A real-world evaluation of the clinical benefits of improved sound processor technology among Chinese cochlear implant users: A focus on Cochlear Nucleus 7

Real-world evidence is increasingly used to support clinical and regulatory decisions globally and may be a useful tool to study the unique needs of cochlear implant users in China. The ability to recognize and understand speech in noise is critical for cochlear implant users, however, this remains a challenge in everyday settings with fluctuating competing noise levels. The Cochlear™ Sound Processor, Nucleus® 7 (CP1000), includes Forward Focus, a spatial noise algorithm aimed to improve speech-in-noise performance, and Made for iPhone/iPod/iPad functionality. We conducted a prospective, single-center, open-label, within-participant, real-world evidence investigation in participants with cochlear implants. The primary objective of this study, conducted in China, was to compare speech perception in spatially separated dynamic noise with the Nucleus 7 to the recipients' current older Cochlear Sound Processor, including the Freedom and Nucleus 5 sound processors. A follow-up study monitored participants from the initial study up to 12-months post the fitting of their Nucleus 7 and investigated hearing ability, satisfaction, and usability of the device via a questionnaire. Forty participants were included in the initial study (age-range 3 to 49 years) and 29 continued to the follow-up study (age-range 5 to 28 years). The participants were heterogeneous in terms of age, cochlear implant experience, and duration of hearing loss. Nucleus 7 significantly improved participant speech recognition performance in noise by 7.54 dB when compared with the participants' current older sound processor (p<0.0001). Overall satisfaction with Nucleus 7 was 72%. Satisfaction in different hearing contexts ranged from 93.1% for understanding a 1:1 conversation in a quiet setting, 62.1% for understanding on the phone, to 34.5% hearing in complex noisy situations. The study demonstrated the benefits of the Nucleus 7 sound processor across different hearing environments in a Chinese population and showed improved hearing ability, usability, and satisfaction in a real-world every-day environment.