American Journal of Audiology最新文献

{"title":"Teleaudiology for Infant Diagnostic Assessments: Audiologists' Views on Challenges and Opportunities in a Well-Established Screening Program.","authors":"Jocelyn Phillips, Dani Tomlin, Kelley Graydon, Julia Sarant","doi":"10.1044/2026_AJA-25-00166","DOIUrl":"10.1044/2026_AJA-25-00166","url":null,"abstract":"<p><strong>Purpose: </strong>Universal newborn hearing screening allows early identification of hearing loss; however, some families face difficulties accessing diagnostic audiology. This study aimed to investigate audiologists' opinions regarding implementing a teleaudiology infant diagnostic audiology service in Victoria, Australia, a region where traditional access barriers persist despite high follow-up rates.</p><p><strong>Method: </strong>Nine experienced infant diagnostic audiologists participated in three focus groups. Prompt questions, based on the Capability, Opportunity, Motivation-Behaviour model of behavior change, explored clinician-identified barriers and facilitators to teleaudiology implementation. Thematic analysis was used to analyze audiologists' opinions of the proposed model.</p><p><strong>Results: </strong>Audiologists identified that teleaudiology infant diagnostic services may introduce a barrier trade-off; while teleaudiology had the capacity to reduce barriers to service access for some families, it may introduce additional challenges compared to in-person testing. Three main barriers or areas of concern regarding a teleaudiology model of infant diagnostic services were identified: communication and support concerns, risk of error, and financial and motivational concerns. Participants proposed a training model, where experienced clinicians could support and upskill less experienced audiologists acting as in-person facilitators of the service, to address both service delivery and workforce development needs.</p><p><strong>Conclusions: </strong>A teleaudiology model of infant diagnostic assessments in Victoria has the potential to improve accessibility if facilitator training, effective family communication, and resource management are prioritized to ensure service quality is not impacted. A proposed training model offers a novel approach to use teleaudiology to maintain service access, as well as improve workforce experience in underserviced areas.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"619-627"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on Aural Rehabilitation From Adult Cochlear Implant Recipients.","authors":"Blair C Richlin, Janel L Cosby, Aaron C Moberly, Meaghan Foody, Stephanie McCabe, Michelle Havlik, Molly Schoenfeld, James R Dornhoffer, Donna L Sorkin, Kate Sinks","doi":"10.1044/2025_AJA-25-00205","DOIUrl":"10.1044/2025_AJA-25-00205","url":null,"abstract":"<p><strong>Purpose: </strong>An Adult Cochlear Implant Aural Rehabilitation Special Interest Group was formed in 2023. Members represent interdisciplinary collaborators, including audiologists, speech-language pathologists, surgeons, nonclinical administrators, manufacturer/industry representatives, and researchers. Current perspectives of adult cochlear implant (CI) recipients regarding aural rehabilitation (AR) remain unknown and understudied. The aim of this study is to survey adult CI recipients to determine their perspectives on the AR process.</p><p><strong>Method: </strong>A web-based national survey was sent to adult CI recipients through multiple channels. The survey asked recipients about their demographics, state of residence, hearing loss history, and device configuration. Questions probed recipients' experiences of learning about AR options, services used, definitions of AR, and perceived value of services received. Questions were also asked about barriers to AR services, preoperative counseling, and satisfaction with their decision to pursue a CI.</p><p><strong>Results: </strong>A total of 115 CI recipients responded to the survey. Results revealed a relative lack of information provided to many CI recipients regarding AR services. Many CI recipients reported wishing they had received additional resources in the areas of music training and equipment troubleshooting. Most participants reported that both one-on-one clinician-guided AR and independent listening practice were effective methods of AR.</p><p><strong>Conclusions: </strong>Findings shed light on current gaps in providing the most effective AR services, which will need to be addressed to optimize hearing health care and outcomes for adult CI recipients. Future work should include outreach to a broader representation of CI users to expand our understanding of AR resources, education, and limitations.