Current demographic and auditory profiles of adult cochlear implant candidates and factors affecting uptake

Henkin, Yael; Shapira, Yehoshua; Soffer, Yifat Yaar

doi:10.1080/14992027.2021.1941327

Cited by 14 publications

(16 citation statements)

References 28 publications

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“…Despite broadening of candidacy criteria, most patients continued to present with at least severe hearing loss (mean PTA, 89 dB HL in 2013-2015 versus 85.2 dB HL in 2015-2020). Other centers corroborate these findings, with average scores between 8% and 26% for speech recognition measures and 85 and 105 dB HL for PTA (31,32). Although this study's mean CNC (19% versus 6%) and AzBio in quiet (27% versus 9%) scores were significantly higher for evaluations completed in 2020 than those in 2015, patients were still presenting far below the upper range of current candidacy criteria (60%).…”

Section: Discussionsupporting

confidence: 74%

“…Along with insurance coverage (5.8%), other reasons for this study's 103 patients not pursuing a CI included reluctance for surgery (38.8%) and opting for hearing aids (25.2%). These findings are underscored in other studies as well (18,32,54). Another possible contributing factor toward not pursuing surgery is better hearing at evaluation as evidenced by significantly lower mean unaided PTA in each ear and higher mean aided speech recognition scores in the poorer ear and bilateral condition.…”

Section: Discussionsupporting

confidence: 66%

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A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery—Are We Doing Better?

et al. 2022

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ObjectiveTo characterize the influence of expanding indications on the profile of adults undergoing cochlear implantation (CI) at a high-volume CI center.Study DesignRetrospective review.SettingTertiary referral center.Patients774 adults undergoing CI evaluation from August 2015 to August 2020.Main Outcome MeasuresDemographics; audiometry; speech recognition; speech, spatial, and qualities of hearing scale (SSQ-12).ResultsOf 745 (96.3%) patients qualifying for implantation, 642 (86.6%) pursued surgery. Median age at evaluation was 69 years; 56.3% were men; 88.2% were Caucasian. Median distance to our center was 95 miles. The majority (51.8%) had public insurance (Medicare, Medicaid), followed by private (47.8%) and military (0.4%). Mean PTA, CNC, and AzBio in quiet and noise for the ear to be implanted were 85.2 dB HL, 15.0%, and 19.2% and 3.5%, respectively. Hybrid/EAS criteria were met by 138 (18.5%) CI candidates, and 436 (77.0%) unilateral CI recipients had aidable contralateral hearing for bimodal hearing configurations. Younger age (odds ratio [OR], 0.96; 95% confidence interval, 0.93–0.99) and non-Caucasian race (OR, 6.95; 95% confidence interval, 3.22–14.98) predicted candidacy. Likelihood of surgery increased for Caucasian (OR, 8.08; 95% confidence interval, 4.85–13.47) and married (OR, 2.28; 95% confidence interval, 1.50–3.47) patients and decreased for those with public insurance (OR, 0.45; 95% confidence interval, 0.29–0.69). A lower SSQ-12 score predicted both candidacy and surgery.ConclusionDespite expansions in criteria, speech understanding remained extremely low at CI evaluation. Younger age and non-Caucasian race predicted candidacy, and Caucasian, married patients with private insurance and lower SSQ scores were more likely to pursue surgery.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 66%

A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery—Are We Doing Better?

et al. 2022

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“…Our study suggests the importance of early HL diagnosis for better results in treatment success and occupation status. Previous evidence suggests that long-standing DHH without treatment might receive fewer benefits than those diagnosed and aided rapidly (36).…”

Section: Discussionmentioning

confidence: 99%

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

Bustos-Rubilar

Kyle

Luna

et al. 2023

Preprint

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Background: Post-lingual deafness represents a critical challenge for adults' well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the Ley Ricarte Soto (LRS) health policy. However, wide variability exists in the use of this device. To date, no study has been published on policy evaluation in Chile or other Latin American countries. Objectives: This study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020. Design: We performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) for social inclusion and occupation status for labour market inclusion. Results: Our study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes (P=0.078 and P= 0.011, respectively). Regarding social determinants of health, finding suggested participants with high social health insurance and a shorter commute time to the clinic (p=0.070 and p=0.086, respectively) had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation (p=0.069 and p=0.021, respectively) had better post-CI occupation status, and findings suggested an impact of high education levels. Conclusions: In evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them near each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these parameters could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities

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“…In our experience, it is not always clear when a person should be referred for CI evaluation. Several publications have discussed the barriers potential CI candidates face and how at least some barriers could be eliminated by updating and standardizing candidacy protocols [ 53 , 54 ]. It has been suggested that there might be value in referring a person even if they do not meet all criteria (yet) [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Do Not Go Gentle into That Deaf Night: A Holistic Perspective on Cochlear Implant Use as Part of Healthy Aging

Illg¹,

Lukaschyk²,

Kludt³

et al. 2022

JPM

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Research suggests that cochlear implant (CI) use in elderly people improves speech perception and health-related quality of life (HRQOL). CI provision could also prevent dementia and other comorbidities and support healthy aging. The aim of this study was (1) to prospectively investigate potential changes in HRQOL and speech perception and (2) to identify clinical action points to improve CI treatment. Participants (n = 45) were CI recipients aged 60–90 with postlingual deafness. They were divided into groups, according to age: Group 1 (n = 20) received a CI between the age of 60–70 years; group 2 (n = 25) between the age of 71–90 years. HRQOL and speech perception were assessed preoperatively, and three and twelve months postoperatively. HRQOL and speech perception increased significantly within one year postoperatively in both groups. No difference between groups was found. We conclude that CI treatment improves speech perception and HRQOL in elderly users. Improvement of the referral process for CI treatment and a holistic approach when discussing CI treatment in the elderly population could prevent auditory deprivation and the deterioration of cognitive abilities.

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Current demographic and auditory profiles of adult cochlear implant candidates and factors affecting uptake

Cited by 14 publications

References 28 publications

A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery—Are We Doing Better?

A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery—Are We Doing Better?

A country-wide health policy in Chile for deaf adults using cochlear implants: analysis of health determinants and social impacts

Do Not Go Gentle into That Deaf Night: A Holistic Perspective on Cochlear Implant Use as Part of Healthy Aging

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