Meta-analysis of Cochlear Implantation Outcomes Evaluated With General Health-related Patient-reported Outcome Measures

Overview

Journal Otol Neurotol

Specialties Neurology
Otorhinolaryngology

Date 2017 Dec 12

PMID 29227446

Citations 28

Authors

Theodore R Mcrackan

Michael Bauschard

Jonathan L Hatch

Emily Franko-Tobin

Harris Richard Droghini

Craig A Velozo

Shaun A Nguyen

Judy R Dubno

Affiliations

Soon will be listed here.

Abstract

Objective: Determine the change in general health-related quality of life (HRQOL) after cochlear implantation and association with speech recognition.

Study Design: Meta-analysis.

Methods: Search was performed following the PRISMA statement using PubMed, Medline, Scopus, and CINAHL. Studies on adult cochlear implant (CI) patients measuring HRQOL before and after cochlear implantation were included. Standardized mean difference (SMD) for each measure and pooled effects were determined. A meta-analysis of correlations was also performed between all non-disease-specific patient-reported outcome measures (PROMs) and speech recognition after cochlear implantation.

Results: Twenty-two articles met criteria for meta-analysis of HRQOL improvement, but 15 (65%) were excluded due to incomplete statistical reporting. From the seven articles with 274 CI patients that met inclusion criteria, pooled analyses showed a medium positive effect of cochlear implantation on HRQOL (SMD = 0.79). Subset analysis of the HUI-3 measure showed a large effect (SMD = 0.84). Nine articles with 550 CI patients met inclusion criteria for meta-analysis of correlations between non-disease specific PROMs and speech recognition after cochlear implantation. Pooled analysis showed a low correlation between non-disease-specific PROMs and word recognition in quiet (r = 0.35), sentence recognition in quiet (r = 0.40), and sentence recognition in noise (r = 0.32).

Conclusion: Although regularly used, HRQOL measures are not intended to measure nor do they accurately reflect the complex difficulties facing CI patients. Only a medium positive effect of cochlear implantation on HRQOL was observed along with a low correlation between non-disease-specific PROMs and speech recognition. The use of such instruments in this population may underestimate the benefit of cochlear implantation.

Citing Articles

Unilateral Versus Bilateral Cochlear Implants in Adults: A Cross-Sectional Questionnaire Study Across Multiple Hearing Domains.

Pantaleo A, Curatoli L, Cavallaro G, Auricchio D, Murri A, Quaranta N Audiol Res. 2025; 15(1.

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Evaluation of the Nijmegen Cochlear Implant Questionnaire in Danish.

Neumann C, Schmidt J Int Arch Otorhinolaryngol. 2025; 29(1):1-8.

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Listening effort and fatigue among cochlear implant users: a scoping review.

Philips C, Jacquemin L, Lammers M, Mertens G, Gilles A, Vanderveken O Front Neurol. 2023; 14:1278508.

PMID: 38020642 PMC: 10656682. DOI: 10.3389/fneur.2023.1278508.

Determinants of Cochlear Implant Satisfaction and Decisional Regret in Adult Cochlear Implant Users.

Shannon C, Schvartz-Leyzac K, Dubno J, Mcrackan T Otol Neurotol. 2023; 44(10):e722-e729.

PMID: 37853774 PMC: 10840889. DOI: 10.1097/MAO.0000000000004028.

References

Mo B, Lindbaek M, Harris S . Cochlear implants and quality of life: a prospective study. Ear Hear. 2005; 26(2):186-94. DOI: 10.1097/00003446-200504000-00006. View

Mukaka M . Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2013; 24(3):69-71. PMC: 3576830. View

Tambs K . Moderate effects of hearing loss on mental health and subjective well-being: results from the Nord-Trøndelag Hearing Loss Study. Psychosom Med. 2004; 66(5):776-82. DOI: 10.1097/01.psy.0000133328.03596.fb. View

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009; 62(10):e1-34. DOI: 10.1016/j.jclinepi.2009.06.006. View

Brazier J, Roberts J, Deverill M . The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002; 21(2):271-92. DOI: 10.1016/s0167-6296(01)00130-8. View