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"441-456"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid Psychological Diagnoses in Children With Single-Sided Deafness Who Received or Are Under Consideration for Cochlear Implantation.","authors":"Rachel A Landsman, Amanda M Griffin, Michael F Hoffman, Megan Herlihy, Greg R Licameli","doi":"10.1044/2026_AJA-25-00155","DOIUrl":"10.1044/2026_AJA-25-00155","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to describe the range and prevalence of comorbid psychological diagnoses in patients with single-sided deafness (SSD)¹ identified during routine neuropsychological evaluations before and after cochlear implantation.</p><p><strong>Method: </strong>A retrospective chart review of all patients with SSD referred for neuropsychological evaluation for consideration or following receipt of a cochlear implant (CI) from January 2021 to June 2024 was conducted. Neuropsychological evaluation findings were reviewed to identify the presence of comorbid psychological condition(s).</p><p><strong>Results: </strong>Twenty-three of 52 (44.23%) children with SSD in this clinical sample were found to have a comorbid psychological diagnosis. The most common diagnoses in school-aged children were attention-deficit/hyperactivity disorder and anxiety disorders. For 15 of the 52 (28.85%) subjects, neuropsychological testing revealed previously undiagnosed and untreated diagnoses. A total of 55.56% of children with SSD 6 years of age or older who received a CI had a comorbid psychological condition.</p><p><strong>Conclusions: </strong>Children with SSD who are referred for CI evaluation appear to be at a greater risk for psychological diagnoses than the general population. This highlights the need for standardized psychological/neuropsychological assessments in this population, as these evaluations help ensure that all the needs of children with SSD are well supported, including psychological interventions when needed.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"423-433"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short Forms and Computerized Adaptive Tests With Monosyllabic Words Can Efficiently Measure Speech Recognition.","authors":"Bryant A Seamon, Craig Salvador, Lois J Mathews, Craig A Velozo, Judy R Dubno, Theodore R McRackan","doi":"10.1044/2025_AJA-24-00240","DOIUrl":"10.1044/2025_AJA-24-00240","url":null,"abstract":"<p><strong>Purpose: </strong>Construct validity of the Northwestern University Auditory Test No. 6 (NU-6) monosyllabic word lists or shortened versions have not been examined using the Rasch measurement theory. The study purposes were to test the fit of the Rasch measurement model to monosyllabic word lists and whether short forms and computerized adaptive testing can measure speech recognition.</p><p><strong>Method: </strong>A cross-sectional study design with 50 persons (average age = 71 years; 35 female, 15 male) with mild-to-moderate hearing loss was used to test the fit of NU-6 Word Lists 1 and 2 to the Rasch measurement model. Pearson's correlations quantified the accuracy of person measures from short forms or computer-adaptive testing simulations with measures from the full lists. Average standard error of person measures quantified measurement precision.</p><p><strong>Results: </strong>Word lists were unidimensional, had negligible misfit, and had high person reliability. Nineteen- and 11-word short forms were made per list. Person measures from 19-word short forms had a high linear association with person measures from the full word lists (List 1: <i>r</i> = .92, <i>p</i> < .0001, <i>SE</i> = 0.76; List 2: <i>r</i> = .91, <i>p</i> < .0001, <i>SE</i> = 0.74) compared to moderate association for the 11-word short form (List 1: <i>r</i> = .84, <i>p</i> < .0001, <i>SE</i> = 0.99; List 2: <i>r</i> = .81, <i>p</i> < .0001, <i>SE</i> = 0.97). Person measures from computerized adaptive testing simulation reached a correlation threshold, <i>r</i> > .90, after 15-20 words were administered for both lists. A precision-based stopping rule used an average of 18 (List 1) or 20 (List 2) words.</p><p><strong>Conclusion: </strong>Short forms with 19 words and computerized adaptive testing may accurately and precisely measure speech recognition.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"518-530"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Cochlear Implant Use Predicts Pitch and Melody Perception in Adolescents With Prelingual Deafness.","authors":"Sevgi Kadihanoglu, Mustafa Yüksel, Merve Ozbal Batuk","doi":"10.1044/2025_AJA-25-00249","DOIUrl":"10.1044/2025_AJA-25-00249","url":null,"abstract":"<p><strong>Purpose: </strong>While speech outcomes have been extensively studied, limited evidence exists regarding how real-world auditory experience shapes music perception-particularly in adolescents with prelingual deafness. This study aimed to explore the relationship between daily cochlear implant (CI) use, long-term CI experience, and music perception abilities in adolescent CI users.