Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands; University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
J Clin Epidemiol. 2021 Sep;137:182-194. doi: 10.1016/j.jclinepi.2021.04.005. Epub 2021 Apr 20.
Cochlear implants (CIs) are implantable hearing devices with a wide variation in clinical outcome between patients. We aim to provide an overview of the literature on prediction models and their performance for clinical outcome after cochlear implantation in bilateral hearing loss or deafness.
In this systematic review, studies describing the development or external validation of a multivariable model for predicting clinical CI outcome were eligible for selection.
A total of 4,042 references were screened. We included nine development studies and one external validation study. The outcome measure of all development studies was speech perception performance after cochlear implantation. The most commonly used model predictors were duration of hearing loss or deafness (n = 7), different types of preoperative measurements (n = 5), and etiology (n = 3). In three studies, crucial information to enable the model to be used for individual risk prediction was missing. One study performed internal validation,two models were externally validated. One study reported specific discrimination or calibration performance measures.
Although many articles describe development studies of prediction models for speech perception performance after cochlear implantation, the value of most of these models for their application in clinical practice remains unclear. Therefore, research should focus on increasing the clinical relevance of existing CI outcome prediction models.
人工耳蜗植入物（CIs）是一种可植入的听力设备，患者之间的临床效果差异很大。我们旨在提供一份关于双侧听力损失或耳聋患者人工耳蜗植入后临床效果预测模型及其性能的文献综述。
在这项系统评价中，描述用于预测人工耳蜗植入后临床 CI 结果的多变量模型的开发或外部验证的研究有资格被选择。
共筛选出 4042 篇参考文献。我们纳入了 9 项开发研究和 1 项外部验证研究。所有开发研究的结局测量都是人工耳蜗植入后言语感知表现。最常用的模型预测因子是听力损失或耳聋的持续时间（n=7）、不同类型的术前测量（n=5）和病因（n=3）。在三项研究中，缺乏使模型能够用于个体风险预测的关键信息。一项研究进行了内部验证，两个模型进行了外部验证。一项研究报告了特定的区分或校准性能指标。
尽管许多文章都描述了人工耳蜗植入后言语感知表现预测模型的开发研究，但这些模型在临床实践中的应用价值尚不清楚。因此，研究应侧重于提高现有 CI 结果预测模型的临床相关性。
