Cost-effectiveness of CI in developing countries

Magro, Isabelle; Emmett, Susan D.; Saunders, James E.

doi:10.1097/moo.0000000000000451

Cited by 18 publications

(15 citation statements)

References 48 publications

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“…In general, data is lacking on outcomes from cochlear implantation in low-and middle-income countries, although data from several countries in South America and Asia show that in most locations implant use rates are over 95%. 49,50…”

Section: Cochlear Implant Programmesmentioning

confidence: 99%

Training for hearing care providers

Bhutta

Muñoz

et al. 2019

Bull. World Health Organ.

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The lack of an appropriately trained global hearing-care workforce is recognized as a barrier to developing and implementing services to treat ear and hearing disorders. In this article we examine some of the published literature on the current global workforce for ear and hearing care. We outline the status of both the primary-care workforce, including community health workers, and specialist services, including audiologists, ear, nose and throat specialists, speech and language therapists, and teachers of the deaf. We discuss models of training health workers in ear and hearing care, including the role of task-sharing and the challenges of training in low and middle-income countries. We structure the article by the components of ear and hearing care that may be delivered in isolation or in integrated models of care: primary care assessment and intervention; screening; hearing tests; hearing rehabilitation; middle-ear surgery; deaf services; and cochlear implant programmes. We highlight important knowledge gaps and areas for future research and reporting.

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Section: Cochlear Implant Programmesmentioning

confidence: 99%

Training for hearing care providers

Bhutta

Muñoz

et al. 2019

Bull. World Health Organ.

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“…Our search yielded 1437 unique articles, of which 117 unique studies with decision models (Table 1, Batch 1) and 17 systematic reviews [132][133][134][135][136][137][138][139][140][141][142][143][144][145][146][147][148] met the inclusion criteria (Fig. 1).…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

Evidence gaps in economic analyses of hearing healthcare: A systematic review

et al. 2021

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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:72À100). 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.

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“…These challenges stem from speech comprehension difficulties, leading to inconsistent device use [1]. Evidence suggests that clinical auditory training (AT) augmented with software programs may improve speech comprehension; however, AT remains globally inaccessible because of financial and clinical time constraints [2][3][4][5][6][7][8]. For instance, in the United States, public insurance programs such as Medicare and Medicaid provide insufficient funding to cover the cost of AT [9].…”

Section: Introductionmentioning

confidence: 99%

An mHealth App (Speech Banana) for Auditory Training: App Design and Development Study

Ratnanather¹,

Bhattacharya²,

Heston³

et al. 2021

JMIR Mhealth Uhealth

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Background With the growing adult population using electronic hearing devices such as cochlear implants or hearing aids, there is an increasing worldwide need for auditory training (AT) to promote optimal device use. However, financial resources and scheduling conflicts make clinical AT infeasible. Objective To address this gap between need and accessibility, we primarily aimed to develop a mobile health (mHealth) app called Speech Banana for AT. The app would be substantially more affordable and portable than clinical AT; would deliver a validated training model that is reflective of modern techniques; and would track users’ progress in speech comprehension, providing greater continuity between periodic in-person visits. To improve international availability, our secondary aim was to implement the English language training model into Korean as a proof of concept for worldwide usability. Methods A problem- and objective-centered Design Science Research Methodology approach was adopted to develop the Speech Banana app. A review of previous literature and computer-based learning programs outlined current AT gaps, whereas interviews with speech pathologists and users clarified the features that were addressed in the app. Past and present users were invited to evaluate the app via community forums and the System Usability Scale. Results Speech Banana has been implemented in English and Korean languages for iPad and web use. The app comprises 38 lessons, which include analytic exercises pairing visual and auditory stimuli, and synthetic quizzes presenting auditory stimuli only. During quizzes, users type the sentence heard, and the app provides visual feedback on performance. Users may select a male or female speaker and the volume of background noise, allowing for training with a range of frequencies and signal-to-noise ratios. There were more than 3200 downloads of the English iPad app and almost 100 downloads of the Korean app; more than 100 users registered for the web apps. The English app received a System Usability Scale rating of “good” from 6 users, and the Korean app received a rating of “OK” from 16 users. Conclusions Speech Banana offers AT accessibility with a validated curriculum, allowing users to develop speech comprehension skills with the aid of a mobile device. This mHealth app holds potential as a supplement to clinical AT, particularly in this era of global telemedicine.

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Cost-effectiveness of CI in developing countries

Cited by 18 publications

References 48 publications

Training for hearing care providers

Training for hearing care providers

Evidence gaps in economic analyses of hearing healthcare: A systematic review

An mHealth App (Speech Banana) for Auditory Training: App Design and Development Study

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