</p><p><strong>Method: </strong>This cross-sectional study included 24 unilateral adolescent CI users and 12 age-matched peers with normal hearing (NH). Participants completed two music perception tasks: pitch direction discrimination (PDD) and melodic contour identification (MCI). Daily CI use and cumulative CI usage duration (time since implantation) were obtained via data logging and included in the analyses.</p><p><strong>Results: </strong>The CI group demonstrated significantly poorer performance compared with peers with NH on both PDD and MCI tests. Longer daily CI use was moderately associated with better performance on both the PDD and MCI tasks, while total CI experience correlated positively with MCI scores.</p><p><strong>Conclusions: </strong>Consistent daily CI use is associated with better performance in both basic pitch discrimination and higher order melodic perception in adolescents. These findings highlight the value of maximizing auditory input not only for speech perception outcomes but also for supporting music-related auditory skills.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"545-556"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Aging on Middle Ear Absorbance Characteristics Across Frequencies.","authors":"Apoorva Shivaprakash, Animesh Barman, Arunraj Karuppannan","doi":"10.1044/2025_AJA-25-00140","DOIUrl":"10.1044/2025_AJA-25-00140","url":null,"abstract":"<p><strong>Purpose: </strong>Although age-related auditory changes are well recognized, limited studies have examined how aging affects middle ear mechanics, which can be assessed using wideband tympanometry (WBT). Unlike conventional tympanometry, WBT offers frequency-specific insights into middle ear acoustic transfer function. Ethnic differences in the anatomy of the external and middle ear such as canal length, ossicular dimensions, and stapes configuration may influence acoustic transmission. This study aimed to investigate the effect of aging on middle ear absorbance across frequencies using WBT.</p><p><strong>Method: </strong>A nonexperimental, standard group comparison design was used to test 60 ears from older adults (50-70 years of age) and young adults (20-30 years of age) with clinically normal hearing. Wideband absorbance was measured using click stimuli (0.2-8 kHz) at 100 dB peSPL under both ambient and peak pressure. Data were analyzed using mixed repeated-measures analysis of variance to assess the main and interaction effects of group, gender, frequency, and pressure condition; independent <i>t</i> test for between-group comparisons at each frequency; and paired <i>t</i> test between pressure within-group comparisons.</p><p><strong>Results: </strong>Both groups showed a similar wideband absorbance pattern. However, older adults exhibited a significantly higher absorbance at low frequencies (250-600 Hz) and a lower absorbance at high frequencies (2000-8000 Hz) compared to young adults. These differences indicate age-related alterations in middle ear mechanics, likely due to ossicular joint loosening and tissue degeneration. Pressure-related absorbance changes were more pronounced in younger adults at low to mid frequencies, suggesting that middle ear function in this group is more sensitive to pressure variations. Moreover, gender did not show a significant main effect on absorbance across frequencies.</p><p><strong>Conclusions: </strong>WBT appears to be a sensitive tool to detect subtle age-related changes that may not be evident with conventional tympanometry. The findings offer insights into age-related middle ear changes and suggest possible modification that might be considered during hearing aid fitting in older adults. Additionally, it also suggests that gender may not be a significant factor in assessing middle ear transfer function.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"497-505"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Evaluation of Artificial Intelligence Chatbots for Central Auditory Processing Disorder Information.","authors":"Alyssa J Davidson, W Wiktor Jedrzejczak, Jennifer McCullagh, Jeanane M Ferre, Amy Bradbury, Shannon B Palmer, Vasiliki M Iliadou, Frank E Musiek","doi":"10.1044/2026_AJA-25-00224","DOIUrl":"10.1044/2026_AJA-25-00224","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) chatbots based on large language models (LLMs) can deliver medical information, but their performance on specialized topics such as central auditory processing disorder (CAPD) remains unexplored. This study evaluated the accuracy and completeness of three AI chatbots (ChatGPT, Gemini, and Claude) in providing CAPD-related information across varying levels of question complexity.