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 supporting audiologists who 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: 01/03/2026
Checklist for Local Site Leads:
- Identification of a supervising consultant and ensuring your site runs on Auditbase.
- 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.
- Complete the provided site information form.
- 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
- Data collection window: 01/01/26 – 01/03/26 using extraction forms (provided)
- Submission of anonymised data to the INTEGRATE Project Management Team before the deadline of 01/03/2026.
You will be supported by a regional lead and the project management team at all stages throughout this process.
Contact Us:
If you want further information, please feel free to contact us: circa2@entintegrate.co.uk
Supporting Documents:
NB: Not all documents are yet live and will be updated as the study progresses.
Site Lead Registration: https://forms.gle/XvWhkTXv68H4rtCR7
Site information form: TBC
Instructions on how to run the Crystal Report on AuditBase: TBC
Study protocol: to be disseminated to site and regional leads.
CIRCA Study Publication: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004296