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Sorrentino F, Cazzador D, Gazzola F, Cassarà A, Ariano M, Colombo A, Franchella S, Trevisi P, de Filippis C, Marioni G, Zanoletti E, Brotto D. Remote Check as a tele-health instrument for cochlear implant recipients: Analysis of impact and feasibility of application. Am J Otolaryngol 2024; 45:104294. [PMID: 38657534 DOI: 10.1016/j.amjoto.2024.104294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE The number of cochlear implant (CI) surgeries is growing over time, with the risk of overloading CI centers in the post-surgical management. Telemedicine is a possible solution to address this phenomenon. Remote Check (RC) is an application that is specific for CI recipients monitoring. The aim of this study is to evaluate the feasibility of application, potential economic impact and patients' acceptance of RC. METHODS The study is retrospective investigation, data on clinical, audiological features (from remote and on-site evaluation), and satisfaction surveys of 66 consecutive patients were collected; costs required for RC and for on-site evaluations were recorded as well. RESULTS One hundred and ninety RC sessions were completed by the patients (2.88 sessions per patient). RC and on-site audiometry significantly correlated except for the 500 Hz frequency. Estimated costs for the Italian National Health System for RC review and on-site evaluations were 1.32€ and 3.49€ per minute, respectively. High satisfaction for RC was reached in 91 % of patients. CONCLUSION RC revealed to be a reliable, cost-effective and well accepted tool in CI monitoring. This study preliminarily supports the hypothesis that RC could be a valid instrument to reduce CI management overload in the outpatient clinic.
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Affiliation(s)
- Flavia Sorrentino
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy.
| | - Diego Cazzador
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Filippo Gazzola
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Antonino Cassarà
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Marzia Ariano
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Anna Colombo
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Sebastiano Franchella
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Patrizia Trevisi
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Cosimo de Filippis
- Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, Treviso, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience, University of Padova, Treviso, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
| | - Davide Brotto
- Section of Otorhinolaryngology, Department of Neuroscience, University of Padova, Padova, Italy
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Aboye GT, Vande Walle M, Simegn GL, Aerts JM. mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe. Digit Health 2023; 9:20552076231180972. [PMID: 37377558 PMCID: PMC10291558 DOI: 10.1177/20552076231180972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
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Affiliation(s)
- Genet Tadese Aboye
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
- School of Biomedical Engineering, Jimma University, Jimma, Ethiopia
| | - Martijn Vande Walle
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
| | | | - Jean-Marie Aerts
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
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van der Mescht L, le Roux T, Mahomed-Asmail F, De Sousa KC, Swanepoel DW. Remote Monitoring of Adult Cochlear Implant Recipients Using Digits-in-Noise Self-Testing. Am J Audiol 2022; 31:923-935. [PMID: 35738000 DOI: 10.1044/2022_aja-21-00248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
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.
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Affiliation(s)
- Lize van der Mescht
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.,Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa
| | - Karina C De Sousa
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.,Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.,Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, and University of Pretoria, South Africa.,Ear Science Institute Australia, Subiaco, Western Australia
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Holtmann LC, Deuß E, Meyer M, Kaster F, Bastian T, Schleupner MC, Hagedorn E, Lang S, Arweiler-Harbeck D. Detection accuracy of soft tissue complications during remote cochlear implant follow-up. Cochlear Implants Int 2022; 23:249-256. [PMID: 35477412 DOI: 10.1080/14670100.2022.2067644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE After cochlear implantation (CI), long-term follow-up is obligatory. Remote-care options which provide a standard of care comparable to in-person consultations, could be an attractive addition to a cochlear implant centre's portfolio. The aim of this study was to evaluate the accuracy of photographs of the skin covering the implant to reliably detect skin irritations or soft tissue complications. METHODS During routine follow-up consultations, 109 CI patients were examined in person and asked to take a photograph of the skin covering the implant using their smartphones. Photographs were digitally and remotely evaluated by two CI physicians who were blinded to the findings during the in-person examination. RESULTS In nine cases, skin abnormalities were detected by the CI physician upon in-person examination, seven of which required immediate treatment. Both digital evaluators reliably detected all treatment-requiring conditions. Overall, more skin irritations were suspected digitally compared to in-person examination. Without additional information from the patients' medical record, sensitivity was 100% and specificity was 63%; with additional information provided, sensitivity was 100%, and specificity increased to 65.3%. CONCLUSION Digital photographic assessment of the skin covering the implant is a highly sensitive method to detect skin irritations and could reduce the number of necessary in-person consultations.
