International survey of cochlear implant candidacy.
BACKGROUND
The goal of this work was to determine international differences in candidacy based on audiometric and speech perception measures, and to evaluate the information in light of the funding structure and access to implants within different countries.


METHODS
An online questionnaire was circulated to professionals in 25 countries. There were 28 respondents, representing the candidacy practice in 17 countries.


RESULTS
Results showed differences in the funding model between countries. Unilateral implants for both adults and children and bilateral implants for children were covered by national funding in approximately 60% of countries (30% used medical insurance, and 10% self-funding). Fewer countries provided bilateral implants routinely for adults: national funding was available in only 22% (37% used medical insurance and 41% self-funding). Main evolving candidacy areas are asymmetric losses, auditory neuropathy spectrum disorders and electro-acoustic stimulation. For countries using speech-based adult candidacy assessments, the majority (40%) used word tests, 24% used sentence tests, and 36% used a mixture of both. For countries using audiometry for candidacy (70-80% of countries), the majority used levels of 75-85 dB HL at frequencies above 1 kHz. The United Kingdom and Belgium had the most conservative audiometric criteria, and countries such as Australia, Germany, and Italy were the most lenient. Countries with a purely self-funding model had greater flexibility in candidacy requirements.
a UCL Department of Speech , Hearing and Phonetics Science , 2 Wakefield Street, London WC1N 1PF , UK.
D
D
Vickers
b ONICI, Independent Information & Research Centre on Cochlear Implants , Waardstraat 9, 3520 Zonhoven , Belgium.
L
L
De Raeve
c Royal National Throat Nose and Ear Hospital , 332 Gray's Inn Road, London , UK.
J
J
Graham
D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D001302:Audiometry, Speech / Q000379:methods*; D001315:Australia; D001530:Belgium; D002648:Child; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D005858:Germany; D006801:Humans; D007558:Italy; D018579:Patient Selection; D013067:Speech Perception; D011795:Surveys and Questionnaires; D006113:United Kingdom
cochlear implant candidacy; international; worldwide