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Ledesma ALL, Evangelista KDS, de Alexandria DML, Sales JDS, Caldas FF, Bahmad F. Satisfaction and quality of life in cochlear implant users with long sensory deprivation. Codas 2023; 35:e20210021. [PMID: 37466501 PMCID: PMC10446750 DOI: 10.1590/2317-1782/20232021021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/17/2022] [Indexed: 07/20/2023] Open
Abstract
PURPOSE The aim of the study was to verify the level of satisfaction of CI users with long periods of hearing deprivation, highlighting the positive and negative aspects of the use of the device and their quality of life. METHODS This is a analytical research, of the type observational cross-sectional study. The study was performed with 24 patients from a private Institute of Otorhinolaryngology. Three surveys were applied: Satisfaction with Amplification in Daily Life (SADL), International Outcome Inventory - Cochlear Implant (IOI - CI) to assess cochlear implant satisfaction and WHOQOL- bref to assess the quality of life. The results in the pre and post lingual groups were compared. RESULTS The highest degree of satisfaction was reported with regard to personal image, positive effects, and how the users feel about their CI. The lowest degree of satisfaction was reported regarding the cost-benefit of the CI and the competitive noise. In the WHOQOL-bref assessment, the highest scores were found in physical, psychological and social relations domains. When comparing the results of the surveys, the pre and post-lingual groups showed no difference in relation to the achieved scores. CONCLUSION The participants had a high level of satisfaction with the use of cochlear implants. The longer the sensory deprivation time, the greater the degree of satisfaction with the device. The use of the CI electronic device reflects on the individual's quality of life.
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Affiliation(s)
| | | | | | - Jéssica da Silva Sales
- Faculdade de Fonoaudiologia, Centro Universitário Planalto do Distrito Federal – UNIPLAN - Brasília (DF), Brasil.
| | - Fernanda Ferreira Caldas
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília – UnB - Brasília (DF), Brasil.
| | - Fayez Bahmad
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília – UnB - Brasília (DF), Brasil.
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Wijewickrema S, Bester C, Gerard JM, Collins A, O’Leary S. Automatic analysis of cochlear response using electrocochleography signals during cochlear implant surgery. PLoS One 2022; 17:e0269187. [PMID: 35834542 PMCID: PMC9282464 DOI: 10.1371/journal.pone.0269187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Cochlear implants (CIs) provide an opportunity for the hearing impaired to perceive sound through electrical stimulation of the hearing (cochlear) nerve. However, there is a high risk of losing a patient’s natural hearing during CI surgery, which has been shown to reduce speech perception in noisy environments as well as music appreciation. This is a major barrier to the adoption of CIs by the hearing impaired. Electrocochleography (ECochG) has been used to detect intra-operative trauma that may lead to loss of natural hearing. There is early evidence that ECochG can enable early intervention to save natural hearing of the patient. However, detection of trauma by observing changes in the ECochG response is typically carried out by a human expert. Here, we discuss a method of automating the analysis of cochlear responses during CI surgery. We establish, using historical patient data, that the proposed method is highly accurate (∼94% and ∼95% for sensitivity and specificity respectively) when compared to a human expert. The automation of real-time cochlear response analysis is expected to improve the scalability of ECochG and improve patient safety.
