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Bekele Okuba T, Lystad RP, Boisvert I, McMaugh A, Moore RC, Walsan R, Mitchell RJ. Cochlear implantation impact on health service utilisation and social outcomes: a systematic review. BMC Health Serv Res 2023; 23:929. [PMID: 37649056 PMCID: PMC10468908 DOI: 10.1186/s12913-023-09900-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Hearing loss can have a negative impact on individuals' health and engagement with social activities. Integrated approaches that tackle barriers and social outcomes could mitigate some of these effects for cochlear implants (CI) users. This review aims to synthesise the evidence of the impact of a CI on adults' health service utilisation and social outcomes. METHODS Five databases (MEDLINE, Scopus, ERIC, CINAHL and PsychINFO) were searched from 1st January 2000 to 16 January 2023 and May 2023. Articles that reported on health service utilisation or social outcomes post-CI in adults aged ≥ 18 years were included. Health service utilisation includes hospital admissions, emergency department (ED) presentations, general practitioner (GP) visits, CI revision surgery and pharmaceutical use. Social outcomes include education, autonomy, social participation, training, disability, social housing, social welfare benefits, occupation, employment, income level, anxiety, depression, quality of life (QoL), communication and cognition. Searched articles were screened in two stages ̶̶̶ by going through the title and abstract then full text. Information extracted from the included studies was narratively synthesised. RESULTS There were 44 studies included in this review, with 20 (45.5%) cohort studies, 18 (40.9%) cross-sectional and six (13.6%) qualitative studies. Nine studies (20.5%) reported on health service utilisation and 35 (79.5%) on social outcomes. Five out of nine studies showed benefits of CI in improving adults' health service utilisation including reduced use of prescription medication, reduced number of surgical and audiological visits. Most of the studies 27 (77.1%) revealed improvements for at least one social outcome, such as work or employment 18 (85.7%), social participation 14 (93.3%), autonomy 8 (88.9%), education (all nine studies), perceived hearing disability (five out of six studies) and income (all three studies) post-CI. None of the included studies had a low risk of bias. CONCLUSIONS This review identified beneficial impacts of CI in improving adults' health service utilisation and social outcomes. Improvement in hearing enhanced social interactions and working lives. There is a need for large scale, well-designed epidemiological studies examining health and social outcomes post-CI.
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Affiliation(s)
- Tolesa Bekele Okuba
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Isabelle Boisvert
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Anne McMaugh
- Macquarie School of Education, Faculty of Arts, Macquarie University, Sydney, Australia
| | | | - Ramya Walsan
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Williams CYK, Li RX, Luo MY, Bance M. Exploring patient experiences and concerns in the online Cochlear implant community: A cross-sectional study and validation of automated topic modelling. Clin Otolaryngol 2023; 48:442-450. [PMID: 36645237 DOI: 10.1111/coa.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/20/2022] [Accepted: 01/07/2023] [Indexed: 01/17/2023]
Abstract
OBJECTIVE There is a paucity of research examining patient experiences of cochlear implants. We sought to use natural language processing methods to explore patient experiences and concerns in the online cochlear implant (CI) community. MATERIALS AND METHODS Cross-sectional study of posts on the online Reddit r/CochlearImplants forum from 1 March 2015 to 11 November 2021. Natural language processing using the BERTopic automated topic modelling technique was employed to cluster posts into semantically similar topics. Topic categorisation was manually validated by two independent reviewers and Cohen's kappa calculated to determine inter-rater reliability between machine vs human and human vs human categorisation. RESULTS We retrieved 987 posts from 588 unique Reddit users on the r/CochlearImplants forum. Posts were initially categorised by BERTopic into 16 different Topics, which were increased to 23 Topics following manual inspection. The most popular topics related to CI connectivity (n = 112), adults considering getting a CI (n = 107), surgery-related posts (n = 89) and day-to-day living with a CI (n = 85). Cohen's kappa among all posts was 0.62 (machine vs. human) and 0.72 (human vs. human), and among categorised posts was 0.85 (machine vs. human) and 0.84 (human vs. human). CONCLUSIONS This cross-sectional study of social media discussions among the online cochlear implant community identified common attitudes, experiences and concerns of patients living with, or seeking, a cochlear implant. Our validation of natural language processing methods to categorise topics shows that automated analysis of similar Otolaryngology-related content is a viable and accurate alternative to manual qualitative approaches.
