Remote cochlear implant programming in real-life listening environments: a feasibility and acceptability study

Objectives This study investigates the feasibility, acceptability, and perceived benefits of conducting cochlear implant (CI) remote fitting in real-life listening situations. Methods Twelve post-lingually deafened CI users participated in four sessions: a baseline in-clinic visit, two remote fitting sessions (at home and in a real-life setting), and a final in-clinic evaluation. Participants completed a Client Oriented Scale of Improvement (COSI) and a custom post-study survey to assess usability, technical stability, satisfaction, and communication quality. Results Half of the participants (six out of twelve) reported high satisfaction or satisfaction (four out of twelve) with remote fitting. Frequently cited benefits included reduced travel time and improved satisfaction in specific listening situations, while common drawbacks were technical issues and reduced non-verbal communication. Group-level speech intelligibility in quiet remained stable across sessions, which served as a safety check. All participants would recommend remote fitting to other CI users, and most considered it important for future CI care. Conclusion This study provides insights into challenges and lessons learned of using remote fitting tools for practicing clinicians and designers of future remote programming tools. Remote fitting in real-world settings is feasible and well accepted by CI users with relatively good aided speech intelligibility. It can offer added value by enabling fitting and subjective assessment in listening situations that are according to the COSI, important to the CI user. Improving current remote fitting tools with better communication features and usability may broaden access, particularly for users with poorer speech recognition, and may increase adoption within hybrid care pathways.