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Review
. 2018 Apr;128(4):982-990.
doi: 10.1002/lary.26738. Epub 2017 Jul 21.

Meta-analysis of quality-of-life improvement after cochlear implantation and associations with speech recognition abilities

Theodore R McRackan  1 , Michael Bauschard  1 , Jonathan L Hatch  1 , Emily Franko-Tobin  1 , H Richard Droghini  1 , Shaun A Nguyen  1 , Judy R Dubno  1
Affiliations
Review

Meta-analysis of quality-of-life improvement after cochlear implantation and associations with speech recognition abilities

Theodore R McRackan et al. Laryngoscope. 2018 Apr.

Abstract

Objectives: Determine the impact of cochlear implantation on quality of life (QOL) and determine the correlation between QOL and speech recognition ability.

Study design: Two authors independently searched PubMed, Medline, Scopus, and the Cumulative Index to Nursing and Allied Health Literature to identify studies reporting hearing-specific or cochlear implant (CI)-specific QOL outcomes before and after cochlear implantation, and studies reporting correlations between QOL and speech recognition after cochlear implantation. Data from the included articles were obtained independently by two authors. Standardized mean difference (SMD) for each measure and pooled effects were determined to assess improvement in QOL before and after cochlear implantation.

Results: From 14 articles with 679 CI patients who met the inclusion criteria, pooled analyses of all hearing-specific QOL measures revealed a very strong improvement in QOL after cochlear implantation (SMD = 1.77). Subset analysis of CI-specific QOL measures also showed very strong improvement (SMD = 1.69). Thirteen articles with 715 patients met the criteria to evaluate associations between QOL and speech recognition. Pooled analyses showed a low positive correlation between hearing-specific QOL and word recognition in quiet (r = 0.213), sentence recognition in quiet (r = 0.241), and sentence recognition in noise (r = 0.238). Subset analysis of CI-specific QOL showed similarly low positive correlations with word recognition in quiet (r = 0.213), word recognition in noise (r = 0.241), and sentence recognition in noise (r = 0.255).

Conclusions: Using hearing-specific and CI-specific measures of QOL, patients report significantly improved QOL after cochlear implantation. However, widely used clinical measures of speech recognition are poor predictors of patient-reported QOL with CIs. Laryngoscope, 128:982-990, 2018.

Keywords: Cochlear implant; outcomes research; quality of life; speech recognition; word recognition.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Literature review process utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) search method. The flowchart details the methods used to select articles for inclusion in the meta-analysis of quality of life (QOL) improvement and meta-analysis of correlations. Four articles satisfied criteria for both meta-analyses.
Figure 2
Figure 2
Forest plot of PROMS including subset analysis of hearing-specific and CI-specific QOL PROMs. CI-specific QOL PROMs included only the NCIQ as only this PROM met inclusion criteria for this subset analysis. HPS: Hearing Participation Scale; PQLF: Patient Quality of Life Form; HHI: Hearing Handicap Inventory; APHAB: Abbreviated Profile of Hearing Aid Benefit; SSQ: Speech, Spatial, and Qualities of hearing Questionnaire; NCIQ: Nijmegan Cochlear Implant Questionnaire; IV: Inverse Variance.
Figure 3
Figure 3
Forest plots pertaining to meta-analysis of correlations for articles reporting CI-specific (top) and hearing-specific (bottom) QOL measures. Pooled correlations are represented by diamonds. PROM: patient-reported outcome measure; CI: cochlear implant; HISQUI-29: Hearing Implant Sound Quality Index; PIPHL: Performance Inventory for Profound Hearing Loss
See this image and copyright information in PMC

References

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