Bone-anchored hearing aids (BAHAs) for people who are bilaterally deaf: a systematic review and economic evaluation

Abstract

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Preoperative Headband Assessment for Semi-Implantable Bone Conduction Hearing Devices in Conductive Hearing Loss

“…Although our cohort of patients had normal BC thresholds, the siBCI may also be a better option for hearing rehabilitation than a pBCI in patients with mixed hearing loss (MHL) whose BC threshold is raised in the high frequencies; in our series, aided thresholds at 4 kHz closely matched the bone curve, whereas reported data on pBCI performance suggests a reduction in hearing gain at 4 kHz and above (3,4,10). According to a large systematic review by Colquitt et al, PTA 4 functional gain for pBCIs ranges from 18 to 45 dB (11). In our study, functional gain for the siBCI lies toward the upper end of this range (43.75 dB).…”

Mini Review of the Cost-Effectiveness of Unilateral Osseointegrated Implants in Adults: Possibly Cost-Effective for the Correct Indication

“…Cost-effectiveness analyses are an effective tool for comparing the relative value of therapies, and these comparisons can only be accurate when the quality of the ratio inputs are high. We reviewed a single case-control level 3b study [Monksfield at al., 2011] and a systematic review level 3a study [Colquitt et al, 2011]. There is limited quality of life data available for patients living with an osseointegrated implant.…”

“…The authors further contend that if the BAHA is partly or fully supported by private insurance, the cost-effectiveness is improved as the cost to provide or maintain the device is transferred to a private third party ( table 1 ). Colquitt et al [2011] performed a systemic review of 12 contemporary papers to assess the clinical effectiveness and cost-effectiveness of BAHA osseointegrated implant versus conventional hearing aids (ACHA and boneconduction hearing aids, BCHA) for bilateral hearing loss. The authors report that the overall quality of evidence is weak for the studies reviewed and a meta-analysis was impossible due to differences in outcome measures and patient populations.…”

“…The ICER is significantly higher in this systematic review versus the cost-effectiveness analysis of Monksfield et al [2011] as the authors also factored in costs for 'adverse events' and a smaller computed QALY benefit ( table 1 ). However, Colquitt et al [2011] contend that their cost-effectiveness and ICER calculations are severely limited by a lack of useable evidence on the quality of life outcomes of BAHA versus conventional aids ( table 1 ).…”

Bilateral Bone‐Anchored Hearing Aids for Bilateral Permanent Conductive Hearing Loss

“…10 While bilateral BAHA appears to have potential for additional benefit above unilateral fitting, a second BAHA comes with the risks of adverse events associated with surgery, as well as significant additional cost. 11 It is currently unclear whether the potential for benefit outweighs these potential risks. In light of this, we performed a systematic literature review to answer the following question: What is the evidence for bilateral versus unilateral implantation of the BAHA in individuals with bilateral permanent conductive hearing loss?…”