Bone-conduction hearing implants: a potential postcode lottery
Bibliographic record
Abstract
Background Bone conduction hearing implants (BCHIs) are a valuable alternative option for patients with hearing loss when conventional hearing aids are not effective or a viable option. In the UK, specialist sites offer BCHI services. We aimed to understand whether patients face geographical barriers to accessing this healthcare service. Methods A retrospective cohort study was performed at five hospitals in the North West of England over a one-year period (January–December 2023). Results In total, 167 primary BCHIs were implanted (median age, 57.7 years; female, n=52 (31.1%)). Patients travelled a median distance of 17.3km from their home to the BCHI site. Of the patients receiving a BCHI, 108 (64.7%) lived in the locality of a BCHI site. The remaining 59 (35.3%) were referred from a non-BCHI centre. The majority of BCHIs were percutaneous (n=154/167, 92.2%) and were performed under local anaesthetic (n=127/167, 76.0%). No correlation between patient age and distance travelled was identified (p=0.22, R=−0.0951). Conclusions The findings suggest a greater percentage of all BCHIs that are conducted are seen first at a BCHI centre initially rather than seen elsewhere. This could represent a potential geographical barrier to accessing BCHI services for patients not living in the locality of a non-BCHI providing centre. Future work is required to better understand BCHI service barriers on a national level and to identify methods to ensure equitable access for all.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".