Cost-Utility of the Cochlear Implant in Adults&lt;subtitle&gt;A Meta-analysis&lt;/subtitle&gt;

Cheng, Andre; Niparko, John K.

doi:10.1001/archotol.125.11.1214

Cited by 95 publications

(81 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…costs on medical reimbursement levels, which have been argued to underestimate the true hospital costs of implantation (Cheng & Niparko, 1999;Cheng et al, 2000;Garber, et al, 2002;Summerfield et al, 2003). Additionally, Barton et al (2006a) demonstrated that our estimates of the educational costsavings associated with implantation may be smaller than those reported by Cheng et al (2000) and O'Neill et al (2000) because we controlled for more confounding variables.…”

Section: Ear and Hearing / October 2006mentioning

confidence: 63%

“…Third, the health-service costs of implantation were based on reimbursement levels rather than actual costs. Reimbursement levels do not always provide a good estimate of the true cost of the resources consumed in providing heath care (Beck, Beecham, Mandalia, Griffith, Walters, Boulton, & Miller, 1999), and there is evidence that the level of public reimbursement for cochlear implantation in the United States is often below cost (Cheng & Niparko, 1999;Garber, Ridgely, Bradley & Chin, 2002).…”

Section: Ear and Hearing / October 2006mentioning

confidence: 99%

“…Possibly, Cheng et al (2000) recorded a higher estimate because of recall bias associated with retrospective data collection (Dawson et al, 2002). In a meta-analysis of seven studies which estimated the gain in quality of life associated with implantation for adults (Cheng & Niparko, 1999), the four largest gains came from the four studies which used retrospective methods. Additionally, our revisions to the questionnaire may also account for part of the difference.…”

Section: Comparisons With Other Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Hearing-Impaired Children in the United Kingdom, IV: Cost-Effectiveness of Pediatric Cochlear Implantation

et al. 2006

View full text Add to dashboard Cite

Objective: To estimate the cost-effectiveness of pediatric cochlear implantation by conducting a costutility analysis from a societal perspective. Design:In a cross-sectional survey, the parents of a representative sample of hearing-impaired children assessed the health utility of their child using a revised version of the Health Utilities Index Mark III questionnaire. Linear regression was used to estimate the gain in health utility associated with implantation while controlling for eight potentially confounding variables: average (4-frequency, unaided, preoperative) hearing level (AHL), age at onset of hearing-impairment, age, gender, number of additional disabilities, parental occupational skill level, ethnicity, and parental hearing status. The gain in health utility was accumulated to estimate the number of quality-adjusted life years (QALYs) that would be gained from implantation over 15 yr and over a child's lifetime. The incremental societal cost of implantation, calculated in euros (€) at 2001/2 levels, was estimated by summing the incremental costs of implantation that are incurred in the health sector, in the education sector, and by the child's family. The cost-effectiveness of cochlear implantation was estimated by calculating the incremental societal cost per QALY gained and was compared with an upper limit of acceptability of €50,000 per QALY. Results:The parents of 403 implanted children, and 1863 nonimplanted children, completed the health utility questionnaire. Higher health utility was associated with a more favorable AHL, an older age at onset of hearing impairment, female gender, having fewer additional disabilities, having parents with a greater occupational skill level, white ethnicity, and implantation. The gain in health utility associated with implantation was estimated to be higher for children with a worse preoperative AHL and who were implanted when younger. Over 15 yr, for a child implanted at age 6 with a preoperative loss of 115 dB, 2.23 QALYs were estimated to be gained, compared with a mean incremental societal cost of €57,359, yielding a mean cost per QALY of €25,629.Cost-effectiveness was more favorable: (1) when estimated over a child's lifetime rather than 15 yr, (2) for children with a worse preoperative AHL, and (3) for children who were implanted when younger. Conclusions:The mean cost of gaining a QALY for the children in the present sample falls within acceptable limits. The strategy of giving highest priority for implantation to children with the greatest loss of hearing, and who are younger, maximizes benefit for a given cost.

show abstract

Section: Ear and Hearing / October 2006mentioning

confidence: 63%

Section: Ear and Hearing / October 2006mentioning

confidence: 99%

Section: Comparisons With Other Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Hearing-Impaired Children in the United Kingdom, IV: Cost-Effectiveness of Pediatric Cochlear Implantation

et al. 2006

View full text Add to dashboard Cite

show abstract

“…1,2,15 However, cochlear implantation is a low volume, high cost medical intervention. In spite of tremendous improvements in the technology of cochlear implantation, the cost of the device has remained high (between $15 000 and $35 000, depending upon the manufacturers and local market).…”

Section: Discussionmentioning

confidence: 99%

The Pakistan (Lahore) cochlear implant programme: issues relating to implantation in a developing country

Khan

Mukhtar²,

Saeed

et al. 2007

J. Laryngol. Otol.

View full text Add to dashboard Cite

The Pakistan cochlear implant programme was started in Lahore in August 2000. It was initially established with the technical support of the Manchester cochlear implant team. There are no government resources available for cochlear implantation in Pakistan and the cost of cochlear implantation is met by the candidates and their families. Up till December 2005, 52 individuals have been implanted. Forty-four (84.6 per cent) of these patients were children and eight (15.4 per cent) patients were adults. Congenital deafness (94 per cent) is the main aetiological factor in children. Seventy-six per cent of these children were born to blood related parents. All patients received a Med-El Combi 40þ device. The listening progress profile, the meaningful auditory integration scale and the meaningful use of speech scale were used to assess the auditory performance in children. Thirty-nine children achieved an average listening progress profile score of 37.7 after 12 months of implantation. The overall rate of major and minor complications was 11.5 per cent. Failure rate for the device itself has been 3.8 per cent. In addition to considering these preliminary outcomes and funding issues, the problems of setting up a cochlear implant programme in a developing country are discussed.

show abstract

“…32 Nevertheless, we are currently aware of several examples of reviews or systematic reviews conducted in the health care field in which the authors have pooled either resource use or cost estimates [33][34][35][36][37][38] or cost-utility ratios. 39 The review by Bower and colleagues 34 is summarised as a case study in Box 3.3.…”

Section: Guidance For Conducting Systematic Reviews Of Economic Studiesmentioning

confidence: 99%

The Role of Economic Perspectives and Evidence in Systematic Review

Anderson

Shemilt

2010

Evidence‐Based Decisions and Economics

View full text Add to dashboard Cite

Cost-Utility of the Cochlear Implant in Adults<subtitle>A Meta-analysis</subtitle>

Cited by 95 publications

References 19 publications

Hearing-Impaired Children in the United Kingdom, IV: Cost-Effectiveness of Pediatric Cochlear Implantation

Hearing-Impaired Children in the United Kingdom, IV: Cost-Effectiveness of Pediatric Cochlear Implantation

The Pakistan (Lahore) cochlear implant programme: issues relating to implantation in a developing country

The Role of Economic Perspectives and Evidence in Systematic Review

Contact Info

Product

Resources

About