</p><p><strong>Method: </strong>Forty-four questions, categorized into four difficulty levels (patient level, easy, intermediate, and specialized; <i>n</i> = 11 each), were submitted to each chatbot, generating 132 responses. Seven clinical experts, blinded to chatbot identity, independently rated accuracy and completeness on a 1-5 Likert scale. Data were analyzed with analyses of variance, correlations, and interrater comparisons.</p><p><strong>Results: </strong>Chatbot performance was similar, with mean accuracy below 4.0 and completeness about 3.5. Complex questions often scored below 3.0 across experts. Only three of the 44 questions, primarily patient level or relatively simple, received consistently high expert ratings (≥ 4 for both accuracy and completeness) across all three chatbots. Performance declined with question difficulty, although differences were not statistically significant. Accuracy and completeness were correlated across chatbots.</p><p><strong>Conclusions: </strong>Current AI chatbots provided generally accurate CAPD information but fell short of clinical standards, particularly on specialized questions. Their limited performance underscores the need for clinician oversight in CAPD assessment and management. Chatbots may serve as helpful adjuncts but should not replace expert evaluation and guidance in clinical settings.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.31975101.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"668-679"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Effects of Frequency Maps on Sentence Perception Between Simulated Bimodal Hearing and Electric Acoustic Stimulation Hearing.","authors":"Yang-Soo Yoon, Raha Nekoutabar, Sydney Dukes, Trisha Karnik, Kelly N Jahn","doi":"10.1044/2026_AJA-25-00225","DOIUrl":"10.1044/2026_AJA-25-00225","url":null,"abstract":"<p><strong>Purpose: </strong>Using acoustic simulations of bimodal (BM) and electric acoustic stimulation (EAS) hearing, we investigated if optimal frequency maps differ between these configurations, whether one provides greater benefit, and whether optimal maps vary with the degree of residual hearing.</p><p><strong>Method: </strong>Adults with normal hearing completed sentence perception tasks across frequency maps, simulated hearing configurations (BM vs. EAS), simulated residual hearing bandwidths, and signal-to-noise ratios (SNRs). Acoustic stimulation was simulated with three bandpass filters: 50-250 Hz (A250), 50-500 Hz (A500), and 50-750 Hz (A750). Electric stimulation was simulated with an eight-channel vocoder. The lower boundary of the electric input was shifted to create four maps relative to the acoustic bandwidth: full overlap, narrow overlap (NO), meet, and gap.</p><p><strong>Results: </strong>For BM hearing, the meet map was most effective. For EAS, gap and NO maps yielded the greatest benefits in noise, whereas the meet map performed best in quiet. Optimal maps varied with both residual hearing and SNR. EAS generally outperformed BM hearing at A500 across SNRs, whereas BM hearing performed better at A250 and A750 at -6 dB, and at A750 in quiet. Benefits correlated positively with residual hearing bandwidth.</p><p><strong>Conclusions: </strong>Optimal maps differed between EAS and BM hearing, reflecting distinct acoustic-electric interactions. EAS often provided an advantage, likely due to reduced neural delay mismatches and improved binaural integration. However, no single map was consistently optimal; outcomes depended on residual hearing and SNR, highlighting variability in spectral integration efficiency with available acoustic input.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"604-618"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional Associations Between Hyperglycemia and Hearing Loss at the Year 35 Coronary Artery Risk Development in Young Adults Observational Cohort Study.","authors":"Pamela J Schreiner, Meredith E Adams, Lisa S Chow, Donald M Lloyd-Jones","doi":"10.1044/2026_AJA-25-00138","DOIUrl":"10.1044/2026_AJA-25-00138","url":null,"abstract":"<p><strong>Purpose: </strong>Sustained hyperglycemia is associated with pathogenic effects on microvasculature and sensory neurons, and diabetes may also affect the vasculature and neural systems of the inner ear. We examined the association of hyperglycemia with sensorineural hearing loss (HL) at three frequency ranges in a biracial, population-based cohort.