A1 Journal article (refereed)
The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients (2022)

Dietz, A., Heinrich, A., Törmäkangas, T., Iso-Mustajärvi, M., Miettinen, P., Willberg, T., & Linder, P. H. (2022). The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients. Frontiers in Neuroscience, 16, Article 786939. https://doi.org/10.3389/fnins.2022.786939

JYU authors or editors

Publication details

All authors or editors: Dietz, Aarno; Heinrich, Antje; Törmäkangas, Timo; Iso-Mustajärvi, Matti; Miettinen, Petrus; Willberg, Tytti; Linder, Pia H.

Journal or series: Frontiers in Neuroscience

ISSN: 1662-4548

eISSN: 1662-453X

Publication year: 2022

Publication date: 06/06/2022

Volume: 16

Article number: 786939

Publisher: Frontiers Media SA

Publication country: Switzerland

Publication language: English

DOI: https://doi.org/10.3389/fnins.2022.786939

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/82528

Publication is parallel published: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207276/

Abstract

Understanding speech is essential for adequate social interaction, and its functioning affects health, wellbeing, and quality of life (QoL). Untreated hearing loss (HL) is associated with reduced social activity, depression and cognitive decline. Severe and profound HL is routinely rehabilitated with cochlear implantation. The success of treatment is mostly assessed by performance-based outcome measures such as speech perception. The ultimate goal of cochlear implantation, however, is to improve the patient’s QoL. Therefore, patient-reported outcomes measures (PROMs) would be clinically valuable as they assess subjective benefits and overall effectiveness of treatment. The aim of this study was to assess the patient-reported benefits of unilateral cochlear implantation in an unselected Finnish patient cohort of patients with bilateral HL. The study design was a prospective evaluation of 118 patients. The patient cohort was longitudinally followed up with repeated within-subject measurements preoperatively and at 6 and 12 months postoperatively. The main outcome measures were one performance-based speech-in-noise (SiN) test (Finnish Matrix Sentence Test), and two PROMs [Finnish versions of the Speech, Spatial, Qualities of Hearing questionnaire (SSQ) and the Nijmegen Cochlear Implant Questionnaire (NCIQ)]. The results showed significant average improvements in SiN scores, from +0.8 dB signal-to-noise ratio (SNR) preoperatively to −3.7 and −3.8 dB SNR at 6 and12 month follow-up, respectively. Significant improvements were also found for SSQ and NCIQ scores in all subdomains from the preoperative state to 6 and 12 months after first fitting. No clinically significant improvements were observed in any of the outcome measures between 6 and 12 months. Preoperatively, poor SiN scores were associated with low scoring in several subdomains of the SSQ and NCIQ. Poor preoperative SiN scores and low PROMs scoring were significantly associated with larger postoperative improvements. No significant association was found between SiN scores and PROMs postoperatively. This study demonstrates significant benefits of cochlear implantation in the performance-based and patient-reported outcomes in an unselected patient sample. The lack of association between performance and PROMs scores postoperatively suggests that both capture unique aspects of benefit, highlighting the need to clinically implement PROMs in addition to performance-based measures for a more holistic assessment of treatment benefit.

Keywords: cochlear implants; treatment outcomes; quality of life

Free keywords: cochlear implant; outcome measures; Quality of Life; SSQ; NCIQ; speech perception

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2022

JUFO rating: 1