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

McRackan, Theodore R.; Bauschard, Michael J.; Hatch, Jonathan L.; Franko-Tobin, Emily; Droghini, Harris Richard; Velozo, Craig A.; Nguyen, Shaun A.; Dubno, Judy R.

doi:10.1097/mao.0000000000001620

Cited by 56 publications

(86 citation statements)

References 38 publications

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“…Humes [2003] and Humes et al [2003] showed no correlation in a similar sample as well as in a large meta-analysis. In addition, absent to low correlations between patient self-report and speech recognition have been reported in cochlear implant users [Brendel et al, 2014;McRackan et al, 2016;Ramakers et al, 2017;McRackan et al, 2018a;McRackan et al, 2018b;Moberly et al, 2018]. Together, these data support the added value of PROMs as an independent measure of patient-perceived benefit from hearing interventions.…”

Section: Discussionmentioning

confidence: 74%

Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

et al. 2020

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Purpose: To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. Methods: Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. Results: Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively). Conclusion: Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.

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Section: Discussionmentioning

confidence: 74%

Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

et al. 2020

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“…To address the critical need for PROMs for adult CI users, we first developed the 81-item CIQOL item bank consisting of six domain-specific CIQOL item banks (McRackan, Bauschard, Hatch, Franko-Tobin, Droghini, Nguyen, et al, 2018) following the Patient-Reported Outcomes Measurement Information System (PROMIS) and Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) guidelines (Mokkink et al, 2010;PROMIS, 2013). To briefly summarize these steps, a systematic literature search was first conducted to identify PROMs previously used in the adult CI user population (McRackan, Bauschard, Hatch, Franko-Tobin, Droghini, Nguyen, et al, 2018;McRackan, Bauschard, Hatch, Franko-Tobin, Droghini, Velozo, et al, 2018). Information found through the literature search guided the development of a focus group protocol for patients with CI.…”

Section: Ciqol Item Bank Developmentmentioning

confidence: 99%

“…Although cochlear implantation is thought to provide benefits beyond communication, such as emotional state and social engagement, changes in speech recognition outcomes with cochlear implantation have been the primary research focus. Moreover, cochlear implant (CI) outcomes assessed using speech recognition (Adunka, Gantz, Dunn, Gurgel, & Buchman, 2018) correlate poorly with user self-reports of real-world communication ability and QOL (Capretta & Moberly, 2016;McRackan, Bauschard, Hatch, Franko-Tobin, Droghini, Nguyen, et al, 2018;McRackan, Bauschard, Hatch, Franko-Tobin, Droghini, Velozo, et al, 2018).…”

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confidence: 99%

Cochlear Implant Quality of Life (CIQOL): Development of a Profile Instrument (CIQOL-35 Profile) and a Global Measure (CIQOL-10 Global)

McRackan

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Velozo

et al. 2019

J Speech Lang Hear Res

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Purpose: Valid, reliable, and efficient patient-reported outcome measures are needed to quantify quality of life (QOL) outcomes after cochlear implantation to supplement information obtained from performance-based outcomes. We previously developed the Cochlear Implant Quality of Life (CIQOL) item bank to serve as the source of items for subsequent instruments. This study reports the development and psychometric properties for 2 of these new instruments, the CIQOL-35 Profile and the CIQOL-10 Global. Method: Cochlear implant (CI) users referred from the CIQOL Development Consortium (n = 371), consisting of 20 CI centers across the United States, provided responses to the 81-item CIQOL item bank, which are grouped into 6 QOL domains (communication, emotional, entertainment, environment, listening effort, and social). Responses to the 81 CIQOL items were analyzed using item response theory to determine individual item difficulty, discrimination, and model fit to select the set of items for the profile instrument and global measure that would optimize their measurement characteristics. Results: The 35-item CIQOL-35 Profile instrument assesses outcomes represented in the 6 domains of the CIQOL final item pool. The 10-item CIQOL-10 Global measure produces a single, overall QOL score. After ensuring the upper and lower ends of the item difficulty continuum were represented (item difficulty range: −2.48 to 2.47), the items with the highest discrimination ability for each domain were selected for the CIQOL-35 Profile instrument (discrimination range: 0.67-1.37). Items were selected for the CIQOL-10 Global measure in a similar manner. Conclusion: The CIQOL-35 Profile and CIQOL-10 Global instruments provide psychometrically sound and efficient measures that can be used to assess QOL in adult CI users in both clinical and research settings.

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“…Within the literature, cochlear implantation is frequently referred to as the "standard of care" [9,10], "treatment of choice" [11,12], or the "gold standard" for management of patients with severe-to-profound sensorineural hearing loss [13] perhaps based on the common belief that patients with severe-to-profound hearing loss cannot derive benefit from traditional hearing aids [c.f . 14].…”

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

Cited by 56 publications

References 38 publications

Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

Cochlear Implant Quality of Life (CIQOL): Development of a Profile Instrument (CIQOL-35 Profile) and a Global Measure (CIQOL-10 Global)

Cochlear implantation outcomes in adults: A scoping review

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