Iowa Cochlear Implant Clinical Research Center VII

项目主任/首席调查员(最后、第一、中间)：甘茨，布鲁斯·J 项目摘要--项目1 过去35年的人工耳蜗(CI)研究主要集中在与言语有关的结果上 感知力。最近，由于较新、较短的候选人资格，候选人资格已扩展到受影响较轻的人群 植入物，包括混合(声电)设计。领域中改进/更改的潜力 除了言语，知觉还能为政策和康复决策提供信息。 人类生态学描述了人类与其自然、社会和建筑环境之间的关系。 这一概念认为，必须从社会科学和自然科学两方面来研究人的行为。 有利位置。在听力保健中，干预的成功同样与解剖学/生理学有关 与环境和个人(即，生态)因素有关，这些因素使每个人 独一无二的。该项目的总体目标是确定干预对用户的影响 自然环境中与听力有关的功能和残疾(即现实世界的结果)，并澄清 哪些生态因素以及感知因素会影响这些现实世界的结果。 到目前为止，大多数人工耳蜗术(CI)的研究都集中在确定解剖学和人工授精的效果 生理因素对实验室结果的影响，如言语感知。然而，我们认识到， 现实世界的结果表现出很大的异质性，这可能部分是由于更广泛的 环境和个人背景(即生态)在听障人群中的基础。AS 助听器(HA)的情况，很大的差异可以通过检查个人 生态因素。对于(1)CI生态因子的特征了解甚少 种群，(2)生态因素对现实世界结果的异质性的影响 人口，以及(3)这如何影响随着时间的变化。随着CI量化的扩展适应症 在CI中，影响真实世界结果的生态因素至关重要，因为最终现实世界的结果 确定社会负担和政策。此外，因为传统的回溯性自我报告结果 措施往往会受到回忆偏差的影响，除了标准化的问卷调查和数据记录 处理器上的功能，使用基于智能手机的生态瞬时评估(EMA)系统 捕捉用户在现场(即在自然环境中)的实时体验。这将允许测量 除了听力难易的主观评估外，听力环境的特点。二 旨在研究生态因素对CI听者结果的影响。 目标1.描述与参与者的倾听和交流相关的环境因素 每个干预组(目标1A)，并确定干预对这些因素的影响(目标1B)。 目标2.记录干预对现实世界结果的影响(目标2A)，并确定在多大程度上 随着时间的推移，环境、个人和感知因素会缓和这些结果(目标2B)(目标2C)。

Program Director/Principal Investigator (Last, First, Middle): Gantz, Bruce J. PROJECT SUMMARY – PROJECT 1 The past 35 years of cochlear implant (CI) research have focused on outcomes primarily related to speech perception. Candidacy recently has extended into the less severely impaired population due to newer, shorter implants, including hybrid (acoustic-plus-electric) designs. The potential for improvement/change in domains other than speech perception can inform both policy and rehabilitative decision-making. Human ecology describes the relationship between humans and their natural, social, and built environments. This concept considers that human behaviors must be studied from both the social and natural science vantage points. In hearing health care, success with intervention is as much related to the anatomy/physiology of the individual as it is to the environmental and personal (i.e., ecological) factors that make each individual unique from the next. The overall goal of this project is to determine the impact of intervention on user's hearing-related functions and disability in their natural environments (i.e., real-world outcomes) and to clarify what ecological factors, as well as perceptual factors, affect these real-world outcomes. To date most cochlear implant (CI) research has focused on determining the effect of anatomical and physiological factors on laboratory outcomes, such as speech perception. We recognize, however, that the real-world outcomes exhibit great heterogeneity, which is likely due, in part, to the broader range of environmental and personal contextual (i.e., ecological) underpinnings in the hearing impaired population. As has been the case with hearing aids (HA), much variance can be accounted for by examining individual ecological factors. Very little is understood about (1) the characteristics of ecological factors of the CI population, (2) the influence that ecological factors have on the heterogeneity of real-world outcomes of this population, and (3) how this influences changes over time. With the expanded indications for CI quantifying the ecological factors that parlay into real-world outcomes in CI is critical because real-world outcomes ultimately determine societal burden and policy. Furthermore, because traditional retrospective self-reported outcome measures are often subject to recall bias, we will, in addition to standardized questionnaires and a data-logging feature on the processors, use a smartphone-based ecological momentary assessment (EMA) system to capture users' real-time experiences in situ (i.e., in natural environment). This will allow for measurement of the characteristics of listening environments in addition to subjective assessment of listening difficulty/ease. Two Aims have been designed to study the influence of ecological factors have on outcomes of listeners with a CI. Aim 1. To characterize environmental factors that are relevant to listening and communication for participants in each intervention group (Aim 1A) and to determine the effect of intervention on these factors (Aim 1B). Aim 2. To document the effect of intervention on real-world outcomes (Aim 2A) and determine to what extent environmental, personal, and perceptual factors moderate those outcomes (Aim 2B) over time (Aim 2C).