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Affiliation(s)
- Sudanthi Wijewickrema
- Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Australia
- * E-mail:
| | - Christofer Bester
- Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Australia
| | - Jean-Marc Gerard
- Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Australia
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Aaron Collins
- Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Australia
| | - Stephen O’Leary
- Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Australia
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
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Nagi MA, Dewi PEN, Thavorncharoensap M, Sangroongruangsri S. A Systematic Review on Economic Evaluation Studies of Diagnostic and Therapeutic Interventions in the Middle East and North Africa. Appl Health Econ Health Policy 2022; 20:315-335. [PMID: 34931297 DOI: 10.1007/s40258-021-00703-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Due to the increase in healthcare budget constraint, economic evaluation (EE) evidence is increasingly required to inform resource allocation decisions. This study aimed to systematically review quantity, characteristics, and quality of full EE studies on diagnostic and therapeutic interventions conducted in 26 Middle East and North Africa (MENA) countries. METHODS PubMed and Scopus databases were comprehensively searched to identify the published EE studies in the MENA region. The quality of reviewed studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS The search identified 69 studies. The cost-utility approach was adopted in 49 studies (71 %). More than half (38 studies; 55 %) were conducted in Iran and Turkey. Sixteen countries (62 %) did not have any EE studies. The most frequently analyzed therapeutic areas were infectious diseases (19 studies; 28 %), cardiovascular diseases (11 studies; 16 %), and malignancies (10 studies; 14 %). Ten studies (14 %), 46 (67 %), 12 (17 %), and 1 study (1 %) were classified as excellent, high, moderate, and poor quality, respectively. The mean of items reported was 85.10 % (standard deviation 13.32 %). Characterizing heterogeneity, measurement of effectiveness, time horizon, and discount rate were missed in 21 (60 %), 22 (32 %), 20 (29 %) and 15 (25 %) studies, respectively. Data on effectiveness and utility relied primarily on studies conducted outside the region. CONCLUSIONS The quantity of EE studies in the MENA region remains low; however, overall quality is high to excellent. The availability of local data, capacity building, and national guidelines are vital to improve both the quantity and quality of EE studies in the region.
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Affiliation(s)
- Mouaddh Abdulmalik Nagi
- Doctor of Philosophy Program in Social, Economic, and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen.
| | - Pramitha Esha Nirmala Dewi
- Doctor of Philosophy Program in Social, Economic, and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Department of Pharmacy Profession, Faculty of Medicine and health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Montarat Thavorncharoensap
- Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, 10400, Thailand
| | - Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, 10400, Thailand
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Borre ED, Diab MM, Ayer A, Zhang G, Emmett SD, Tucci DL, Wilson BS, Kaalund K, Ogbuoji O, Sanders GD. Evidence gaps in economic analyses of hearing healthcare: A systematic review. EClinicalMedicine 2021; 35:100872. [PMID: 34027332 PMCID: PMC8129894 DOI: 10.1016/j.eclinm.2021.100872] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Hearing loss is a common and costly medical condition. This systematic review sought to identify evidence gaps in published model-based economic analyses addressing hearing loss to inform model development for an ongoing Lancet Commission. METHODS We searched the published literature through 14 June 2020 and our inclusion criteria included decision model-based cost-effectiveness analyses that addressed diagnosis, treatment, or prevention of hearing loss. Two investigators screened articles for inclusion at the title, abstract, and full-text levels. Data were abstracted and the studies were assessed for the qualities of model structure, data assumptions, and reporting using a previously published quality scale. FINDINGS Of 1437 articles identified by our search, 117 unique studies met the inclusion criteria. Most of these model-based analyses were set in high-income countries (n = 96, 82%). The evaluated interventions were hearing screening (n = 35, 30%), cochlear implantation (n = 34, 29%), hearing aid use (n = 28, 24%), vaccination (n = 22, 19%), and other interventions (n = 29, 25%); some studies included multiple interventions. Eighty-six studies reported the main outcome in quality-adjusted or disability-adjusted life-years, 24 of which derived their own utility values. The majority of the studies used decision tree (n = 72, 62%) or Markov (n = 41, 35%) models. Forty-one studies (35%) incorporated indirect economic effects. The median quality rating was 92/100 (IQR:72-100). INTERPRETATION The review identified a large body of literature exploring the economic efficiency of hearing healthcare interventions. However, gaps in evidence remain in evaluation of hearing healthcare in low- and middle-income countries, as well as in investigating interventions across the lifespan. Additionally, considerable uncertainty remains around productivity benefits of hearing healthcare interventions as well as utility values for hearing-assisted health states. Future economic evaluations could address these limitations. FUNDING NCATS 3UL1-TR002553-03S3.
