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基于循证模型的人工耳蜗售后护理对临床效率和患者结局的影响。

Effects of an evidence-based model for cochlear implant aftercare delivery on clinical efficiency and patient outcomes.

机构信息

Michigan Ear Institute, Farmington Hills, MI, USA.

Cochlear Hearing Center, Bellaire, TX, USA.

出版信息

Cochlear Implants Int. 2023 Nov;24(6):325-334. doi: 10.1080/14670100.2023.2188007. Epub 2023 Mar 16.

Abstract

OBJECTIVES

To assess an evidence-based model (EBM) approach to cochlear implant (CI) aftercare that includes a modified, reduced treatment schedule for newly-implanted adult CI recipients consisting of four appointments (initial activation, 1-, 3- and 6- months postactivation) in the first year post-surgery.

METHOD

This prospective multicenter proof-of-concept study was conducted across three clinics in the United States by five experienced CI clinicians. Seventeen newly-implanted adult patients with postlingual hearing loss enrolled in the study. Hearing outcomes were measured using objective speech testing and subjective self-report measures.

RESULTS

Most recipients (14/17; 82%) were able to follow the four-appointment EBM schedule. The reduced number of visits translated into an average time savings of 3 hours per patient. Significant improvements in speech perception were observed at both 3- and 6-months postactivation, as measured by CNC words in quiet and AzBio sentences at +10 dB SNR, consistent with published results achieved by traditional practices. Recipients were significantly satisfied with telephone, music, small group conversation, and television listening at 6 months postactivation. Recipient satisfaction with overall service was rated as "excellent" by 14/14 (100%) respondents.

CONCLUSION

The four-appointment EBM approach delivered efficient and effective audiological aftercare to CI recipients in the first year following CI implantation.

摘要

目的

评估一种基于循证医学(EBM)的人工耳蜗(CI)后续治疗模式,该模式包括为新植入的成年 CI 接受者制定改良的、简化的治疗方案,在术后第一年包括四次就诊(初始激活后、激活后 1、3 和 6 个月)。

方法

这项前瞻性多中心概念验证研究在美国的三个诊所由五名经验丰富的 CI 临床医生进行。研究纳入了 17 名患有后天性听力损失的新植入成年患者。使用客观语音测试和主观自我报告测量来评估听力结果。

结果

大多数接受者(17 名中的 14 名;82%)能够遵循四诊 EBM 方案。就诊次数的减少平均为每位患者节省了 3 个小时。正如传统实践所取得的结果一样,在激活后 3 个月和 6 个月时,通过安静环境下的 CNC 单词和+10 dB SNR 下的 AzBio 句子,观察到言语感知有显著改善,这与已发表的结果一致。在激活后 6 个月时,接受者对电话、音乐、小组对话和电视收听的满意度显著提高。14/14(100%)的受访者对整体服务满意度评为“优秀”。

结论

在 CI 植入后的第一年,四诊 EBM 方法为 CI 接受者提供了高效且有效的听觉后续治疗。

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