Cochlear Implant Unit, Tygerberg Hospital, 5th Floor Gold Ave, Francie van Zijl Drive, Tygerberg, 7505, South Africa.
Department of Mathematics and Statistics, Macquarie University, North Ryde, NSW, 2109, Australia.
Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4723-4731. doi: 10.1007/s00405-020-06589-1. Epub 2021 Jan 15.
Cochlear implantation can restore access to sound and speech understanding in subjects with substantial hearing loss. The Health Utilities Index Mark III (HUI3) measures the impact of an intervention on the patient's quality of life and is sensitive to changes in hearing. In the current study we used factor analysis to predict a clinically important gain in HUI3 scores in adult cochlear implant recipients.
Data were collected in an observational study for 137 adult recipients from a single center who had at least 1-year HUI3 follow-up. Demographic and other baseline parameters were retrospectively analyzed for their association with a clinically important HUI3 scale gain, defined as at least 0.1 points. Data were also collected for the speech spatial qualities (SSQ) scale.
Baseline telephone use and HUI3 hearing, speech and emotion attribute levels were significantly associated with clinically important gains in HUI3 scores. However, SSQ scores increased significantly with or without clinically important HUI3 gains.
Those subjects who were unhappy or experienced difficulties communicating with strangers or in a group were twice as likely to obtain a clinically important gain in health utility compared to those who were happy or had less difficulty communicating. Subjects who were unable to use the telephone prior to cochlear implantation were one and a half times more likely to obtain a clinically important gain. The SSQ scale was more sensitive to hearing improvements due to cochlear implantation. An inability to use the telephone is an easy to assess biomarker for candidacy for cochlear implantation.
人工耳蜗植入可以为有严重听力损失的患者恢复对声音和言语理解的能力。健康效用指数第 3 版（HUI3）衡量干预对患者生活质量的影响，并且对听力变化敏感。在目前的研究中，我们使用因子分析来预测成人人工耳蜗植入者 HUI3 评分的临床显著增益。
在一项单中心的观察性研究中，对 137 名成人接受者进行了数据收集，这些接受者至少有 1 年的 HUI3 随访。回顾性分析了人口统计学和其他基线参数与临床显著 HUI3 量表增益的相关性，定义为至少 0.1 分。还收集了言语空间质量（SSQ）量表的数据。
基线电话使用情况和 HUI3 的听力、言语和情绪属性水平与 HUI3 评分的临床显著增益显著相关。然而，SSQ 评分无论是否有临床显著的 HUI3 增益都显著增加。
与那些感到满意或在沟通方面没有困难的人相比，那些感到不满意或在与陌生人或在群体中沟通方面有困难的人获得健康效用临床显著增益的可能性要高出一倍。在植入人工耳蜗之前无法使用电话的患者获得临床显著增益的可能性要高出 1.5 倍。SSQ 量表对人工耳蜗植入引起的听力改善更为敏感。无法使用电话是评估人工耳蜗植入候选资格的一个简单的生物标志物。
