Cochlear Implant Access in Six Developed Countries

Sorkin, Donna L.; Buchman, Craig A.

doi:10.1097/mao.0000000000000946

Cited by 106 publications

(107 citation statements)

References 6 publications

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“…Given the relatively low penetration rates for cochlear implantation that have been reported in recent years [7,19], it is likely that many adults with hearing impairment who may benefit from a cochlear implant have limited access to this technology due to restrictive or ambiguous candidacy criteria being used in many clinics [20]. A systematic approach to integrating current evidence with a focus on clinical applicability appears to be lacking, despite an abundance of published studies on the efficacy of unilateral cochlear implantation [c.f.…”

Section: Introductionmentioning

confidence: 99%

Cochlear implantation outcomes in adults: A scoping review

et al. 2020

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Cochlear implantation has become known as "the treatment of choice" for adults with severe to profound hearing loss. Wide variability exists, however, in the way hearing loss severity is measured and in the candidacy criteria used to recommend cochlear implantation. ObjectivesThis study aimed to provide a descriptive analysis of recent evidence available in the literature in relation to the efficacy of unilateral cochlear implantation in adults, the general findings of these studies, and the populations to which these findings apply. It also aimed to appraise the individual success rate and the magnitude of benefit following implantation. DesignA scoping review was conducted to identify English-language, peer-reviewed journal articles published between 2000 and 2018 assessing the outcomes of cochlear implantation in adults who received their first cochlear implant from 2000 onwards. To be included, studies had to report speech perception or self-reported measures of listening or quality of life at least three months after implantation. Systematic searches were conducted in Medline, Embase, Web of Science and Google Scholar. A two-stage screening approach was used, with seven reviewers independently screening titles and abstracts against inclusion criteria and three from this group further reviewing full-texts. A data charting form was developed and trialled, with 10% of the study data extracted in duplicate to compare results and further refine the form. Data relevant for efficacy analyses were extracted from studies with sample sizes of at least 10 participants. ResultsA total of 4182 abstracts were screened against inclusion criteria, and of these, 603 fulltexts were further screened. After exclusion of non-eligible articles, 201 articles were included in the first part of this scoping review. The majority of these articles were case series or comparative studies without a concurrent group, and had small sample sizes. Data PLOS ONECompeting interests: The authors have declared that no competing interests exist. synthesis conducted with the 102 articles with more than 10 participants highlighted that the average word perception ability improved from 8.2% to 53.9% after implantation. Selfreported benefit improved by 21.5 percentage points. At the individual level, 82.0% of adults with postlingual hearing loss and 53.4% of adults with prelingual hearing loss improved their speech perception ability by 15 percentage points or more. A small proportion had poorer ability after implantation or had stopped using the cochlear implant. ConclusionsDespite broad inconsistencies in measurement, research design, and reporting across articles, it is evident that cochlear implantation is beneficial to the majority of adults of any age who have limited aided speech perception abilities. While many adults with severe-to-profound hearing loss may also have poor speech perception abilities with hearing aids, the validity of using hearing loss severity as a criterion for cochlear implantation has not been demonstrated. Clinical and...

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Section: Introductionmentioning

confidence: 99%

Cochlear implantation outcomes in adults: A scoping review

et al. 2020

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“…The uptake of hearing aids (HAs) and cochlear implants (CIs) for the treatment of hearing-impaired individuals is low, with multiple sources reporting that these devices remain underutilised. The prevalence of HA use amongst those with hearing loss ranges from 14.2% to 33.1% [8][9][10] and the uptake of CIs is 10% or less of the people who clinically need them in adult populations globally [11]. The welldocumented benefits of hearing devices include improved hearing ability, improved sound quality, and enhanced quality of life [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical equipoise is reinforced by personal preference and personal decision-making. HCPs may, for example, lack awareness of the benefits of CIs for patients with significant hearing loss which affects their assessment and referral for implantation, and limits informative discussions with patients [11,[17][18][19]. Decision-making processes can also be influenced by the commercial interests of hearing clinics where sales commissions and targets motivate some audiologists in their prescribing habits [20,21].…”

Section: Introductionmentioning

confidence: 99%

Exploring the recruitment, ethical considerations, conduct and information dissemination of an audiology trial: a pretrial qualitative study (q-COACH)

