The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients
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 wit...
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| Format: | Article |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.786939/full |
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| author | Aarno Dietz Antje Heinrich Timo Törmäkangas Matti Iso-Mustajärvi Petrus Miettinen Petrus Miettinen Tytti Willberg Tytti Willberg Pia H. Linder |
| author_facet | Aarno Dietz Antje Heinrich Timo Törmäkangas Matti Iso-Mustajärvi Petrus Miettinen Petrus Miettinen Tytti Willberg Tytti Willberg Pia H. Linder |
| author_sort | Aarno Dietz |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T17:49:51Z |
| format | Article |
| id | doaj.art-7b66c29dc4f84a71b5d95c8bac40d941 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-13T17:49:51Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-7b66c29dc4f84a71b5d95c8bac40d9412022-12-22T02:36:46ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-06-011610.3389/fnins.2022.786939786939The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish RecipientsAarno Dietz0Antje Heinrich1Timo Törmäkangas2Matti Iso-Mustajärvi3Petrus Miettinen4Petrus Miettinen5Tytti Willberg6Tytti Willberg7Pia H. Linder8Department of Otolaryngology, Kuopio University Hospital, Kuopio, FinlandDivision of Human Communication, Development and Hearing, School of Health Sciences, University of Manchester, Manchester, United KingdomDepartment of Health Sciences, University of Jyväskylä, Jyväskylä, FinlandDepartment of Otolaryngology, Kuopio University Hospital, Kuopio, FinlandDepartment of Otolaryngology, Kuopio University Hospital, Kuopio, FinlandFaculty of Health Sciences, University of Eastern Finland, Kuopio, FinlandFaculty of Health Sciences, University of Eastern Finland, Kuopio, FinlandDepartment of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital, Turku, FinlandDepartment of Otolaryngology, Kuopio University Hospital, Kuopio, FinlandUnderstanding 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.https://www.frontiersin.org/articles/10.3389/fnins.2022.786939/fullcochlear implantoutcome measuresQuality of LifeSSQNCIQspeech perception |
| spellingShingle | Aarno Dietz Antje Heinrich Timo Törmäkangas Matti Iso-Mustajärvi Petrus Miettinen Petrus Miettinen Tytti Willberg Tytti Willberg Pia H. Linder The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients Frontiers in Neuroscience cochlear implant outcome measures Quality of Life SSQ NCIQ speech perception |
| title | The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients |
| title_full | The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients |
| title_fullStr | The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients |
| title_full_unstemmed | The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients |
| title_short | The Effectiveness of Unilateral Cochlear Implantation on Performance-Based and Patient-Reported Outcome Measures in Finnish Recipients |
| title_sort | effectiveness of unilateral cochlear implantation on performance based and patient reported outcome measures in finnish recipients |
| topic | cochlear implant outcome measures Quality of Life SSQ NCIQ speech perception |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.786939/full |
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