Evaluating recommended audiometric changes to candidacy using the speech intelligibility index

Abstract

Introduction: The National Institute of Health and Care Excellence (NICE) has derived candidacy guidelines for cochlear implants in the UK based on audiometric thresholds (90 dB HL or above at 2 and 4 kHz; hereafter referred to as the 90 dB HL criteria). Recent research has proposed that these criteria should be changed to 80 dB HL at 2 and 4 kHz (hereafter referred to as the 80 dB HL criteria) in the ear to be implanted.Methods: In this study, we analysed aided SII scores derived for different hearing loss profiles falling within the current 90 dB HL criteria and equivalent profiles falling within the new 80 dB HL criteria.Results: The aided SII scores demonstrated that the majority of potential hearing configurations falling within the new proposed 80 dB HL criteria have aided SII values of less than 0.65 (a recommended cut-off point below which there is not sufficient audibility to receive adequate benefit through hearing aids).Conclusions: This supports the proposed change to the 80 dB HL criterion level and also highlights the additional value of the SII score in supporting candidacy decisions for CI, especially for borderline candidates.