Calvino M, Gavilan J, Sanchez-Cuadrado I, Perez-Mora R, Munoz E, Diez-Sebastian J . Using the HISQUI29 to assess the sound quality levels of Spanish adults with unilateral cochlear implants and no contralateral hearing. Eur Arch Otorhinolaryngol. 2015; 273(9):2343-53. DOI: 10.1007/s00405-015-3789-0. View

Vermeire K, Brokx J, Wuyts F, Cochet E, Hofkens A, Van de Heyning P . Quality-of-life benefit from cochlear implantation in the elderly. Otol Neurotol. 2005; 26(2):188-95. DOI: 10.1097/00129492-200503000-00010. View

Palmer C, Niparko J, Wyatt J, Rothman M, de Lissovoy G . A prospective study of the cost-utility of the multichannel cochlear implant. Arch Otolaryngol Head Neck Surg. 1999; 125(11):1221-8. DOI: 10.1001/archotol.125.11.1221. View

10.

Liu H, Cella D, Gershon R, Shen J, Morales L, Riley W . Representativeness of the Patient-Reported Outcomes Measurement Information System Internet panel. J Clin Epidemiol. 2010; 63(11):1169-78. PMC: 2943555. DOI: 10.1016/j.jclinepi.2009.11.021. View

11.

Mcrackan T, Bauschard M, Hatch J, Franko-Tobin E, Droghini H, Nguyen S . Meta-analysis of quality-of-life improvement after cochlear implantation and associations with speech recognition abilities. Laryngoscope. 2017; 128(4):982-990. PMC: 5776066. DOI: 10.1002/lary.26738. View

12.

Cook K, Jensen S, Schalet B, Beaumont J, Amtmann D, Czajkowski S . PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. J Clin Epidemiol. 2016; 73:89-102. PMC: 5131708. DOI: 10.1016/j.jclinepi.2015.08.038. View

13.

Kumar R, Mawman D, Sankaran D, Melling C, ODriscoll M, Freeman S . Cochlear implantation in early deafened, late implanted adults: Do they benefit?. Cochlear Implants Int. 2016; 17 Suppl 1:22-5. DOI: 10.1080/14670100.2016.1161142. View

14.

Lin F, Niparko J . Measuring health-related quality of life after pediatric cochlear implantation: a systematic review. Int J Pediatr Otorhinolaryngol. 2006; 70(10):1695-706. DOI: 10.1016/j.ijporl.2006.05.009. View

15.

Luxford W . Minimum speech test battery for postlingually deafened adult cochlear implant patients. Otolaryngol Head Neck Surg. 2001; 124(2):125-6. DOI: 10.1067/mhn.2001.113035. View

16.

Vermeire K, Brokx J, Wuyts F, Cochet E, Hofkens A, De Bodt M . Good speech recognition and quality-of-life scores after cochlear implantation in patients with DFNA9. Otol Neurotol. 2005; 27(1):44-9. DOI: 10.1097/01.mao.0000187240.33712.01. View

17.

Francis H, Chee N, Yeagle J, Cheng A, Niparko J . Impact of cochlear implants on the functional health status of older adults. Laryngoscope. 2002; 112(8 Pt 1):1482-8. DOI: 10.1097/00005537-200208000-00028. View

18.

Damen G, Beynon A, Krabbe P, Mulder J, Mylanus E . Cochlear implantation and quality of life in postlingually deaf adults: long-term follow-up. Otolaryngol Head Neck Surg. 2007; 136(4):597-604. DOI: 10.1016/j.otohns.2006.11.044. View

19.

Hawthorne G, Hogan A, Giles E, Stewart M, Kethel L, White K . Evaluating the health-related quality of life effects of cochlear implants: a prospective study of an adult cochlear implant program. Int J Audiol. 2004; 43(4):183-92. DOI: 10.1080/14992020400050026. View

20.

Dawes P, Emsley R, Cruickshanks K, Moore D, Fortnum H, Edmondson-Jones M . Hearing loss and cognition: the role of hearing AIDS, social isolation and depression. PLoS One. 2015; 10(3):e0119616. PMC: 4356542. DOI: 10.1371/journal.pone.0119616. View