Meta-analysis of Cochlear Implantation Outcomes Evaluated with General Health-related Patient-reported Outcome Measures

Theodore R. McRackan; Michael Bauschard; Jonathan L. Hatch; Emily Franko-Tobin; Harris Richard Droghini; Craig A. Velozo; Shaun A. Nguyen; Judy R. Dubno

doi:10.1097/MAO.0000000000001620

Meta-analysis of Cochlear Implantation Outcomes Evaluated with General Health-related Patient-reported Outcome Measures

Theodore R. McRackan, Michael Bauschard, Jonathan L. Hatch, Emily Franko-Tobin, Harris Richard Droghini, Craig A. Velozo, Shaun A. Nguyen, Judy R. Dubno

Research output: Contribution to journal › Article › peer-review

39 Scopus citations

Abstract

Objective: Determine the change in general health-related quality of life (HRQOL) after cochlear implantation and association with speech recognition. Study Design: Meta-analysis. Methods: Search was performed following the PRISMA statement using PubMed, Medline, Scopus, and CINAHL. Studies on adult cochlear implant (CI) patients measuring HRQOL before and after cochlear implantation were included. Standardized mean difference (SMD) for each measure and pooled effects were determined. A meta-analysis of correlations was also performed between all non-disease-specific patient-reported outcome measures (PROMs) and speech recognition after cochlear implantation. Results: Twenty-two articles met criteria for meta-analysis of HRQOL improvement, but 15 (65%) were excluded due to incomplete statistical reporting. From the seven articles with 274 CI patients that met inclusion criteria, pooled analyses showed a medium positive effect of cochlear implantation on HRQOL (SMD = 0.79). Subset analysis of the HUI-3 measure showed a large effect (SMD = 0.84). Nine articles with 550 CI patients met inclusion criteria for meta-analysis of correlations between non-disease specific PROMs and speech recognition after cochlear implantation. Pooled analysis showed a low correlation between non-disease-specific PROMs and word recognition in quiet (r = 0.35), sentence recognition in quiet (r = 0.40), and sentence recognition in noise (r = 0.32). Conclusion: Although regularly used, HRQOL measures are not intended to measure nor do they accurately reflect the complex difficulties facing CI patients. Only a medium positive effect of cochlear implantation on HRQOL was observed along with a low correlation between non-disease-specific PROMs and speech recognition. The use of such instruments in this population may underestimate the benefit of cochlear implantation.

Original language	English (US)
Pages (from-to)	29-36
Number of pages	8
Journal	Otology and Neurotology
Volume	39
Issue number	1
DOIs	https://doi.org/10.1097/MAO.0000000000001620
State	Published - Jan 1 2018
Externally published	Yes

Keywords

Cochlear implant
Cochlear implantation
Patient reported outcome measure
Quality of life
Speech recognition

ASJC Scopus subject areas

Otorhinolaryngology
Sensory Systems
Clinical Neurology

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10.1097/MAO.0000000000001620

Cite this

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title = "Meta-analysis of Cochlear Implantation Outcomes Evaluated with General Health-related Patient-reported Outcome Measures",

abstract = "Objective: Determine the change in general health-related quality of life (HRQOL) after cochlear implantation and association with speech recognition. Study Design: Meta-analysis. Methods: Search was performed following the PRISMA statement using PubMed, Medline, Scopus, and CINAHL. Studies on adult cochlear implant (CI) patients measuring HRQOL before and after cochlear implantation were included. Standardized mean difference (SMD) for each measure and pooled effects were determined. A meta-analysis of correlations was also performed between all non-disease-specific patient-reported outcome measures (PROMs) and speech recognition after cochlear implantation. Results: Twenty-two articles met criteria for meta-analysis of HRQOL improvement, but 15 (65%) were excluded due to incomplete statistical reporting. From the seven articles with 274 CI patients that met inclusion criteria, pooled analyses showed a medium positive effect of cochlear implantation on HRQOL (SMD = 0.79). Subset analysis of the HUI-3 measure showed a large effect (SMD = 0.84). Nine articles with 550 CI patients met inclusion criteria for meta-analysis of correlations between non-disease specific PROMs and speech recognition after cochlear implantation. Pooled analysis showed a low correlation between non-disease-specific PROMs and word recognition in quiet (r = 0.35), sentence recognition in quiet (r = 0.40), and sentence recognition in noise (r = 0.32). Conclusion: Although regularly used, HRQOL measures are not intended to measure nor do they accurately reflect the complex difficulties facing CI patients. Only a medium positive effect of cochlear implantation on HRQOL was observed along with a low correlation between non-disease-specific PROMs and speech recognition. The use of such instruments in this population may underestimate the benefit of cochlear implantation.",

keywords = "Cochlear implant, Cochlear implantation, Patient reported outcome measure, Quality of life, Speech recognition",

author = "McRackan, {Theodore R.} and Michael Bauschard and Hatch, {Jonathan L.} and Emily Franko-Tobin and Droghini, {Harris Richard} and Velozo, {Craig A.} and Nguyen, {Shaun A.} and Dubno, {Judy R.}",

