Moving Beyond GDP

Emmett, Susan D.; Tucci, Debara L.; Bento, Ricardo Ferreira; García, Juan Manuel Méjica; Juman, Solaiman; Chiossone-Kerdel, Juan A.; Liu, Ta J.; Muñoz, Patricia Castellanos de; Ullauri, Alejandra; Letort, Jose J.; Mansilla, Teresita; Urquijo, Diana P.; Aparicio, Maria Leonor; Gong, Wenfeng; Francis, Howard W.; Saunders, James E.

doi:10.1097/mao.0000000000001148

Cited by 15 publications

(3 citation statements)

References 33 publications

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“…The cost-effectiveness of cochlear implants has been established in developed countries 71 and in some developing countries. 71,74–77 These analyses have evaluated the lifetime costs of cochlear implants, including the costs of the device and of surgery and rehabilitation, versus the benefits, as determined on the basis of health-preference measures. Measures of cost-effectiveness have also been used to compare cochlear implants with other treatments, such as educational programs for deaf persons, and these assessments have shown that cochlear implants compare favorably with other treatments.…”

Section: Treatment Of Sensorineural Hearing Lossmentioning

confidence: 99%

Hearing Loss in Adults

2017

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Section: Treatment Of Sensorineural Hearing Lossmentioning

confidence: 99%

Hearing Loss in Adults

2017

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“…As the number of CI operations continues to rise, one must consider the burden of preoperative imaging. The cost of preoperative imaging creates a financial burden for healthcare systems, especially those with scarce resources and for patients (3)(4)(5)(6). In one study by Brown et al (7), the average cost of imaging per patient was $2,343 for CT, $3,624 for MRI, and $5,830 for both.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Imaging in Cochlear Implants

Lee,

Saunders

2024

Otol Neurotol

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Objective To determine the utility of computed tomography (CT) and magnetic resonance imaging (MRI) in cochlear implant candidates. Study Design Retrospective case review. Setting Tertiary referral hospital. Patients A total of 207 cochlear implanted patients with CT and/or MRI Intervention(s) N/A. Main Outcome Measure(s) Age versus abnormal radiologic findings, imaging abnormality versus postoperative outcomes, postoperative outcomes versus electrode design, Cambridge Cochlear Implant Protocol (CCIP) status for imaging abnormalities, sensitivity and specificity of CT and MRI for round-window/cochlear occlusion, and MRI for incomplete partitions. Results A total of 207 patients with CT, MRI, or both were reviewed retrospectively. Less than half (15.5%) of CT scans had findings that might affect surgical intervention compared with 5.9% of MRI. No significant difference was found between children and adults for relevant imaging abnormalities (grade 4 or higher) with either CT (p = 0.931) or MRI (p = 0.606). CCIP status correlated with cochlear abnormalities (p = 0.040); however, only 46.2% of radiographic abnormalities on CT would be identified by these criteria. For detecting cochlear occlusion requiring surgical intervention, the sensitivity and specificity for CT were 40% (4 of 10; 95% confidence interval [CI], 12.16–73.76) and 95.73% (95% CI, 91.40–98.27), respectively. For MRI, the sensitivity and specificity were 33.33% (1 of 3; 95% CI, 0.84–90.57) and 96.97% (63 of 65; 95% CI, 89.32–99.63), respectively. There was no difference for postoperative AzBio scores for higher-grade imaging abnormalities (p = 0.6012) or for electrode designs (p = 0.3699). Conclusions Significant radiographic abnormalities were relatively uncommon in cochlear implant patients on either CT or MRI at our single-center institution. If present, abnormal imaging findings rarely translated to management changes. CCIP status does not reliably predict which patients are likely to have abnormalities. Both MRI and CT have low sensitivity for round-window or cochlear occlusion, but detection likely leads to changes in surgical management.

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“…Currently, the majority of CI units are distributed in developed countries because affordability remains a prohibitive challenge to people who need such devices in developing or under-developed countries. However, developing countries have started to estimate its cost-effectiveness in terms of the socioeconomic impact of hearing loss because the condition affects individuals in ways that limit their lives by depriving them of opportunities to be properly educated [ 1 , 2 , 3 , 4 ]. This includes impaired speech and language development and poor academic achievement, resulting in increased drop-out rates in adolescence.…”

Section: Introductionmentioning

confidence: 99%

Manufacturable 32-Channel Cochlear Electrode Array and Preliminary Assessment of Its Feasibility for Clinical Use

Shin¹,

Ha²,

Choi³

et al. 2021

Micromachines

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(1) Background: In this study, we introduce a manufacturable 32-channel cochlear electrode array. In contrast to conventional cochlear electrode arrays manufactured by manual processes that consist of electrode-wire welding, the placement of each electrode, and silicone molding over wired structures, the proposed cochlear electrode array is manufactured by semi-automated laser micro-structuring and a mass-produced layer-by-layer silicone deposition scheme similar to the semiconductor fabrication process. (2) Methods: The proposed 32-channel electrode array has 32 electrode contacts with a length of 24 mm and 0.75 mm spacing between contacts. The width of the electrode array is 0.45 mm at its apex and 0.8 mm at its base, and it has a three-layered arrangement consisting of a 32-channel electrode layer and two 16-lead wire layers. To assess its feasibility, we conducted an electrochemical evaluation, stiffness measurements, and insertion force measurements. (3) Results: The electrochemical impedance and charge storage capacity are 3.11 ± 0.89 kOhm at 1 kHz and 5.09 mC/cm2, respectively. The V/H ratio, which indicates how large the vertical stiffness is compared to the horizontal stiffness, is 1.26. The insertion force is 17.4 mN at 8 mm from the round window, and the maximum extraction force is 61.4 mN. (4) Conclusions: The results of the preliminary feasibility assessment of the proposed 32-channel cochlear electrode array are presented. After further assessments are performed, a 32-channel cochlear implant system consisting of the proposed 32-channel electrode array, 32-channel neural stimulation and recording IC, titanium-based hermetic package, and sound processor with wireless power and signal transmission coil will be completed.

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Moving Beyond GDP

Abstract: Both cochlear implantation and deaf education are widely cost effective in Latin America. In the lower-middle income economy of Guatemala, implant cost may have a larger impact. GDP is less influential in the middle- and high-income economies included in this study.

Cited by 15 publications

References 33 publications

Hearing Loss in Adults

Hearing Loss in Adults

Preoperative Imaging in Cochlear Implants

Manufacturable 32-Channel Cochlear Electrode Array and Preliminary Assessment of Its Feasibility for Clinical Use

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