Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Otol Neurotol. 2023 Dec 1;44(10):e722-e729. doi: 10.1097/MAO.0000000000004028. Epub 2023 Oct 19.
Determine associations expected and actual cochlear implant (CI) outcomes, decisional regret, and satisfaction in experienced adult CI users.
Cross-sectional cohort study.
Tertiary medical center.
Thirty-nine adult CI users meeting traditional bilateral hearing loss indications with ≥12 months CI experience.
INTERVENTIONS/MAIN OUTCOME MEASURES: Patients completed the validated Satisfaction with Amplification in Daily Living and Decisional Regret instruments. Pre- and post-CI outcomes (CI Quality of Life [CIQOL]-Expectations; CIQOL-35 Profile; CNC words, AzBio Sentences) were obtained from a prospectively maintained clinical database.
Using established cutoff scores, 29% of patients reported a substantial degree of post-CI decisional regret. For each CIQOL domain, patients without decisional regret obtained post-CI outcome scores closer to pre-CI expectations compared with patients with decisional regret ( d = 0.34 to 0.91); similar results were observed with higher CI user satisfaction ( d = 0.17-0.83). Notably, the degree of pre- to post-CI improvement in CNC or AzBio scores did not differ between patients with and without decisional regret or with lower and higher satisfaction. Finally, greater pre-/postimprovement in CIQOL-35 Profile domain scores demonstrated far stronger associations with lower decisional regret and higher satisfaction than changes in speech recognition scores.
Patients with better alignment of their pre-CI expectations and post-CI outcomes and greater pre-/post-CIQOL improvement had lower decisional regret and higher satisfaction. This emphasizes the importance of evidence-based pre-CI counseling regarding real-world CI benefits and caution against assuming that improvements in speech recognition are related to patient satisfaction.
确定有经验的成年人工耳蜗（CI）使用者的预期和实际 CI 结果、决策后悔和满意度的关联。
横断面队列研究。
三级医疗中心。
39 名符合传统双侧听力损失指征且具有≥12 个月 CI 经验的成年 CI 用户。
干预/主要观察指标：患者完成了经过验证的日常生活放大满意度和决策后悔量表。从一个前瞻性维护的临床数据库中获得了 CI 前和 CI 后的结果（CI 生活质量[CIQOL]-预期；CIQOL-35 简表；CNC 词，AzBio 句子）。
使用既定的临界值，29%的患者报告了大量的 CI 后决策后悔。对于每个 CIQOL 域，如果患者没有决策后悔，那么他们的 CI 后结果评分更接近 CI 前的预期，而对于有决策后悔的患者则不同（d = 0.34 至 0.91）；与更高的 CI 用户满意度（d = 0.17-0.83）的情况相似。值得注意的是，具有决策后悔和低满意度的患者与无决策后悔和高满意度的患者之间的 CNC 或 AzBio 评分的 CI 前至 CI 后的改善程度没有差异。最后，CIQOL-35 简表域评分的改善程度与决策后悔和满意度的相关性更强，而不是与语音识别评分的变化。
CI 前预期和 CI 后结果的一致性更好、CIQOL 前/后的改善程度更大的患者，其决策后悔和满意度越低。这强调了基于证据的 CI 前咨询的重要性，即关于现实世界 CI 益处的咨询，并提醒人们不要假设语音识别的改善与患者满意度有关。
