Speech-in-noise performance in objectively determined cochlear implant maps, including the effect of cognitive state

Jessica M. Yiannos; Christofer W. Bester; Christopher Zhao; Barbara Gell; Dona M. P. Jayakody

doi:10.1371/journal.pone.0286986

Peer Review History

Original SubmissionJanuary 9, 2023
7 Mar 2023 Decision Letter - Prashanth Prabhu, Editor PONE-D-23-00636Speech-in-noise performance in objectively determined cochlear implant maps: evaluating the effect of cognitive state.PLOS ONE Dear Dr. Bester, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Apr 21 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The title of the present study is “Speech-in-noise performance in objectively determined cochlear implant maps: evaluating the effect of cognitive state” in which authors made an attempt to compare speech reception outcomes between subjective and eSRT objectively determined CI maps for Adult MED-EL recipients. In addition, the effect of cognition skills was also looked into on cochlear implantees. The present study is having clinical relevance for the clinicians and provides evidences for in terms of best method to perform MAP i.e. while performing mapping for the cochlear implantees of different age groups as well as difficult-to test Populations including individuals with cognitive impairment. The specific comments are mentioned in the PDF files. Manuscript needs revision before evaluating further for consideration to publish in the present form. ****** 6. 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Revision 1
24 May 2023 Author Response Response to editor: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf The documents have been updated for style. 2. Thank you for stating the following in the Competing Interests section: "It is disclosed that one of the authors is a clinical specialist working for MED-EL Australasia. " Please confirm that this does not alter your adherence to all PLOS ONE policies on sharing data and materials, by including the following statement: "This does not alter our adherence to PLOS ONE policies on sharing data and materials.” (as detailed online in our guide for authors http://journals.plos.org/plosone/s/competing-interests). If there are restrictions on sharing of data and/or materials, please state these. Please note that we cannot proceed with consideration of your article until this information has been declared. Please include your updated Competing Interests statement in your cover letter; we will change the online submission form on your behalf. Thank you, I can confirm that this does not alter our adherence to PLOS ONE policy, and this has been updated in the cover letter. 3. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized. Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access. We will update your Data Availability statement to reflect the information you provide in your cover letter. Thank you, unfortunately we have not been able to upload the data while abiding by Dryad’s rules around re-identifiable human data, i.e. replication requires more than 3 indirect identifiers. I do not believe we will be able to upload this data in an acceptably anonymized format. 4. Please amend either the title on the online submission form (via Edit Submission) or the title in the manuscript so that they are identical. Ok! Thanks for this catch! 5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Seems ok to us. Response to reviewer: In line no. 80-85, it is mentioned that objective mapping procedures include eCAP, eABR and eSRT. Later, the description of eSRT mentioned by the authors. It will be interesting and meaningful for the reader if the test-retest reliability of the eSRT mentioned here based on the literature. In addition, in normal circumstances, the presence and absence of the eSRT in different age groups (Children, adults and older adults) based on literature will be meaningful for the readers. Prior to eSRT, few lines about the eCAP and eABR over eSRT preference by the clinician with the literature support will also be valuable. This is a very good point, we have added the details on the eCAP and eABR in the paragraph, detailing the relatively poor correlation between eCAP and eABR thresholds and the behavioural scores we are interested in, and the risk of these thresholds being more than 5 programming units higher than the most which eSRT may be able to improve upon. In line 93-94, the mentioned statement “intraoperatively obtained eSRT are not correlated with postoperatively obtained eSRT” supported with reason from the existing literature will add value to it. It is very interesting – the articles on the topic don’t advance concrete theories for the discrepancy! A sentence has been added raising the potential for measurement differences or surgical impact as confounding factors. In line 102-109, the several clinical advantages of the eSRT are mentioned. It will be good if the limitation of the eSRT too mentioned if any. Added information that the eSRT, as classically measured, overestimates maximum comfort levels (MCLs) which may lead to overstimulation and thus must be used with caution. More