Factors contributing to clinically important health utility gains in cochlear implant recipients

Abstract

Purpose Cochlear implantation can restore access to sound and speech understanding in subjects with substantial hearing loss. The Health Utilities Index Mark III (HUI3) measures the impact of an intervention on the patient’s quality of life and is sensitive to changes in hearing. In the current study we used factor analysis to predict a clinically important gain in HUI3 scores in adult cochlear implant recipients. Methods Data were collected in an observational study for 137 adult recipients from a single center who had at least 1-year HUI3 follow-up. Demographic and other baseline parameters were retrospectively analyzed for their association with a clinically important HUI3 scale gain, defined as at least 0.1 points. Data were also collected for the speech spatial qualities (SSQ) scale. Results Baseline telephone use and HUI3 hearing, speech and emotion attribute levels were significantly associated with clinically important gains in HUI3 scores. However, SSQ scores increased significantly with or without clinically important HUI3 gains. Conclusion Those subjects who were unhappy or experienced difficulties communicating with strangers or in a group were twice as likely to obtain a clinically important gain in health utility compared to those who were happy or had less difficulty communicating. Subjects who were unable to use the telephone prior to cochlear implantation were one and a half times more likely to obtain a clinically important gain. The SSQ scale was more sensitive to hearing improvements due to cochlear implantation. An inability to use the telephone is an easy to assess biomarker for candidacy for cochlear implantation.

Change in Health-Related Quality of Life in Cochlear Implant Recipients in China

“…In keeping with Müller, who reported that those patients with worse hearing levels before surgery were more likely to gain more HUI3 scores after CI [ 6 ], the regression analysis illustrated that primary hearing level had a large impact on the gain in quality of life. It reflected that the population with poorer hearing may achieve higher health quality postoperatively.…”

“…Single-attribute utility scores were assessed when evaluated the changes of a single attribute. Multiattribute scores were used to compare integrated changes [ 6 , 7 ].…”

Design, implementation, and management of an international medical device registry

“…These data were utilized at various intervals to generate a wide range of local and international conference posters or presentations as well as white paper articles and publications in peer-reviewed journals. Scientific findings describing outcomes for CI recipients as captured via the IROS registry resulted in five publications [ 12 , 21 , 22 , 28 , 37 ]. A summary of the results from the IROS registry following its closure is also publicly registered [ ClinicalTrials.gov NCT02004353].…”

Design, Implementation and Management of an International Medical Device Registry

“…These data were utilized at various intervals to generate a wide range of local and international conference posters or presentations as well as articles and publications in peer-reviewed journals. Scienti c ndings for CIs from the IROS registry have been published in several papers [Czerniejewska-Wolska 2015, Lenarz 2017, Wyss 2019, Müller 2021, James 2021. Pooled data could identify outcome trends as well as provide input for the design for more robust comparative studies.…”