Abstract
OBJECTIVE: To determine if unaided, non-linguistic psychoacoustic measures can be effective in evaluating cochlear implant (CI) candidacy. STUDY DESIGN: Prospective split-cohort study including predictor development subgroup and independent predictor validation subgroup. SETTING: Tertiary referral center. SUBJECTS: Fifteen subjects (28 ears) with hearing loss were recruited from patients visiting the University of Washington Medical Center for CI evaluation. METHODS: Spectral-ripple discrimination (using a 13-dB modulation depth) and temporal modulation detection using 10- and 100-Hz modulation frequencies were assessed with stimuli presented through insert earphones. Correlations between performance for psychoacoustic tasks and speech perception tasks were assessed. Receiver operating characteristic curve analysis was performed to estimate the optimal psychoacoustic score for CI candidacy evaluation in the development subgroup and then tested in an independent sample. RESULTS: Strong correlations were observed between spectral-ripple thresholds and both aided sentence recognition and unaided word recognition. Weaker relationships were found between temporal modulation detection and speech tests. Receiver operating characteristic curve analysis demonstrated that the unaided spectral-ripple discrimination shows a good sensitivity, specificity, positive predictive value, and negative predictive value compared to the current gold standard, aided sentence recognition. CONCLUSION: Results demonstrated that the unaided spectral-ripple discrimination test could be a promising tool for evaluating CI candidacy.