concerningly, up to 30% of patients show no measurable reflexes, limiting the possible clinical use. Line 133: Since authors targeted 18-85 years of unilateral CI recipients for the study, one paragraph about the possible factors influencing the CI mapping including outcome might help the readers. A sentence referencing the possible factors influencing CI map, and how this map affects CI outcomes have been added to the first paragraph of the introduction. In line 130, the mean age of the participants can be added. This has been added. Since participants are adults and older adults, any screening test for auditory processing disorders (APD) could have been ruled out. Unfortunately, no APD testing was carried out in this population. In line 173, authors should mention the no. of participants excluded due to no reliable eSRT responses. The number of patients without a reliable eSRT is included in the results (N = 4), this line has been removed as misleading in the methods. In line 176, the testing time for conducting psychophysical-based M-level & MAP can be added at the end of the paragraph. Unfortunately, testing time was not recorded during these sessions. In line 192, authors should mention that for how many participants speech masking was used while administrating speech assessment measures. Unfortunately, this information was not recorded during these sessions. In line 196-199, For HISQUI questionnaire maximum score and the time taken to perform the test should be mentioned. Further, it should also be mentioned. The HISQUI score is reported as a percentage out of a possible maximum of 133, we have clarified this in the methods and the results. Line 211: 27 can be written in words as "Twenty-seven" Done! Table 1: How authors justify the large variation in the Implantation age, years of hearing loss, BE3PTA across participants. Any insight on these factors in discussion will be interesting for the reader. This wide variability was a potential strength of the study, as it gives the best chance of catching a difference between the objective and behaviourally determined MAPs – i.e. if older patients, or patients with lower BE3PTA scores, had larger discrepancies between MAP approaches, we may have caught them using this approach. Of course, this adds the possibility that we are adding too much variability to catch real changes. A paragraph on potential limitations has been added in the discussion. Line 229: replace with "and" Done! Line 236: Authors should made an attempt to explain the possible reason for the significantly higher M levels in mid electrode position. This is a difficult point, as there are many contributing variables that would have to be assessed individually to assess the possible mechanisms. We have outlined the difficulty of reasoning this difference, and added further comparison with other publications. A possible addition to the discussion could be to investigate these changes with appropriate controls for demographics, insertion dynamics? Line 257: What could be the limitation comparing only 6 participants with cognitive impairment with rest of the participants with normal cognitive function. I think author do mentioned as one of limitations. This is limiting, and has been described in the discussion. Line 308: In objective assessment, Authors can throw insight about how appropriate while measuring eSRT in comparison to eCAP and eABR. As per a previous reviewer comment, this has been addressed in the introduction, and would repetitive if included in the discussion as well. Line 343: As authors pointed out that auditory processing impairment could be the reason for poor SPIN test performance. It would be more meaningful if author can elaborate further to substantiate the reason mentioned for poor SPIN score. As the difference in SPIN score is between the two MAP types, i.e. a behaviourally determined MAP provided significantly better SPIN scores than the objectively determined MAP, it is unclear how auditory processing impairment could contribute to the discrepancy. We have included a possible explanation for this difference in lines 341-349, that the increased M-level in the objectively-determined MAP along the mid-basal electrodes is in a prime frequency range for fine-structure processing in the speech-discrimination and understanding frequency range. https://doi.org/10.1371/journal.pone.0286986.r002
30 May 2023 Decision Letter - Prashanth Prabhu, Editor Speech-in-noise performance in objectively determined cochlear implant maps, including the effect of cognitive state PONE-D-23-00636R1 Dear Dr. Jayakody, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Prashanth Prabhu Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0286986.r003
Formally Accepted
5 Jun 2023 Acceptance Letter - Prashanth Prabhu, Editor PONE-D-23-00636R1 Speech-in-noise performance in objectively determined cochlear implant maps, including the effect of cognitive state. Dear Dr. Jayakody: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Prashanth Prabhu Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0286986.r004

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