Francis-Auton

Warren

Braithwaite

et al. 2020

Trials

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Introduction: Randomised controlled trials (RCTs), while still considered the gold standard approach in medical research, can encounter impediments to their successful conduct and the dissemination of results. Pretrial qualitative research can usefully address some of these impediments, including recruitment and retention, ethical conduct, and preferred methods of dissemination. However, pretrial qualitative work is rarely undertaken in audiology. The Comparison of outcomes with hearing aids and cochlear implants in adults with moderately severeto-profound bilateral sensorineural hearing loss (COACH) is a proposed RCT aiming to clarify when hearing aids (HAs) or cochlear implants (CIs) are the most suitable for different degrees of hearing loss and for which kinds of patients. q-COACH is a pretrial, qualitative study examining stakeholders' experiences of HAs and CIs, current clinical practices and stakeholders' perspectives of the design, conduct and dissemination plans for the proposed COACH study. Methods: Twenty-four participants including general practitioners, audiologists, adult HA users, and adult support networks undertook either semi-structured individual or paired interviews and completed demographic questionnaires. Data were analysed thematically. Results: Four key themes arose from this study: 1) rethinking sampling and recruitment strategies, 2) ethical considerations, 3) refining trial conduct, and 4) interconnected, appropriate and accessible methods of results dissemination. Conclusions: This qualitative investigation identified key considerations for the proposed RCT design, conduct and dissemination to help with successful implementation of COACH, and to indicate a plan of action at all RCT stages that would be acceptable to potential participants. By drawing on the perspectives of multiple key stakeholders and including a more general discussion of their experience and opinions of hearing loss, hearing device use and service availability, the study revealed experiential and ethical paradigms in which stakeholders operate. In so doing, q-COACH has exposed the benefits of preliminary qualitative investigations that enable detailed and rich understandings of the phenomenon at stake, forestalling problems and improving the quality of trial design, conduct and dissemination, while informing future RCT development discussions.

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“…6 Adults over the age of 65 years have a greater prevalence of hearing loss but an even lower utilization rate for CI than younger adults with acquired loss 9 ; for example, in Australia utilization in this group is 0.3%. 5 The perception of hearing loss as a natural consequence of the aging process, by both patient and professional, acts as an additional barrier to treatment for this group, and people who regarded hearing loss as being inconsequential and accept it passively are less likely to seek treatment. 10 …”

Section: Introductionmentioning

confidence: 99%

Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign

D’Haese

Bodt

Rompaey

et al. 2018

INQUIRY

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The objectives of this study were to assess the factors which contribute to individuals’ health motivation to address hearing loss and to gather baseline data that could then be used to measure the impact of an awareness campaign. An online questionnaire with 13 closed set questions was completed by 100 subjects in each country including Austria, Germany, France, Sweden, and the United Kingdom. The questionnaire was based around the Health Belief Model, which describes how, in order to take action to address a medical problem, the individual must perceive that the condition presents a threat to their well-being that exceeds any barriers to treatment. Good hearing was regarded as being important in all countries. There was agreement that the main sign of hearing loss was turning up the TV or radio. In most countries, hearing aids were thought to be not particularly visible, not require much maintenance, a hindrance while doing sport, and must be removed before bed. Perceptions of hearing implants were that they were permanently fitted, not externally visible, and do not need to be removed before bed. Medical issues were mostly researched through a doctor and then via the Internet. In this sample, there was a good understanding of the consequences and signs of hearing loss, but although hearing implants were viewed as being different to hearing aids, there was little understanding that the external speech processor was similar to a hearing aid in its physical characteristics. When actions were taken, the key professionals consulted about hearing problems were the general practitioner and ear, nose, and throat specialist.

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Cochlear Implant Access in Six Developed Countries

Cited by 106 publications

References 6 publications

Cochlear implantation outcomes in adults: A scoping review

Cochlear implantation outcomes in adults: A scoping review

Exploring the recruitment, ethical considerations, conduct and information dissemination of an audiology trial: a pretrial qualitative study (q-COACH)

Awareness of Hearing Loss in Older Adults: Results of a Survey Conducted in 500 Subjects Across 5 European Countries as a Basis for an Online Awareness Campaign

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