardized script, so the content of discussions varied. The study did not measure post-implant speech recognition, quality of life, satisfaction, or regret. Interview findings came from a subset of participants, not the full cohort. The expectation scores were higher than previously published CIQOL-Expectations data, which may reflect study participation effects.
Declared interests
One author declared being on the medical advisory board for Envoy Medical.
The easy way to misread this
Do not conclude that the CI evaluation process reliably lowers expectations for everyone. The whole cohort showed no significant change, and the significant decreases were seen mainly in the high-expectations group.