Designing Clinical Decision Support for Early Cochlear Implant Candidacy Identification in Medical Practice : A Qualitative Interpretative Single Case Study

Sammanfattning

Despite growing evidence that cochlear implants (CIs) can significantly improve speech understanding and quality of life across an increasingly broad range of patient groups, many potentially suitable candidates remain unidentified. Current referral pathways are often shaped by limited assessment procedures and uncertainty regarding candidacy criteria, contributing to persistent under-referral in hearing healthcare. Against this background, this thesis explores how a self-administered, language-agnostic psychoacoustic hearing screening tool can be designed to support clinicians in the early identification of potential CI candidates. Grounded in a qualitative, interpretative single case study design, the research investigates how psychoacoustic screening results can be translated into a clinical decision support (CDS) concept. The study combines insights from psychoacoustic research, CDS literature, empirical findings and regulatory considerations surrounding digital health technologies. The findings highlight that clinicians require decision-support tools that provide rapid, transparent and workflow-compatible orientation. These insights informed the development of a non-directive CDS concept centered around layered visualization approaches, progressive disclosure and flexible interaction principles that allow clinicians to explore psychoacoustic listening profiles in greater depth.