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成人人工耳蜗植入结局领域分析:一项系统评价

Analysis of Outcome Domains in Adult Cochlear Implantation: A Systematic Review.

作者信息

Vila Peter M, Hullar Timothy E, Buchman Craig A, Lieu Judith E C

机构信息

Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA

Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.

出版信息

Otolaryngol Head Neck Surg. 2016 Aug;155(2):238-45. doi: 10.1177/0194599816641382. Epub 2016 Apr 5.

Abstract

OBJECTIVES

To determine the breadth of outcome domains used in the reporting of adult cochlear implant surgery for the purpose of registry and quality measure development.

DATA SOURCES

Systematic review of randomized controlled trials.

REVIEW METHODS

In consultation with a medical librarian, search strategies were constructed to identify randomized controlled trials studying adults undergoing cochlear implantation. MEDLINE, EMBASE, Scopus, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and the Database of Abstracts of Reviews of Effects were searched from database inception to July 2015. Studies were evaluated for level of evidence and risk of bias with the Cochrane Collaboration's Risk of Bias Tool, and outcome domains were extracted from each study.

RESULTS

Of 4473 unique citations found, 8 studies were included in this review. All 8 trials were evidence level 1B. Risk of bias was low in 2 trials and high in the other 6. Reported outcome domains included speech perception in quiet and noise, speech tracking, quality of life, timbre perception, hearing preservation, vestibular function, electrode insertion technique, functional measures, functional imaging, fitting time, and tinnitus.

CONCLUSIONS

An analysis of randomized controlled trials studying cochlear implantation in adults yielded a wide spectrum of outcome domains. This is the first study to comprehensively describe the breadth of outcome domains in adult cochlear implantation. Validated instruments from these domains could be considered for potential inclusion as quality measures and registry use.

摘要

目的

为了登记注册及制定质量指标,确定成人人工耳蜗植入手术报告中所使用的结果领域范围。

数据来源

对随机对照试验的系统评价。

评价方法

与医学图书馆员协商后,构建检索策略以识别研究接受人工耳蜗植入的成人的随机对照试验。检索了MEDLINE、EMBASE、Scopus、CINAHL、Cochrane系统评价数据库、Cochrane对照试验中心注册库以及循证医学数据库,检索时间从各数据库建库至2015年7月。使用Cochrane协作网的偏倚风险工具对研究进行证据水平和偏倚风险评估,并从每项研究中提取结果领域。

结果

在检索到的4473条独特文献中,本评价纳入了8项研究。所有8项试验的证据水平均为1B级。2项试验的偏倚风险较低,另外6项试验的偏倚风险较高。报告的结果领域包括安静和噪声环境下的言语感知、言语跟踪、生活质量、音色感知、听力保留、前庭功能、电极插入技术、功能测量、功能成像、调试时间和耳鸣。

结论

对研究成人人工耳蜗植入的随机对照试验进行分析,得出了广泛的结果领域。这是第一项全面描述成人人工耳蜗植入结果领域范围的研究。这些领域经过验证的工具可考虑作为质量指标和登记注册使用而被纳入。

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本文引用的文献

1
Getting the Most From Cochlear Implants.
JAMA Otolaryngol Head Neck Surg. 2016 Mar;142(3):256-7. doi: 10.1001/jamaoto.2015.3904.
2
Is There a Need for Performance Measures for Cochlear Implant Centers?人工耳蜗植入中心是否需要性能指标?
Otolaryngol Head Neck Surg. 2015 Oct;153(4):484-7. doi: 10.1177/0194599815575006. Epub 2015 Mar 24.
9
Cochlear implantation in adults: a systematic review and meta-analysis.成人人工耳蜗植入:系统评价和荟萃分析。
JAMA Otolaryngol Head Neck Surg. 2013 Mar;139(3):265-72. doi: 10.1001/jamaoto.2013.1744.

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