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Affiliation(s)
- Christopher Y K Williams
- School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rosia X Li
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Michael Y Luo
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Manohar Bance
- Department of Otolaryngology-Head and Neck Surgery, Addenbrooke's Hospital, Cambridge, UK
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Hughes SE, Boisvert I, McMahon CM, Steyn A, Neal K. Perceived listening ability and hearing loss: Systematic review and qualitative meta-synthesis. PLoS One 2022; 17:e0276265. [PMID: 36282860 PMCID: PMC9595527 DOI: 10.1371/journal.pone.0276265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hearing loss (HL) can affect communication in complex ways. Understanding how adults with HL reflect on and conceptualise the way they listen (metacognition) is required if interventions, and the outcome measures used to evaluate them, are to address barriers to functional communication arising from HL. OBJECTIVES This study describes how adults with HL experience and report the processes, behaviours, and components of listening, as presented in published studies. DESIGN Systematic review and meta-synthesis of qualitative studies. METHODS Systematic searches identified English-language, peer-reviewed journal articles reporting the results of qualitative or mixed-methods studies of adults' with HL perceived listening abilities. Medline, PsychInfo, Web of Science, Embase, and Google Scholar were searched from inception to November 2021. Handsearching reference lists of included studies identified additional studies for inclusion. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to appraise studies' methodological quality. Data from included studies were analysed using thematic meta-synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Confidence in the Evidence from Reviews of QUALitative (CERQual) approach assessed confidence in the review findings. Two reviewers independently completed all screening and quality appraisal. Thematic meta-synthesis and GRADE CERQual assessment was completed by one reviewer and confirmed by a second reviewer. Discrepancies were resolved through discussion. RESULTS Data from 46 studies were included in the review. Thematic meta-synthesis identified six descriptive themes: 1) perceived listening ability; 2) external modifiers; 3) psychosocial impacts of hearing loss; 4) communication partner perspectives; 5) self-efficacy for listening; and 6) cognitive load. GRADE CERQual ratings for descriptive themes ranged from low to moderate confidence. Descriptive themes were related by analytic themes of liminality and reciprocity. CONCLUSIONS Adults with HL provide in-depth accounts of components and processes of listening, with studies reporting both cognitive and affective experiences consistent with theoretical models of metacognition. The findings will inform content generation for a hearing-specific patient-reported outcome measure of perceived listening ability in everyday communication.
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Affiliation(s)
- Sarah E. Hughes
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC), West Midlands, United Kingdom
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- National Institute of Health and Care Research (NIHR) Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, University of Birmingham, Birmingham, United Kingdom
- Narra Consulting Limited, Wales, United Kingdom
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, United Kingdom
- * E-mail:
| | - Isabelle Boisvert
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- HEAR Centre, Macquarie University, Sydney, Australia
| | - Catherine M. McMahon
- HEAR Centre, Macquarie University, Sydney, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | | | - Katie Neal
- HEAR Centre, Macquarie University, Sydney, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
- The Shepherd Centre, Sydney, NSW, Australia
- The Listening Lab, Sydney, NSW, Australia
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Kobosko J, Jedrzejczak WW, Porembska DB, Geremek-Samsonowicz A, Skarzynski H. Posttraumatic Growth in Postlingually Deaf Patients With Cochlear Implants: The Effect of Stress-Coping Strategies, Sociodemographics, and Deafness-Related Factors. Front Psychol 2021; 12:546896. [PMID: 34484014 PMCID: PMC8415967 DOI: 10.3389/fpsyg.2021.546896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/19/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to assess whether cochlear implant (CI) users who had been postlingually deaf developed a more positive outlook on life—the so-called posttraumatic growth (PTG)—as a result of their disability and to examine how PTG related to their stress-coping strategies and personal circumstances. The study group consisted of 119 postlingually deaf CI users. The participants were asked to anonymously fill in several questionnaires: the Post-Traumatic Growth Inventory (PTGI), Coping Orientations to Problems Experienced (Brief COPE), and a form asking for personal details and factors related to their deafness and CI use. The PTG of postlingually deaf CI users was similar to that found in people with other severe health problems. The time that had elapsed since the hearing was lost and the time from receiving a CI were positively correlated with PTG. The level of PTG was correlated with the particular coping strategies used and differed between men and women. We found that the development of PTG could emerge from both approach-oriented coping strategies (e.g., active coping and planning) and avoidance-oriented coping strategies (e.g., denial, self-distraction, and self-blame). Paradoxically, the avoidance strategies could play a positive role in the development of PTG. This reinforces the idea, previously raised in the PTG literature, that such strategies exert a defensive and protective function—an “illusory” side of PTG—which operates together with the positive constructive side, and both help develop the sense of well-being of a person.
