Remote monitoring in cochlear implant users: feasibility and reliability in adolescents

This study evaluated the feasibility and reliability of home-based monitoring of auditory performance in adolescent cochlear implant (CI) users. Objectives were to: (1) compare self-administered Remote Check (RC) audiometry with clinic-based audiometry, (2) assess how reliably audiologists can determine follow-up needs using RC and two validated questionnaires, (3) evaluate the feasibility of an RC-based follow-up schedule and (4) explore adolescents’ and parents’ experiences with RC and their openness to replacing in-clinic visits with remote monitoring. This prospective cohort study enrolled eighteen experienced CI users aged 10–19 years. Participants completed the RC test battery and two patient-reported outcome measures at home, which were reviewed by an audiologist. During annual clinical visits, aided thresholds and speech perception in noise were measured and CI fitting was assessed, which were reviewed by a second audiologist. Afterward, participants and their parents completed evaluation questionnaires. Twenty-five implanted ears were included. RC-derived aided thresholds were on average 6.4 decibels lower than clinical thresholds, while digits-in-noise results did not differ significantly. Audiologists reached concordant conclusions in two-thirds of cases, while three CI related issues were not identified through RC. Questionnaire responses indicated high satisfaction, with 79% of adolescents and 88% of parents preferring RC-based follow-up. Most participants completed RC independently at home. Variability limits individual interpretation, and some CI issues were missed remotely. While RC shows promise as an adjunct CI aftercare for adolescents, specific limitations related to account mismatch, incomplete datalogging and adolescent bimodal users were identified.