Program Director/Principal Investigator (Last, First, Middle): Gantz, Bruce J. PROJECT SUMMARY ? PROJECT 1 The past 35 years of cochlear implant (CI) research have focused on outcomes primarily related to speech perception. Candidacy recently has extended into the less severely impaired population due to newer, shorter implants, including hybrid (acoustic-plus-electric) designs. The potential for improvement/change in domains other than speech perception can inform both policy and rehabilitative decision-making. Human ecology describes the relationship between humans and their natural, social, and built environments. This concept considers that human behaviors must be studied from both the social and natural science vantage points. In hearing health care, success with intervention is as much related to the anatomy/physiology of the individual as it is to the environmental and personal (i.e., ecological) factors that make each individual unique from the next. The overall goal of this project is to determine the impact of intervention on user's hearing-related functions and disability in their natural environments (i.e., real-world outcomes) and to clarify what ecological factors, as well as perceptual factors, affect these real-world outcomes. To date most cochlear implant (CI) research has focused on determining the effect of anatomical and physiological factors on laboratory outcomes, such as speech perception. We recognize, however, that the real-world outcomes exhibit great heterogeneity, which is likely due, in part, to the broader range of environmental and personal contextual (i.e., ecological) underpinnings in the hearing impaired population. As has been the case with hearing aids (HA), much variance can be accounted for by examining individual ecological factors. Very little is understood about (1) the characteristics of ecological factors of the CI population, (2) the influence that ecological factors have on the heterogeneity of real-world outcomes of this population, and (3) how this influences changes over time. With the expanded indications for CI quantifying the ecological factors that parlay into real-world outcomes in CI is critical because real-world outcomes ultimately determine societal burden and policy. Furthermore, because traditional retrospective self-reported outcome measures are often subject to recall bias, we will, in addition to standardized questionnaires and a data-logging feature on the processors, use a smartphone-based ecological momentary assessment (EMA) system to capture users' real-time experiences in situ (i.e., in natural environment). This will allow for measurement of the characteristics of listening environments in addition to subjective assessment of listening difficulty/ease.
Two Aims have been designed to study the influence of ecological factors have on outcomes of listeners with a CI.
Aim 1. To characterize environmental factors that are relevant to listening and communication for participants in each intervention group (Aim 1A) and to determine the effect of intervention on these factors (Aim 1B).
Aim 2. To document the effect of intervention on real-world outcomes (Aim 2A) and determine to what extent environmental, personal, and perceptual factors moderate those outcomes (Aim 2B) over time (Aim 2C).

Public Health Relevance

Gantz, Bruce J. PROJECT NARRATIVE ? PROJECT 1 To date most cochlear implant (CI) research has focused on determining the effect of anatomical and physiological factors on laboratory outcomes, such as speech and music perception. We recognize, however, that the real-world outcomes exhibit great heterogeneity, which is likely due, in part, to the broader range of environmental and personal contextual (i.e., ecological) underpinnings in the hearing impaired population. The overall goal of this project is to determine the impact of CI intervention on user's outcomes in their natural environments and to clarify what individual factors can affect these real-world outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Specialized Center (P50)
Project #
5P50DC000242-32
Application #
9607092
Study Section
Special Emphasis Panel (ZDC1)
Project Start
Project End
Budget Start
2018-12-01
Budget End
2019-11-30
Support Year
32
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of Iowa
Department
Type
DUNS #
062761671
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Shearer, A Eliot; Tejani, Viral D; Brown, Carolyn J et al. (2018) In Vivo Electrocochleography in Hybrid Cochlear Implant Users Implicates TMPRSS3 in Spiral Ganglion Function. Sci Rep 8:14165
Adunka, Oliver F; Gantz, Bruce J; Dunn, Camille et al. (2018) Minimum Reporting Standards for Adult Cochlear Implantation. Otolaryngol Head Neck Surg 159:215-219
Smith, Nicholas A; McMurray, Bob (2018) Temporal Responsiveness in Mother-Child Dialogue: A Longitudinal Analysis of Children with Normal Hearing and Hearing Loss. Infancy 23:410-431
Wu, Yu-Hsiang; Stangl, Elizabeth; Chipara, Octav et al. (2018) Characteristics of Real-World Signal to Noise Ratios and Speech Listening Situations of Older Adults With Mild to Moderate Hearing Loss. Ear Hear 39:293-304
Gantz, Bruce J; Dunn, Camille C; Oleson, Jacob et al. (2018) Acoustic plus electric speech processing: Long-term results. Laryngoscope 128:473-481
Kim, Jeong-Seo; Tejani, Viral D; Abbas, Paul J et al. (2018) Postoperative Electrocochleography from Hybrid Cochlear Implant users: An Alternative Analysis Procedure. Hear Res 370:304-315
Goman, Adele M; Dunn, Camille C; Gantz, Bruce J et al. (2018) PREVALENCE OF POTENTIAL HYBRID AND CONVENTIONAL COCHLEAR IMPLANT CANDIDATES BASED ON AUDIOMETRIC PROFILE. Otol Neurotol 39:515-517
Bonnard, Damien; Schwalje, Adam; Gantz, Bruce et al. (2018) Electric and acoustic harmonic integration predicts speech-in-noise performance in hybrid cochlear implant users. Hear Res 367:223-230
Pimperton, Hannah; Walker, Elizabeth A (2018) Word Learning in Children With Cochlear Implants: Examining Performance Relative to Hearing Peers and Relations With Age at Implantation. Ear Hear 39:980-991
McMurray, Bob; Ellis, Tyler P; Apfelbaum, Keith S (2018) How Do You Deal With Uncertainty? Cochlear Implant Users Differ in the Dynamics of Lexical Processing of Noncanonical Inputs. Ear Hear :

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