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Affiliation(s)
- Joanna Kobosko
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland
| | - W Wiktor Jedrzejczak
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland
| | - D Beata Porembska
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland.,The Maria Grzegorzewska University, Warsaw, Poland
| | - Anna Geremek-Samsonowicz
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland
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Dixon PR, Feeny D, Tomlinson G, Cushing S, Chen JM, Krahn MD. Health-Related Quality of Life Changes Associated With Hearing Loss. JAMA Otolaryngol Head Neck Surg 2021; 146:630-638. [PMID: 32407468 DOI: 10.1001/jamaoto.2020.0674] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss. Objective To develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure. Design, Setting, and Participants This qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience. Main Outcomes and Measures A set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life. Results The literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health. Conclusions and Relevance The association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.
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Affiliation(s)
- Peter R Dixon
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada
| | - David Feeny
- Department of Economics, McMaster University, Hamilton, Ontario, Canada.,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.,Health Utilities Incorporated, Hamilton, Ontario, Canada
| | - George Tomlinson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada
| | - Sharon Cushing
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joseph M Chen
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Murray D Krahn
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto, Ontario, Canada.,University Health Network, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Nijmeijer HGB, Keijsers NM, Huinck WJ, Mylanus EAM. The effect of cochlear implantation on autonomy, participation and work in postlingually deafened adults: a scoping review. Eur Arch Otorhinolaryngol 2020; 278:3135-3154. [PMID: 33245451 PMCID: PMC8328847 DOI: 10.1007/s00405-020-06490-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/10/2020] [Indexed: 01/20/2023]
Abstract
Purpose This scoping review examines the available evidence on the effect of unilateral cochlear implantation (CI) in adults with postlingual bilateral hearing loss on societal-related outcomes in terms of work, autonomy and participation. Methods Five databases were searched (Pubmed, Web of Science, Embase, PsycINFO and Cochrane Library). Publications were screened in three steps on inclusion criteria. Of the 4230 screened publications, 110 met the inclusion criteria and were assessed for data extraction regarding outcomes “work”, “autonomy”, “participation”. Study characteristics and key findings are presented and narratively described. Results Twenty-seven publications were included and categorized into retrospective (n = 3), cross-sectional (n = 18) or prospective (n = 6) study designs. Measurement or identification of number of outcomes (no) were related to work (no = 20), participation (no = 9) and autonomy or independency (no = 10). Most studies indicated benefits of CI on these outcomes. However, some studies did not or indicated additional barriers for benefits. Eleven publications primarily aimed to study one or more of our primary outcomes. Conclusion In this literature search, scientific databases are reviewed. The results indicate that there is a relatively small body of evidence regarding the effect of CI on the outcomes “work”, “autonomy” and “participation”. Even though there are some limitations of the current study including some overlap in outcome definitions, most included studies indicate a beneficial effect of CI on work, autonomy and participation. The lack of consensus in definitions and the small body of evidence indicates a need for additional prospective studies investigating the societal outcomes of CI in postlingually deafened adults. Electronic supplementary material The online version of this article (10.1007/s00405-020-06490-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hugo G B Nijmeijer
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands.
- Donders Institute for Brain, Cognition and Behavior, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands.
