McRackan Theodore R, Bauschard Michael, Hatch Jonathan L, Franko-Tobin Emily, Droghini H Richard, Nguyen Shaun A, Dubno Judy R
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Laryngoscope. 2018 Apr;128(4):982-990. doi: 10.1002/lary.26738. Epub 2017 Jul 21.
Determine the impact of cochlear implantation on quality of life (QOL) and determine the correlation between QOL and speech recognition ability.
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.
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).
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.
确定人工耳蜗植入对生活质量（QOL）的影响，并确定生活质量与言语识别能力之间的相关性。
两位作者独立检索了PubMed、Medline、Scopus以及护理与联合健康文献累积索引，以识别报告人工耳蜗植入前后听力特异性或人工耳蜗（CI）特异性生活质量结果的研究，以及报告人工耳蜗植入后生活质量与言语识别之间相关性的研究。纳入文章的数据由两位作者独立获取。确定每项测量的标准化平均差（SMD）和合并效应，以评估人工耳蜗植入前后生活质量的改善情况。
在14篇涉及679例符合纳入标准的人工耳蜗植入患者的文章中，对所有听力特异性生活质量测量指标的合并分析显示，人工耳蜗植入后生活质量有非常显著的改善（SMD = 1.77）。对人工耳蜗特异性生活质量测量指标的亚组分析也显示出非常显著的改善（SMD = 1.69）。13篇涉及715例患者的文章符合评估生活质量与言语识别之间关联的标准。合并分析显示，听力特异性生活质量与安静环境下的单词识别（r = 0.213）、安静环境下的句子识别（r = 0.241）以及噪声环境下的句子识别（r = 0.238）之间存在低正相关。人工耳蜗特异性生活质量的亚组分析显示，与安静环境下的单词识别（r = 0.213）、噪声环境下的单词识别（r = 0.241）以及噪声环境下的句子识别（r = 0.255）之间也存在类似的低正相关。
使用听力特异性和人工耳蜗特异性生活质量测量指标，患者报告人工耳蜗植入后生活质量有显著改善。然而，广泛使用的言语识别临床测量指标并不能很好地预测人工耳蜗植入患者报告的生活质量。《喉镜》，2018年，第128卷，第982 - 990页。
