Cost-utility of the cochlear implant in adults: A meta-analysis

André K. Cheng, John K. Niparko

Research output: Contribution to journalArticle

Abstract

Objective: To conduct a meta-analysis of the cost-utility of the cochlear implant in adults. Data Sources: MEDLINE literature search, review of article bibliographies, and consultation with experts. Study Selection: Studies that reported (1) data on adults (age ≥ 18 years) with bilateral, postlingual, profound deafness; (2) a health-utility gain from cochlear implantation on a scale from 0.00 (death) to 1.00 (perfect health); (3) a cost-utility ratio in terms of dollars per quality-adjusted life-year (QALY); and (4) at least 1 conventional statistical parameter (ie, SD, 95% confidence interval [CI], or P value). Data Extraction: From each study, we extracted the number of subjects, study design, health-utility instrument used, health- utility associated with profound deafness, health-utility gain from cochlear implantation, cost-utility of cochlear implantation, and reported statistical parameters. Data Synthesis: Weighted averages were calculated using a statistical weight of 1 per variance. Pooling 9 reports (n = 619), the health-utility of profoundly deaf adults without cochlear implants was 054 (95% CI, 0.52-0.56). Pooling 7 studies (n = 511), the health-utility of profoundly deaf adults after cochlear implantation was 0.80 (95% CI, 0.78- 0.82). This improvement of 0.26 in health-utility resulted in a cost-utility ratio of $12787 per QALY. Conclusions: Profound deafness in adults results in a substantial health-utility loss. Over half of that loss is restored after cochlear implantation, yielding a cost-utility ratio of $12787 per QALY. This figure compares favorably with medical and surgical interventions that are commonly covered by third-party payers in the United States today.

Original languageEnglish (US)
Pages (from-to)1214-1218
Number of pages5
JournalArchives of Otolaryngology--Head and Neck Surgery
Volume125
Issue number11
StatePublished - Nov 1999

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Cochlear Implants
Meta-Analysis
Cochlear Implantation
Costs and Cost Analysis
Health
Quality-Adjusted Life Years
Deafness
Confidence Intervals
Health Insurance Reimbursement
Information Storage and Retrieval
Bibliography
MEDLINE
Referral and Consultation
Weights and Measures

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Cost-utility of the cochlear implant in adults : A meta-analysis. / Cheng, André K.; Niparko, John K.

In: Archives of Otolaryngology--Head and Neck Surgery, Vol. 125, No. 11, 11.1999, p. 1214-1218.

Research output: Contribution to journalArticle

Cheng, André K. ; Niparko, John K. / Cost-utility of the cochlear implant in adults : A meta-analysis. In: Archives of Otolaryngology--Head and Neck Surgery. 1999 ; Vol. 125, No. 11. pp. 1214-1218.
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abstract = "Objective: To conduct a meta-analysis of the cost-utility of the cochlear implant in adults. Data Sources: MEDLINE literature search, review of article bibliographies, and consultation with experts. Study Selection: Studies that reported (1) data on adults (age ≥ 18 years) with bilateral, postlingual, profound deafness; (2) a health-utility gain from cochlear implantation on a scale from 0.00 (death) to 1.00 (perfect health); (3) a cost-utility ratio in terms of dollars per quality-adjusted life-year (QALY); and (4) at least 1 conventional statistical parameter (ie, SD, 95{\%} confidence interval [CI], or P value). Data Extraction: From each study, we extracted the number of subjects, study design, health-utility instrument used, health- utility associated with profound deafness, health-utility gain from cochlear implantation, cost-utility of cochlear implantation, and reported statistical parameters. Data Synthesis: Weighted averages were calculated using a statistical weight of 1 per variance. Pooling 9 reports (n = 619), the health-utility of profoundly deaf adults without cochlear implants was 054 (95{\%} CI, 0.52-0.56). Pooling 7 studies (n = 511), the health-utility of profoundly deaf adults after cochlear implantation was 0.80 (95{\%} CI, 0.78- 0.82). This improvement of 0.26 in health-utility resulted in a cost-utility ratio of $12787 per QALY. Conclusions: Profound deafness in adults results in a substantial health-utility loss. Over half of that loss is restored after cochlear implantation, yielding a cost-utility ratio of $12787 per QALY. This figure compares favorably with medical and surgical interventions that are commonly covered by third-party payers in the United States today.",
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