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Affiliation(s)
- Ethan D. Borre
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States
| | - Mohamed M. Diab
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Austin Ayer
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Gloria Zhang
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Susan D. Emmett
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Debara L. Tucci
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, United States
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, United States
| | - Blake S. Wilson
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, United States
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, United States
- Department of Electrical & Computer Engineering, Pratt School of Engineering, Duke University, Durham, NC, United States
| | - Kamaria Kaalund
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States
| | - Osondu Ogbuoji
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Center for Policy Impact in Global Health, Duke Global Health Institute, Durham NC, United States
| | - Gillian D. Sanders
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, United States
- Duke University Clinical Research Institute, Duke University School of Medicine, Durham NC, United States
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
- Corresponding author at: Gillian Sanders Schmidler, PhD, Duke-Robert J. Margolis, MD, Center for Health Policy, 100 Fuqua Drive, Box 90120, Durham, NC 27708-0120.
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Abstract
OBJECTIVE To estimate the global costs of hearing loss in 2019. DESIGN Prevalence-based costing model. STUDY SAMPLE Hearing loss data from the 2019 Global Burden of Disease study. Additional non-hearing related health care costs, educational support, exclusion from the labour force in countries with full employment and societal costs posed by lost quality of life were determined. All costs were reported in 2019 purchasing power parity (PPP) adjusted international dollars. RESULTS Total global economic costs of hearing loss exceeded $981 billion. 47% of costs were related to quality of life losses, with 32% due to additional costs of poor health in people with hearing loss. 57% of costs were outside of high-income countries. 6.5% of costs were for children aged 0-14. In scenario analysis a 5% reduction in prevalence of hearing loss would reduce global costs by $49 billion. CONCLUSION This analysis highlights major economic consequences of not taking action to address hearing loss worldwide. Small reductions in prevalence and/or severity of hearing loss could avert substantial economic costs to society. These cost estimates can also be used to help in modelling the cost effectiveness of interventions to prevent/tackle hearing loss and strengthen the case for investment.
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Affiliation(s)
- David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Shelly Chadha
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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Sheikh Z, Irune E. Day-case thyroid lobectomy parameters at a tertiary referral head and neck centre: a sensitivity and cost analysis. Eur Arch Otorhinolaryngol 2020; 277:2527-2531. [PMID: 32246256 DOI: 10.1007/s00405-020-05921-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/12/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Day-case thyroid surgery has been endorsed by the American Thyroid Association and the British Association of Day Surgery. Despite the many benefits of day surgery, day-case thyroid surgery is not widely practiced. We describe the use of sensitivity analysis modelling and cost analysis in determining and refining the patient cohort that safely meet the threshold for a new day-case thyroid lobectomy service at a tertiary referral head and neck centre. METHODS All cases of first-time thyroid lobectomy were identified between 2015 and Q2 2019. Patients suitable for day-case thyroid lobectomy were identified retrospectively, according to the following criteria: Age < 65 years, ASA grade < 3, BMI < 30 kg/m2 and distance from tertiary unit < / = 30 min. Sensitivity analysis was undertaken, manipulating each parameter in turn to assess the effect on eligibility and associated cost-savings. RESULTS 259 Thyroid lobectomy procedures were performed, 173 of these met inclusion criteria. Sensitivity analysis revealed that after increasing all day-case parameters by four increments, eligibility increased from 47 (27%) to 112 patients (64.7%), with only one outpatient to inpatient conversion. Multivariate logistical regression analysis found that age was the only variable to increase the risk of adverse outcomes (OR = 1.10, p < 0.05). Using data from the NHS reference costs, if 60% of all thyroid lobectomies nationally were undertaken as day-case, this would have amounted to savings of £26.3 m over five years. CONCLUSION Through sensitivity analysis, we determined that we could safely offer day-case thyroid lobectomy to 64.7% of our patient cohort.
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Affiliation(s)
- Zara Sheikh
- Department of Otolaryngology, Head and Neck Surgery, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
| | - Ekpemi Irune
- Department of Otolaryngology, Head and Neck Surgery, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
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