</p><p><strong>Method: </strong>Among 1,930 Black and White men and women aged 53-65 years who were attending the Year 35 examination of the Coronary Artery Risk Development in Young Adults study, we assessed hearing using an automated method for testing auditory sensitivity to obtain pure-tone air-conduction thresholds. Normal hearing (≤ 25 dB) and HL (> 25 dB) were examined across three frequency ranges: 250-2000 Hz (low/middle), 500-4000 Hz (speech), and 4000-8000 Hz (high). Hyperglycemia was categorized as normal fasting glucose (≤ 5.5 mmol/L), prediabetes (5.6-6.9 mmol/L), and Type 2 diabetes (T2D; ≥ 7 mmol/L or taking medication for diabetes). Cross-sectional associations of prediabetes and T2D with any HL were assessed using crude and multivariable-adjusted logistic regression.</p><p><strong>Results: </strong>Black participants had a higher prevalence of T2D (26.3%) than White participants (13.0%), and men had a higher prevalence of both prediabetes (38.0% vs. 26.0%) and T2D (20.4% vs. 17.8%) than women. HL was rare in the low/middle and speech frequencies, but 38.7% had some HL in the high-frequency range, with 21.6% of the sample considered mild (sound detection thresholds at 26-40 dB) and 10.9% considered moderate (sound detection thresholds at 41-55 dB). Prediabetes was not associated with high-frequency HL, but those with T2D had 50% higher odds (odds ratio [<i>OR</i>] = 1.498, 95% CI [1.173, 1.913]) of HL compared to those without diabetes; this <i>OR</i> increased to 1.657 (95% CI [1.266, 2.170]) after controlling for demographic factors.</p><p><strong>Conclusions: </strong>In this population-based sample of middle-aged participants, HL was most pronounced in the high-frequency range but was mostly mild. T2D was associated with prevalent HL in both crude and adjusted models. However, prediabetes was not associated with HL, suggesting that interventions to both improve glycemic control and detect HL may provide a window of opportunity for both prevention of progression to T2D and prevention or slower progression of HL.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"581-590"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experiences in the Cochlear Implant Reddit Community: Comparing Human and Large Language Model Categorization.","authors":"Daniel R S Habib, Kiran Depala, Jack Lin, Samuel Le, Natalie McFall, Shiv S Dewan, Justin Huang, Michael W S Habib, Anthony E Bishay, Konrad Siebor, Gizem Babaoglu, Naweed I Chowdhury, Aaron C Moberly","doi":"10.1044/2025_AJA-25-00216","DOIUrl":"10.1044/2025_AJA-25-00216","url":null,"abstract":"<p><strong>Purpose: </strong>Although some work has leveraged automated analyses of online communities to gain cochlear implant (CI) patient insights, there remains a gap in comparing human versus automated analysis of the nuanced, real-world experiences patients share outside clinical settings. This study characterizes experiences within the r/Cochlearimplants Reddit community and compares human to large language model (LLM) performance in annotating posts.</p><p><strong>Method: </strong>Using reflexive thematic analysis, 996 publicly available r/Cochlearimplants posts (October 2024-June 2025) were manually coded and consolidated into themes. Three LLMs-OpenAI o3, Gemini 2.5 Pro, and Claude Sonnet 4-were prompted with the posts and human-generated codebook to perform post categorization. Model performance was evaluated against human coding using Cohen's kappa, percent agreement, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and time.</p><p><strong>Results: </strong>Five themes emerged. Community engagement and support (<i>N</i> = 944, 94.8%) frequently involved eliciting advice (<i>N</i> = 721, 72.4%), seeking shared experiences (<i>N</i> = 249, 25.0%), and sharing negative experiences (<i>N</i> = 247, 24.8%). Other themes included the medical/surgical journey (<i>N</i> = 463, 46.5%), device/technical issues (<i>N</i> = 343, 34.4%), daily life/adjustments (<i>N</i> = 236, 23.7%), and media/outreach (7.2%, <i>N</i> = 72). OpenAI o3 and Gemini 2.5 Pro achieved the highest interrater reliability with human annotators (κ = .35 and κ = .34, respectively). OpenAI o3 had higher sensitivity (46.7%) but lower specificity (90.4%) than Gemini 2.5 Pro, which had the highest specificity (93.4%) but lower sensitivity (38.0%). Claude Sonnet 4 showed the lowest agreement (κ = .25) and PPV (30.9%). Compared to human annotation requiring 52 hr across all annotators, each LLM required less than 20 min.</p><p><strong>Conclusions: </strong>Reddit posts revealed rich discourse across CI topics. LLMs demonstrated fair agreement with human coders and can quickly aid in large-scale qualitative analysis. Although careful model selection and human expertise remain essential for accurate interpretation, LLM annotation shows potential for real-time monitoring of patient concerns to inform counseling, rehabilitation strategies, and iterative device design.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.31362847.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"487-496"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}