Sound quality, rather than speech recognition, was the strongest predictor of quality of life in adults with cochlear implants, according to a study published in JASA Express Letters. Sound quality ratings explained 32% of the variance in global Cochlear Implant Quality of Life scores, while speech recognition showed no significant effects.
The cross-sectional study of 41 adult cochlear implant (CI) users, aged 18 to 80 years (median age, 54 years) who completed word and sentence recognition tasks and two validated questionnaires: the Speech, Spatial and Qualities of Hearing (SSQ) and the Cochlear Implant Quality of Life (CIQOL) survey. Higher SSQ sound quality ratings correlated with better scores in communication, emotional well-being, social functioning, and listening effort.
Sound quality predicted 17%–50% of the variance across individual CIQOL domains, with the strongest effects seen in communication and social functioning. The relationship between sound quality and quality of life remained consistent across device configurations, including bilateral, bimodal, and unilateral CI users.
A weak correlation emerged between sound quality ratings and sentence recognition in noise (r = 0.37, P < .001), but speech recognition in quiet and other measures showed no meaningful relationship with CIQOL outcomes. Researchers found that sound quality independently accounted for improvements in listening effort and emotional well-being, indicating that patients’ perceived auditory fidelity influenced satisfaction more than intelligibility metrics. The authors noted that speech recognition alone may not adequately capture real-world hearing experiences, and suggest that sound quality should be considered an independent outcome measure in cochlear implant evaluation.
Study limitations included its cross-sectional design, which prevents causal inference and the remote testing format, which could introduce environmental variability and favor participants with higher digital literacy. The SSQ also lacked CI-specific sound quality measures and device programming data were not available for analysis.
"Moving forward, sound quality should be considered as a distinct and important outcome measure," noted lead author Katelyn A. Berg, Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, and colleagues. " Given these results, future research should focus on developing comprehensive CI-specific sound quality assessments while examining how these relationships evolve longitudinally."
A.C.M. serves as Chief Medical Officer and on the Board of Directors for Otologic Technologies, and is a paid consultant for Amgen. The other authors reported no conflicts of interest.
Source: JASA Express Letters