note = "Funding Information: Address correspondence and reprint requests to Theodore R. McRackan, M.D., Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425; E-mail: mcrackan@musc.edu This publication was supported by a K12 award through the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, NIH/ NCATS Grant Number UL1TR001450 and a grant from the Doris Duke Foundation. The authors have no financial disclosures to make. The authors disclose no conflicts of interest. Publisher Copyright: {\textcopyright} 2017, Otology & Neurotology, Inc.",

year = "2018",

month = jan,

day = "1",

doi = "10.1097/MAO.0000000000001620",

language = "English (US)",

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T1 - Meta-analysis of Cochlear Implantation Outcomes Evaluated with General Health-related Patient-reported Outcome Measures

AU - McRackan, Theodore R.

AU - Bauschard, Michael

AU - Hatch, Jonathan L.

AU - Franko-Tobin, Emily

AU - Droghini, Harris Richard

AU - Velozo, Craig A.

AU - Nguyen, Shaun A.

AU - Dubno, Judy R.

N1 - Funding Information: Address correspondence and reprint requests to Theodore R. McRackan, M.D., Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425; E-mail: mcrackan@musc.edu This publication was supported by a K12 award through the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, NIH/ NCATS Grant Number UL1TR001450 and a grant from the Doris Duke Foundation. The authors have no financial disclosures to make. The authors disclose no conflicts of interest. Publisher Copyright: © 2017, Otology & Neurotology, Inc.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: Determine the change in general health-related quality of life (HRQOL) after cochlear implantation and association with speech recognition. Study Design: Meta-analysis. Methods: Search was performed following the PRISMA statement using PubMed, Medline, Scopus, and CINAHL. Studies on adult cochlear implant (CI) patients measuring HRQOL before and after cochlear implantation were included. Standardized mean difference (SMD) for each measure and pooled effects were determined. A meta-analysis of correlations was also performed between all non-disease-specific patient-reported outcome measures (PROMs) and speech recognition after cochlear implantation. Results: Twenty-two articles met criteria for meta-analysis of HRQOL improvement, but 15 (65%) were excluded due to incomplete statistical reporting. From the seven articles with 274 CI patients that met inclusion criteria, pooled analyses showed a medium positive effect of cochlear implantation on HRQOL (SMD = 0.79). Subset analysis of the HUI-3 measure showed a large effect (SMD = 0.84). Nine articles with 550 CI patients met inclusion criteria for meta-analysis of correlations between non-disease specific PROMs and speech recognition after cochlear implantation. Pooled analysis showed a low correlation between non-disease-specific PROMs and word recognition in quiet (r = 0.35), sentence recognition in quiet (r = 0.40), and sentence recognition in noise (r = 0.32). Conclusion: Although regularly used, HRQOL measures are not intended to measure nor do they accurately reflect the complex difficulties facing CI patients. Only a medium positive effect of cochlear implantation on HRQOL was observed along with a low correlation between non-disease-specific PROMs and speech recognition. The use of such instruments in this population may underestimate the benefit of cochlear implantation.

AB - Objective: Determine the change in general health-related quality of life (HRQOL) after cochlear implantation and association with speech recognition. Study Design: Meta-analysis. Methods: Search was performed following the PRISMA statement using PubMed, Medline, Scopus, and CINAHL. Studies on adult cochlear implant (CI) patients measuring HRQOL before and after cochlear implantation were included. Standardized mean difference (SMD) for each measure and pooled effects were determined. A meta-analysis of correlations was also performed between all non-disease-specific patient-reported outcome measures (PROMs) and speech recognition after cochlear implantation. Results: Twenty-two articles met criteria for meta-analysis of HRQOL improvement, but 15 (65%) were excluded due to incomplete statistical reporting. From the seven articles with 274 CI patients that met inclusion criteria, pooled analyses showed a medium positive effect of cochlear implantation on HRQOL (SMD = 0.79). Subset analysis of the HUI-3 measure showed a large effect (SMD = 0.84). Nine articles with 550 CI patients met inclusion criteria for meta-analysis of correlations between non-disease specific PROMs and speech recognition after cochlear implantation. Pooled analysis showed a low correlation between non-disease-specific PROMs and word recognition in quiet (r = 0.35), sentence recognition in quiet (r = 0.40), and sentence recognition in noise (r = 0.32). Conclusion: Although regularly used, HRQOL measures are not intended to measure nor do they accurately reflect the complex difficulties facing CI patients. Only a medium positive effect of cochlear implantation on HRQOL was observed along with a low correlation between non-disease-specific PROMs and speech recognition. The use of such instruments in this population may underestimate the benefit of cochlear implantation.

KW - Cochlear implant

KW - Cochlear implantation

KW - Patient reported outcome measure

KW - Quality of life

KW - Speech recognition

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Meta-analysis of Cochlear Implantation Outcomes Evaluated with General Health-related Patient-reported Outcome Measures

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