Factors contributing to limited or non-use in the cochlear implant systems in children: 11 years experience

Özdemir, Süleyman; Tuncer, Ülkü; Tarkan, Özgür; Kıroğlu, Mete; Çetik, Fikret; Akar, Funda

doi:10.1016/j.ijporl.2012.11.041

Cited by 28 publications

(36 citation statements)

References 16 publications

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“…When considering the healthcare payer perspective only, the ICER was CNY 40,929 (USD 6,139) per QALY. Both ICERs fell either below or within the thresholds of CNY 49,034 (USD 7,355) and CNY 147,102 (USD 22,065), one to three times China's GDP per capita (2011–2015) (16,17). …”

Section: Resultsmentioning

confidence: 99%

“…The ICERs generated by the economic model of CNY 40,929 (USD 6,139) per QALY and CNY 100,561 (USD 15,084) per QALY from each perspective, fell within one to three times China's GDP per capita (2011–2015) (16,17), suggesting treatment with unilateral CI compared with no CI is cost-effective in the Chinese province of Anhui. The base case ICER estimates may be conservative, given CI is known to enhance the opportunity for children to participate in mainstream education instead of Schools for the Deaf.…”

Section: Discussionmentioning

confidence: 99%

“…There were limited published literature on rates of pediatric CI non-use (16–18), and rates of HA non-use among children (16). An older study from the United Kingdom reported a CI non-use rate of 7.1% (18); however, more recent studies from Turkey (17) and Australia (16) reported rates of 0.96% after 11 years and 0.86% after 3 years, respectively. The one study from Australia reporting on pediatric HA non-use recorded a rate at 3.4% after 3 years (16).…”

Section: Methodsmentioning

confidence: 96%

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Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China

Qiu

Ariyaratne

et al. 2017

Otology &Amp; Neurotology

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Objectives:To evaluate the cost utility of cochlear implantation (CI) for severe to profound sensorineural hearing loss (SNHL) among children from rural settings in P.R. China (China).Research Design:A cost-utility analysis (CUA) was undertaken using data generated from a single-center substudy of the CochlearTM Pediatric Implanted Recipient Observational Study (Cochlear P-IROS). The data were projected over a 20-year time horizon using a decision tree model.Setting:The Chinese healthcare payer and patient perspectives were adopted.Intervention:Unilateral CI of children with a severe-to-profound SNHL compared with their preimplantation state of no treatment or amplification with hearing aids (“no CI” status).Main Outcome Measure/s:Incremental costs per quality adjusted life year (QALY) gained.Results:The mean total discounted cost of unilateral CI was CNY 252,506 (37,876 USD), compared with CNY 29,005 (4,351 USD) for the no CI status from the healthcare payer plus patient perspective. A total discounted benefit of 8.9 QALYs was estimated for CI recipients compared with 6.7 QALYs for the no CI status. From the healthcare payer plus patient perspective, incremental cost-effectiveness ratio (ICER) for unilateral CI compared with no CI was CNY 100,561 (15,084 USD) per QALY. The healthcare payer perspective yielded an ICER of CNY 40,929 (6,139 USD) per QALY. Both ICERs fell within one to three times China's gross domestic product per capita (GDP, 2011–2015), considered “cost-effective” by World Health Organization (WHO) standards.Conclusions:Treatment with unilateral CI is a cost-effective hearing solution for children with severe to profound SNHL in rural China. Increased access to mainstream education and greater opportunities for employment, are potential downstream benefits of CI that may yield further societal and economic benefits. CI may be considered favorably for broader inclusion in medical insurance schemes across China.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 96%

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Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China

Qiu

Ariyaratne

et al. 2017

Otology &Amp; Neurotology

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“…As shown in Table (3), there is significant relation in favor to group (A) regarding postoperative minor complications, but there is more danger of chorda tympani nerve injury in group (A) (patients underwent cochlear implantation by classic approach). As shown in Table ( 4) there is significant relation between the two groups regarding major complications in favor to group (A), but there is significant danger of facial nerve injury in group (A) (patients underwent cochlear implantation by classic approach) As shown in table (5) there is significant difference between the 2 groups as regard to device migration, electrode extrusion and device malfunction in favor to group B. ( Hi-res 90k advantage).…”

Section: Age and Sex Distributionmentioning

confidence: 98%

Evaluation of the Results of Different Procedures in Cochlear Implantation.

