北部社区的远程人工耳蜗候选资格评估、激活和言语感知测试：一项质量改进案例研究。

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中文摘要

目的： 这项在大型成人人工耳蜗（CI）中心开展的质量改进（QI）案例研究旨在改善北部社区获得人工耳蜗（CI）诊疗的机会。通过以新颖方式利用远程听力学改造现有基础设施，我们得以远程完成CI候选资格评估、CI激活和CI言语感知测试。
方法： 对两个远程站点进行了培训并配备设备，以协助开展扩展的CI诊疗服务的远程会话。这些合作站点配备了CI软件、适配器和标准化言语测试WAV声音文件。植入中心的CI听力学家在当地协调员的支持下，使用远程桌面控制完成CI激活，并使用流媒体技术评估CI候选资格评估和CI结局中的助听后言语感知。
结果： 成功完成了五例远程CI候选资格评估和激活，以及三例随访远程CI言语感知测试，且未发生任何不良事件。激活后调查显示参与者满意度很高。案例研究显示，远程评估的言语识别得分与面对面获得的得分之间具有高度一致性，同时也有一例存在高度变异性。
结论： 这些病例报告凸显了远程听力学在改善服务不足地区获得CI诊疗机会方面的潜力。预计未来将扩展到纳入更多CI型号，并适配其他应用，如骨导助听器。

英文摘要

OBJECTIVES: This quality improvement (QI) case study conducted at a large adult CI centre aimed to improve access to cochlear implant (CI) care for northern communities. By adapting existing infrastructure using tele-audiology in novel ways, we were able to complete CI candidacy assessments, CI activations and CI speech perception testing remotely.
METHOD: Two remote sites were trained and equipped to facilitate remote sessions for expanded CI care services. These collaborating sites were outfitted with CI software, adaptors, and standardized speech testing WAV sound files. CI audiologists from the implant centre, with the support of the local Facilitator, used remote desktop control to complete CI activations, plus streaming technology to evaluate aided speech perception for CI candidacy assessments and CI outcomes.
RESULTS: Five remote CI candidacy evaluations and activations were successfully completed, along with three cases of follow-up remote CI speech perception testing without any adverse events. Post-activation surveys indicated a high level of satisfaction among participants. Case studies demonstrated evidence of a high level of agreement as well as a case of high variability between remotely assessed speech recognition scores and those obtained in-person.
CONCLUSION: These case reports highlight tele-audiology's potential to enhance access to CI care for underserved regions. Future expansion to include additional CI models and adaptations to other applications such as bone conduction aids is anticipated.