| | - Noud M Keijsers
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Emmanuel A M Mylanus
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud university medical center, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
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7
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Andries E, Gilles A, Topsakal V, Vanderveken OM, Van de Heyning P, Van Rompaey V, Mertens G. Systematic Review of Quality of Life Assessments after Cochlear Implantation in Older Adults. Audiol Neurootol 2020; 26:61-75. [PMID: 32653882 DOI: 10.1159/000508433] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022] Open
Abstract
Cochlear implants (CI) have increasingly been adopted in older adults with severe to profound sensorineural hearing loss as a result of the growing and aging world population. Consequently, researchers have recently shown great interest in the cost-effectiveness of cochlear implantation and its effect on quality of life (QoL) in older CI users. Therefore, a systematic review and critical evaluation of the available literature on QoL in older adult CI users was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were selected by searching MEDLINE (PubMed) and the Cochrane Library and by checking the reference lists of relevant articles. Inclusion criteria were as follows: (1) the study sample were adults aged 50 years and older with postlingual onset of bilateral severe to profound hearing loss, (2) all subjects received a multi-electrode CI, and (3) QoL was assessed before and after implantation. Out of 1,093 records, 18 articles were accepted for review. Several studies demonstrated significant positive effects of cochlear implantation on QoL in older adults, but high-level evidence-based medicine is lacking. An improvement of QoL was generally reported when using disease-specific instruments, which are designed to detect treatment-specific changes, whereas the outcomes of generic QoL questionnaires, assessing general health states, were rather ambiguous. However, only generic questionnaires would be able to provide calculations of the cost-effectiveness of CI and comparisons across patient populations, diseases, or interventions. Hence, generic and disease-specific QoL instruments are complementary rather than contradictory. In general, older CI users' QoL was assessed using a variety of methods and instruments, which complicated comparisons between studies. There is a need for a standardized, multidimensional, and comprehensive QoL study protocol including all relevant generic and disease-specific instruments to measure and compare QoL, utility, and/or daily life performance in CI users.
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Affiliation(s)
- Ellen Andries
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium, .,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium,
| | - Annick Gilles
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.,Department of Education, Health and Social Work, University College Ghent (HoGent), Ghent, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.,Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
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8
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Crowson MG, Semenov YR, Tucci DL, Niparko JK. Quality of Life and Cost-Effectiveness of Cochlear Implants: A Narrative Review. Audiol Neurootol 2017; 22:236-258. [PMID: 29262414 DOI: 10.1159/000481767] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 09/21/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To review evidence regarding the health-related quality of life (HRQoL) and cost-effectiveness of unilateral and bilateral cochlear implantation (CI) among children and adults with severe-to-profound hearing loss. STUDY DESIGN Narrative review. METHODS Publications related to quality of life (QoL) and costs of care in CI were acquired through searches in English-language databases. Studies were included if they had identified the HRQoL attainment, cost of care, cost-utility, or cost-effectiveness associated with CI. RESULTS 57 studies were critically reviewed. The QoL outcome metrics used in these articles were divided into 2 categories - generic and condition specific. In studies investigating children, many reported no significant difference in QoL attainment between CI recipients and normal-hearing peers. In adults, significant improvements in QoL after implantation and higher QoL than in their nonimplanted (hearing-aided) peers were frequently reported. Studies involving an older adult cohort reported significant improvement in QoL after implantation, which was often independent of audiological performance. Overall, the calculated cost-utility ratios consistently met the threshold of cost acceptance, indicating acceptable values for expenditures on CI. CONCLUSIONS Considerable work has been done on the QoL attainment and health economic implications of CI. Unilateral CI across all age groups leads to reported sustained benefits in the recipients' overall and disease-specific QoL. With increased cost associated with bilateral CI, further study is needed to characterize its costs and benefits with respect to the recipients' health, well-being, and contributions to society.
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Affiliation(s)
- Matthew G Crowson
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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9
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Anderson CA, Lazard DS, Hartley DEH. Plasticity in bilateral superior temporal cortex: Effects of deafness and cochlear implantation on auditory and visual speech processing. Hear Res 2017; 343:138-149. [PMID: 27473501 DOI: 10.1016/j.heares.2016.07.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 12/01/2022]
Abstract
While many individuals can benefit substantially from cochlear implantation, the ability to perceive and understand auditory speech with a cochlear implant (CI) remains highly variable amongst adult recipients. Importantly, auditory performance with a CI cannot be reliably predicted based solely on routinely obtained information regarding clinical characteristics of the CI candidate. This review argues that central factors, notably cortical function and plasticity, should also be considered as important contributors to the observed individual variability in CI outcome. Superior temporal cortex (STC), including auditory association areas, plays a crucial role in the processing of auditory and visual speech information. The current review considers evidence of cortical plasticity within bilateral STC, and how these effects may explain variability in CI outcome. Furthermore, evidence of audio-visual interactions in temporal and occipital cortices is examined, and relation to CI outcome is discussed. To date, longitudinal examination of changes in cortical function and plasticity over the period of rehabilitation with a CI has been restricted by methodological challenges. The application of functional near-infrared spectroscopy (fNIRS) in studying cortical function in CI users is becoming increasingly recognised as a potential solution to these problems. Here we suggest that fNIRS offers a powerful neuroimaging tool to elucidate the relationship between audio-visual interactions, cortical plasticity during deafness and following cochlear implantation, and individual variability in auditory performance with a CI.
