Objective.The paper aims to demonstrate the feasibility of defining a substantial set of psychoacoustic outcome measures with preset\r\ntargets and to adopt a systematicmethodology for reaching these targets in a large group of subjects, bymore than one clinical centre.\r\nDesign. Retrospective data analysis. Setting. Multicentre with 14 participating centres. Patients. 255 adults and children using the\r\nAdvanced Bionics HiRes90k cochlear implant. Intervention. Target driven fitting with the fitting to outcomes expert (FOX) system.\r\nMain Outcome Measures. For each patient, 66 measurable psychoacoustical outcomes were recorded several times after cochlear\r\nimplantation: free field audiometry (6 measures) and speech audiometry (4), spectral discrimination (20), and loudness growth\r\n(36), defined from the A�§E test battery. These outcomes were reduced to 22 summary variables. The initial results were compared\r\nwith the latest results. Results.The state of the fitting process could bewellmonitored bymeans of themeasured variables.The use of\r\nthe FOX computer assisted CI-programming significantly improved the proportion of the 22 variables on target.When recipients\r\nused the automated MAPs provided at switch-on, more than half (57%) of the 22 targets were already achieved before any further\r\noptimisation took place.Once the FOX system was applied there was a significant 24%(P < 0.001) increase in the number of targets\r\nachieved. Conclusions.This study demonstrates that it is feasible to set targets and to report on the effectiveness of a fitting strategy\r\nin terms of these targets. FOX provides an effective tool for achieving a systematic approach to programming, allowing for better\r\noptimisation of recipientsâ�� MAPs. The setting of well-defined outcome targets allowed a range of different centres to successfully\r\napply a systematic methodology to monitoring the quality of the programming provided.
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