Abstract
Objectives: Cochlear implantation can restore access to sound and speech
understanding in subjects with substantial hearing loss where acoustic
hearing aids do not. The Health Utilities Index Mark III (HUI3) is
commonly used to measure health utility across all types of intervention
and is sensitive to changes in hearing. In the current study we analysed
for factors predicting clinically important gains in HUI3 scores in
adult Nucleus cochlear implant recipients, implanted in a single centre.
Design: Retrospective analysis of data collected in an observational
study. Demographic and other baseline parameters were analysed for their
association with gains in HUI3 scores. Participants: One-hundred and
thirty-seven adult recipients of Nucleus cochlear implants who had at
least one-year follow-up. Main Outcome Measures: HUI3 scores and speech,
spatial, quality (SSQ) scale scores were collected at baseline before
device activation and one-year after. Difference scores were computed.
Clinically important gain was defined as 0.1 point on the HUI3 scale.
Results: Baseline telephone use and baseline HUI3 hearing, speech and
emotion attribute levels were significantly associated with clinically
important gains in HUI3 scores. However, SSQ scores increased
significantly with or without clinically important gains in HUI3 scores.
Conclusion: Those subjects who were unable to use the telephone prior to
cochlear implantation were one-and-a-half times more likely to obtain a
clinically important gain in health utility. Those subjects who were
unhappy, or experienced difficulties communicating with strangers were
twice or more likely to obtain a clinically important gain in HUI3
scores compared to those who did not.