CIRCA 2 – INTEGRATE

Re-exploring adult cochlear implant assessment referrals in the United Kingdom: A national multicentre retrospective observational study

Background:

In the UK, approximately 1.2 million individuals are affected by severe-to-profound hearing loss, which is projected to become a top-10 major health burden by 2030. Cochlear implants (CIs) can be transformative for these patients and significantly improve their quality of life. Despite this, the previous CIRCA study showed that of over 6000 UK adults meeting criteria for a CI, only 35.7% were informed of their eligibility and just 9.7% were referred.

CIRCAs’ publication contributed to raising awareness of inequities in referrals, prompted efforts to establish CI identification pathways and promoted the existing “CI champions” scheme. CIRCA2 will evaluate progress made since the original study and identify persisting barriers to access.

AIm:

INTEGRATE aims to reassess referral patterns for patients suitable for cochlear implantation in the UK, building on findings from the original CIRCA study. This work will help improve equitable access to CIs in the future.

Get Involved with CIRCA2:

We are looking for local site leads and collaborators from hospitals across the UK to undertake the data collection for the CIRCA-2 national audit. Site leads can be resident doctors from ENT or Audiovestibular Medicine (AVM) backgrounds, or audiologists.

Study Setting: We are accepting sites from across the United Kingdom (both secondary AND tertiary levels – not just implant centres).

Any site with >100 eligible patients will be granted an extra collaborator to assist with data collection. For each additional 100 patients, a further collaborator will be permitted.

Recognition:

All site leads, collaborators, supervising consultants and audiologists from sites that complete the data collection will be acknowledged as a PubMed citable collaborative author in all publications arising from the collected data.

For anyone wishing to apply for ENT ST3, this contribution to a collaborative project will score you points on your application.

Key Dates:

Site lead recruitment: Now live!

Running of Crystal Report: 01/01/26 – 14/01/2026

Data Collection Opens: 01/01/2026

Data Collection Closes: 31/03/2026

Checklist for Local Site Leads:

Identification of a supervising consultant
Register with INTEGRATE as site lead (form)
Identify an audiologist to support the study and run the Crystal Report (detailed instructions will be provided by the project management team)
Registering the audit with your local audit department as soon as possible.
Collaborating with your local audiology departments to run the Crystal Report to identify patients with an audiogram within CI criteria between 01/07/25 and 31/12/25
Complete the provided site information form.
Data collection window: 01/01/26 – 31/03/26 using extraction forms (provided)
Submission of anonymised data to the INTEGRATE Project Management Team before the deadline of 31/03/2026.

You will be supported by a regional lead and the project management team at all stages throughout this process.