(414) Racial Disparities in Cochlear Implantation for Bilateral Sensorineural Hearing Loss

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Has Audio

Co-Author(s)

Olivia Sosnoski, MS

MS2
University of Tennessee Health Science Center
Memphis, Tennessee, United States

Presenting Author(s)

William Stout, BS

MS4
University of Tennessee Health Science Center
Memphis, Tennessee, United States

Co-Author(s)

Camron M. Davies, MD

Resident Physician
Loma Linda University Health
Riverside, California, United States
Sanjeet V. Rangarajan, MD, MEng

Associate Professor of Otolaryngology - Head and Neck Surgery
University of Tennessee Health Science Center
Memphis, Tennessee, United States
Sarah E. Warren, PhD, AuD, MPH

Assistant Professor
University of Memphis
Memphis, Tennessee, United States
CR

Celine C. Richard, MD, PhD

Faculty
University of Tennessee Health Science Center
Columbus, Ohio, USA
RY

Robert J. Yawn, MD, MBA

University of Tennessee Health Science Center, USA

Disclosure(s):

Olivia Sosnoski, MS: No relevant relationships to disclose.

William Stout, BS: No relevant relationships to disclose.

Camron M. Davies, MD: No relevant relationships to disclose.

Sanjeet V. Rangarajan, MD, MEng: No relevant relationships to disclose.

Sarah E. Warren, PhD, AuD, MPH: No relevant relationships to disclose.

Introduction: Cochlear implants (CI) have become a vital tool for managing bilateral sensorineural hearing loss (SNHL) and are becoming increasingly utilized as treatment for patients with moderate-to-profound SNHL. However, even after identifying eligibility, the pathway to implantation and beyond is complex and often prohibitively expensive, requiring numerous separate appointments and evaluations. Consequently, social determinants of health (SDoH), such as race, may act as barriers to receiving treatment. This study aimed to investigate the impact of race on the likelihood of receiving CIs in patients with bilateral SNHL.

Methods: A retrospective analysis was conducted using the TriNetX Research Platform linked to the Clinical Trials Network of Tennessee HER system, which predominantly consists of patients seen at tertiary medical centers in southwest Tennessee. All patients with bilateral SNHL diagnosed between 2014-2023 were identified using ICD-10 code H90.3 and stratified into two cohorts based on their racial identification as Black or White. Patents were then analyzed by the type and timing of the intervention they received: CI or hearing aid (HA).

Results: 1400 white patients with BL-SNHL were identified, of which 252 received an included intervention within the EHR network, while 990 black patients with BL-SNHL were identified, of which 210 received an included intervention within the EHR network. Among white patients: 64.3% received CIs, 34.1% received HAs – 10% of whom subsequently received CIs. In contrast, among black patients: only 19% received CIs as first-line treatment, 79.5% received HAs – 10% of whom subsequently received CIs.

Conclusions: Although this analysis was not controlled for factors like HL severity, the data in this study is suggestive that SDoH may impact treatment pathways in patients with SNHL. Given the importance of appropriate and adequate treatment on quality of life and hearing outcomes, it is imperative to investigate these disparities further.