Development and preliminary validation of a WeChat-based auditory-speech rehabilitation system for Mandarin-speaking cochlear implant users
Xuyuan Peng, Ran Cao, Pengjun Wang, Zheng Han, Yini Li, Jingjing Wang, Shujian Huang, Wen Lu, Yuli Hu, Jing Wang, Zhengnong Chen, Wendi Shi, Lihui Tao, Jun Zhan, Kun Ni, Dongzhen Yu, Haibo ShiBackground
Cochlear implant (CI) users require long-term auditory-speech rehabilitation to achieve optimal outcomes, yet access to continuous and structured rehabilitation remains limited. Mobile health technologies offer a potential approach to improve the accessibility and continuity of rehabilitation services.
Objective
This study aims to develop a WeChat-based auditory-speech rehabilitation system for Mandarin-speaking CI users and to conduct a preliminary validation of its usability and measurement consistency.
Methods
Guided by a goal-oriented digital design framework, a WeChat-based system was developed to assess six domains of auditory and speech rehabilitation. A total of 20 Mandarin-speaking CI users were recruited from Shanghai Sixth People’s Hospital. Usability and app quality were assessed using the System Usability Scale (SUS) and User Version of the Mobile App Rating Scale (uMARS), respectively. Measurement consistency was evaluated using the intraclass correlation coefficient (ICC), weighted Cohen’s kappa (κ), and Bland-Altman analyses.
Results
20 Mandarin-speaking CI users completed the study. Usability assessment demonstrated favorable ratings (SUS = 71.50, SD = 13.58; uMARS = 4.19, SD = 0.50). The system-generated Categories of Auditory Performance classification showed excellent agreement with the rater (weighted κ = 0.97, 95% CI: 0.93-1.00). Articulation intelligibility scores demonstrated high consistency with rater assessments (system vs. rater 1: ICC = 0.97; system vs. rater 2: ICC = 0.94), with minimal bias observed in Bland-Altman analysis.
Conclusion
This WeChat Mini Program provides preliminary support for the feasibility of a digital auditory-speech rehabilitation approach for Mandarin-speaking CI users. Further studies are needed to validate its broader applicability and effectiveness in out-of-hospital rehabilitation.