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Affiliation(s)
- Carly A Anderson
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
| | - Diane S Lazard
- Institut Arthur Vernes, ENT Surgery, Paris, 75006, France; Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, United Kingdom.
| | - Douglas E H Hartley
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom; Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, United Kingdom; Medical Research Council (MRC) Institute of Hearing Research, The University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom.
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10
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Amraei K, Amirsalari S, Ajalloueyan M. Comparison of intelligence quotients of first- and second-generation deaf children with cochlear implants. Int J Pediatr Otorhinolaryngol 2017; 92:167-170. [PMID: 28012522 DOI: 10.1016/j.ijporl.2016.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/01/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
Abstract
Hearing impairment is a common type of sensory loss in children. Studies indicate that children with hearing impairment are deficient in social, cognitive and communication skills. This study compared the intelligence quotients of first- and second-generation deaf children with cochlear implants. This research is causal-comparative. All 15 deaf children investigated had deaf parents and were selected from Baqiyatallah Cochlear Implant Center. The 15 children with cochlear implants were paired with similar children with hearing parents using purposive sampling. The findings show that the Hotelling trace of multivariate analysis of variance (F = 6.78, p < 0.01, ηP2 = 0.73) was significant. The tests of between-subjects effects for second-generation children was significantly higher than for first-generation children for all intelligence scales except knowledge. It can be assumed that second-generation children joined their family in the use of sign language as the primary experience before a cochlear implant. The use of sign language before cochlear implants is recommended.
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Affiliation(s)
- K Amraei
- Department of Psychology, Faculty of Humanistic Sciences, Lorestan University, Khorramabad, Iran; New Hearing Technologies Research Center, Baqiyatallah University of Medical Science, Tehran, Iran
| | - S Amirsalari
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Science, Tehran, Iran
| | - M Ajalloueyan
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Science, Tehran, Iran.
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Gubbels SP, Gartrell BC, Ploch JL, Hanson KD. Can routine office-based audiometry predict cochlear implant evaluation results? Laryngoscope 2016; 127:216-222. [PMID: 27797418 DOI: 10.1002/lary.26066] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 03/17/2016] [Accepted: 03/28/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVES/HYPOTHESIS Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates. STUDY DESIGN Retrospective, observational, diagnostic study. METHODS The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test). RESULTS The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation. CONCLUSIONS Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation. LEVEL OF EVIDENCE 4 Laryngoscope, 127:216-222, 2017.
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Affiliation(s)
- Samuel P Gubbels
- Department of Otolaryngology, University of Colorado, School of Medicine, Aurora, Colorado.,Department of Surgery, Division of Otolaryngology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin
| | - Brian C Gartrell
- Department of Surgery, Division of Otolaryngology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin.,Department of Family Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jennifer L Ploch
- Department of Surgery, Division of Audiology, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin
| | - Kevin D Hanson
- University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin, U.S.A
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Jeffs E, Redfern K, Stanfield C, Starczewski H, Stone S, Twomey T, Fortnum H. A pilot study to explore the experiences of congenitally or early profoundly deafened candidates who receive cochlear implants as adults. Cochlear Implants Int 2015; 16:312-20. [DOI: 10.1179/1754762815y.0000000011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Mäki-Torkko EM, Vestergren S, Harder H, Lyxell B. From isolation and dependence to autonomy – expectations before and experiences after cochlear implantation in adult cochlear implant users and their significant others. Disabil Rehabil 2014; 37:541-7. [DOI: 10.3109/09638288.2014.935490] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rembar SH, Lind O, Romundstad P, Helvik AS. Psychological well-being among cochlear implant users: a comparison with the general population. Cochlear Implants Int 2013; 13:41-9. [DOI: 10.1179/1754762810y.0000000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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15
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Vengen I. Nytt liv med cochleaimplantat. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2010. [DOI: 10.4045/tidsskr.10.0839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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