Elfeky

Shiekh

Wahba

2014

Zagazig University Medical Journal

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Background:The cochlear implantation has radically changed the outlook for profoundly deaf adults and children. The cochlear implant can provide sufficient hearing sensations to enable most severely or profoundly deafened persons to continue communicating using speech as their primary means of communication .In Classic cochlear implantation; mastoidectomy is done to help retain the electrode leads within the confines of the mastoid cavity. Then the facial recess should be widely opened followed by cochleostomy which is followed by insertion of the electrode array. Minimally invasive cochlear implant surgery has become the mainstay of most experienced centers. Aim of work: to evaluate the results of using different procedures in cochlear implantation. Patients and methods:The study carried out on 41 patients have done cochlear implantation, starting from April 2011 till April 2014, and we excluded postlingual adults and children with congenital anomalies ,postmeningitis cochlear ossification and children with chronic suppurative otitis media (n=7). The patients were divided into two groups: the 1 st group of patients was implanted by classic approach the 2 nd group of patients was implanted by the SMA and another comparison in which, the patients were divided into two groups: the 1 st group of patients was implanted by PULSAR ci100 device the 2 nd group of patients was implanted by HI-RES 90K device; all patients were subjected to full preoperative assessment, and full postoperative assessment of complications (major and minor complications). Results: there is significant relation between the two groups regarding major complications in favor to classic approach but there is significant danger of facial nerve, chorda tympani nerve injury in classic approach, there is no significant difference between the ways of insertion regarding the major complications and there is significant difference between the 2 groups as regard to device migration, electrode extrusion and device malfunction in favor to Hi-res 90k device. Conclusion: classic approach has fewer incidences of major and minor complications than SMA, but there is significant danger of facial nerve, chorda tympani nerve injury in classic approach, Hi-res 90k device is better than PULSAR ci100 device as regard to device migration, electrode extrusion and device malfunction, We still need more assessment for surgical approaches, way of electrode insertion, type of devices.

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“…Also, children with multiple medical conditions resulting from prematurity or perinatal etiologies are more likely to be considered as candidates, expanding the criteria for implantation even more [16]. Consequently the number of pediatric cochlear implantation surgeries has increased significantly since 1990 [17], which necessitates a clear understanding of potential threats to overall outcomes in this population [9].…”

Section: Introductionmentioning

confidence: 99%

Predictors of pediatric cochlear implantation outcomes in South Africa

Roux

Vinck

Butler

et al. 2016

International Journal of Pediatric Otorhinolaryngology

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Objective: To identify and describe predictors of pediatric cochlear implantation outcomes in a South African population. Methods:A retrospective study of 301 pediatric CI recipients from five cochlear implant programs was conducted and cross-sectional outcome data were added at the time of data collection. Twenty potential prognostic factors were identified from the retrospective dataset, including biographical, cochlear implant (CI), family and risk factors. Multiple regression analyses was performed to identify predictor variables that influence outcomes in terms of auditory performance (CAP scores), speech production (SIR scores), communication mode and educational placement.Results: Although implanted children within this sample did not have equal opportunity to access a second implant, bilateral implantation was strongly predictive of better auditory performance and speech production scores, an oral mode of communication and mainstream education. NICU admittance/ prematurity were associated with poorer auditory performance and speech production scores, together with a higher probability for non-oral communication and non-mainstream education. The presence of one or more additional developmental 2 condition was predictive of poorer outcomes in terms of speech production and educational placement, while a delay between diagnosis and implantation of more than one year was also related to non-mainstream education. Ethnicities other than Caucasian were predictive of poorer auditory performance scores and a lower probability for mainstream education.Conclusion: An extensive range of prognostic indicators were identified for pediatric CI outcomes in South Africa. These predictive factors of better and poorer outcomes should guide pediatric CI services to promote optimal outcomes and assist professionals in providing evidence-based informational counselling.

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Factors contributing to limited or non-use in the cochlear implant systems in children: 11 years experience

Cited by 28 publications

References 16 publications

Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China

Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China

Evaluation of the Results of Different Procedures in Cochlear Implantation.

Predictors of pediatric cochlear implantation outcomes in South Africa

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