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Affiliation(s)
- L C Holtmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - E Deuß
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - M Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - F Kaster
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - T Bastian
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - M C Schleupner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - E Hagedorn
- CIC Ruhr Acoustics Bagus, Essen, Germany
| | - S Lang
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - D Arweiler-Harbeck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Essen, University of Duisburg-Essen, Essen, Germany
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Illg A, Bräcker T, Batsoulis C, Opie JM, Lesinski-Schiedat A. CI decision making and expectations by older adults. Cochlear Implants Int 2021; 23:139-147. [PMID: 34963418 DOI: 10.1080/14670100.2021.2019522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To document and analyze the cochlear implant (CI) decision-making process of hearing-impaired older adults. The aim of this study is to assess what support could be helpful during this process in order to improve care delivery. METHODS 32 older adult CI recipients (≥ 60 years) with severe to profound sensorineural hearing loss were interviewed about their CI decision-making process 3-12 months after obtaining their first CI. RESULTS Minimal information was provided to CI candidates by hearing aid acousticians or patient associations. High to very high expectations were reported by patients concerning issues beyond hearing improvement per se. Even though not all expectations were fulfilled by the CI, nearly all recipients who used an implant for at least six months would recommend a CI to others. DISCUSSION We identified an opportunity for those professionals to play a greater role in supporting older CI candidates during the decision-making process. It is desirable to establish a comprehensive network of hearing care professionals to collaborate with CI clinics. CONCLUSION In order to support older patients adequately in deciding about CI, intensive training should be offered to hearing care professionals in order to provide realistic expectations and reduce fear and uncertainty about the implantation process. These topics need to be communicated in a professional manner and adapted to the candidate's age and personality.
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Affiliation(s)
- Angelika Illg
- Department of Otolaryngology, Hannover Medical University, Hannover, Germany
| | - Timo Bräcker
- MED-EL Elektromedizinische Geräte Deutschland GmbH, Research Center, Hannover, Germany
| | - Cornelia Batsoulis
- Department of Otolaryngology, Hannover Medical University, Hannover, Germany
| | - Jane M Opie
- MED-EL Medical Electronics, Innsbruck, Austria
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Fletcher KT, Dicken FW, Adkins MM, Cline TA, McNulty BN, Shinn JB, Bush ML. Audiology Telemedicine Evaluations: Potential Expanded Applications. Otolaryngol Head Neck Surg 2019; 161:63-66. [PMID: 30832542 DOI: 10.1177/0194599819835541] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is underutilization of cochlear implants with delays in implantation linked to distance from implant centers. Telemedicine could connect cochlear implant specialists with patients in rural locations. We piloted telemedicine cochlear implant testing in a small study, largely composed of normal-hearing volunteers to trial this new application of teleaudiology technology. Thirteen subjects (8 with normal hearing and 5 with hearing loss ranging from mild to profound) underwent a traditional cochlear implant evaluation in person and then via telemedicine technology. Routine audiometry, word recognition testing, and Arizona Biological Test (AzBio) and consonant-nucleus-consonant (CNC) testing were performed. Mean (SD) percent difference in AzBio between in-person and remote testing was 1.7% (2.06%). Pure tone average (PTA), speech reception threshold (SRT), and word recognition were similar between methods. CNC testing showed a mean (SD) difference of 6.8% (10.2%) between methods. Testing conditions were acceptable to audiologists and subjects. Further study to validate this method in cochlear implant candidates and a larger population is warranted.
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Affiliation(s)
- Kyle T Fletcher
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Frank W Dicken
- 2 University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Margaret M Adkins
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Trey A Cline
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Beth N McNulty
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Jennifer B Shinn
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Matthew L Bush
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA
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