Measuring Success

Saunders, James E.; Francis, Howard W.; Skarżyński, Henryk

doi:10.1097/mao.0000000000000942

Cited by 23 publications

(7 citation statements)

References 35 publications

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“…The cost-effectiveness of cochlear implants has been established in developed countries 71 and in some developing countries. 71,74–77 These analyses have evaluated the lifetime costs of cochlear implants, including the costs of the device and of surgery and rehabilitation, versus the benefits, as determined on the basis of health-preference measures. Measures of cost-effectiveness have also been used to compare cochlear implants with other treatments, such as educational programs for deaf persons, and these assessments have shown that cochlear implants compare favorably with other treatments.…”

Section: Treatment Of Sensorineural Hearing Lossmentioning

confidence: 99%

Hearing Loss in Adults

2017

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Section: Treatment Of Sensorineural Hearing Lossmentioning

confidence: 99%

Hearing Loss in Adults

2017

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“…functioning and can lead to cognitive decline [32]. Cochlear Implants (CI) restore access to sound and improve social function for most profoundly deaf listeners [33][34][35]. However, not all CI users perform well in the real world and there is substantial unexplained variability in outcomes [36][37][38][39][40][41][42][43].…”

Section: Introductionmentioning

confidence: 99%

Underlying dimensions of real-time word recognition in cochlear implant users

McMurray¹,

Smith²,

Huffman³

et al. 2023

Preprint

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Word recognition is a gateway to language whose cognitive mechanisms are well understood in typical listeners. However, cognitive science has not identified the fundamental dimensions along which processing varies across people or contexts. This is necessary for developing universal theories that fully capture the range of language function; it can inform intervention and assessment; and it is relevant for understanding the links between hearing loss and cognitive decline. This study sought to identify these dimensions in a heterogenous population of Cochlear Implant users. We characterized millisecond-by-millisecond word recognition using the Visual World Paradigm. A principal component analysis revealed three dimensions of processing that mirror prior small-scale studies. Each dimension was predicted by different auditory and demographic factors, and each predicted outcomes over and above auditory fidelity. Thus, real-time language processing varies along a small number of dimensions, which explain variable real-world outcomes of older individuals and people with hearing loss.

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“…Although the CI has been evaluated as cost-effective in some middleincome countries (12), the policy benefits in Chile need to be assessed in detail. Inequalities, lack of funding and social protection programs might influence cost-effectiveness (45).…”

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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Measuring Success

Cited by 23 publications

References 35 publications

Hearing Loss in Adults

Hearing Loss in Adults

Underlying dimensions of real-time word recognition in cochlear implant users

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

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