A New Quality-of-Life Instrument to Assess Functional Outcomes of Cochlear Implantation in Adults

项目总结/摘要 髋关节植入术是治疗双侧重度至极重度感觉神经性麻痹患者的标准治疗方法。 听力损失根据人工耳蜗（CI）适应症的变化和患有人工耳蜗植入术的成年人数量的增加， 由于人口老龄化导致的听力损失，每年进行的成人CI的数量持续增加。CI 结果主要是通过单词和句子识别来评估的，虽然这很重要，但并不 捕捉CI用户多样化的聆听和沟通体验。此外，使用 这些测试组合通常与CI用户对真实世界通信的自我报告相关性很差， 其他能力。缺乏普遍接受的CI特异性患者报告结局指标（PROM）， 评估功能结果和生活质量（QOL）是进一步了解 其中人工耳蜗植入影响成年CI的沟通、社交、情感和其他体验 用户.这项研究的长期目标是将与人工耳蜗植入相关的成果扩展到 那些由语音识别狭义定义的，以提供更全面的理解， 人工耳蜗植入会影响其使用者。本提案的总体目标是确定 通过应用我们新的疾病特异性CI-QOL， 仪器我们的中心假设是，CI用户不仅受益于改善的沟通， 显示在社会、情感和其他CI相关QOL领域的改善，这些领域共同改善了他们的 一般健康相关QOL。基于令人信服的初步结果，我们的假设将通过 完成两个具体目标：1）确定患者人口统计学和听力相关因素的贡献 通过新开发的QOL工具与传统QOL工具的心理测量学比较， 评估CI-QOL领域、功能结局指标和 一般健康相关QOL。目标1将通过一项大型人群横断面研究完成。在Aim中 2、受试者将完成新的CI-QOL量表，功能结局测量对应6项 CI-QOL工具和一般健康相关QOL工具的领域，植入前和 在植入后的前12个月内，这项工作具有创新性，因为它应用了新的CI-QOL 这是一个使用理论框架和方法开发的工具， 适用于成年CI人群。此外，我们的纵向研究是创新的，因为它评估的程度， 其中每个CI-QOL域与功能能力和人工耳蜗植入对一般 健康相关QOL。这些结果还将为未来的研究提供关键的初步数据， 识别影响CI结果的个体患者特征，制定患者特定策略， 性能改进的理由（如新的植入技术、听音方式， 处理策略），并更好地估计CI的健康效用和经济影响。

PROJECT SUMMARY/ABSTRACT Cochlear implantation is the standard of care for patients with bilateral severe-to-profound sensorineural hearing loss. Based on changing cochlear implant (CI) indications and increased numbers of adults with hearing loss due to an aging population, the number of adult CIs performed annually continues to increase. CI outcomes are primarily assessed using word and sentence recognition, which, although important, do not capture the diverse listening and communication experiences of CI users. Moreover, outcomes reported using these test batteries are often are poorly correlated with CI user self-report of real-world communication and other abilities. The lack of a universally accepted CI-specific patient reported outcome measure (PROM) to assess functional outcomes and quality of life (QOL) is a critical barrier to further our understanding of the way in which cochlear implantation influences communication, social, emotional, and other experiences of adult CI users. The long term goal of this research is to expand outcomes related to cochlear implantation beyond those narrowly defined by speech recognition, to provide a more comprehensive understanding of how cochlear implantation impacts its users. The overall objective of the current proposal is to determine the impact of cochlear implantation on patient QOL through the application of our new, disease-specific CI-QOL instrument. Our central hypothesis is that CI users not only benefit from improved communication, but also show improvements in social, emotional, and other CI-related QOL domains that together improve their general health-related QOL. Based on compelling preliminary results, our hypothesis will be tested by completing two specific aims: 1) Determine the contribution of patient demographic and hearing-related factors to CI-QOL through the psychometric comparison of the newly developed QOL instrument against legacy measures; and 2) Assess the relationships between CI-QOL domains, functional outcome measures, and general health-related QOL. Aim 1 will be completed through a large population cross-sectional study. In Aim 2, participants will complete the new CI-QOL instrument, functional outcome measures corresponding to the 6 domains of CI-QOL instrument, and a general health-related QOL instrument, before implantation and at intervals throughout the first 12 months post implantation. This work is innovative as it applies a new CI-QOL instrument that has been developed using a theoretical framework and approaches that have never been applied to the adult CI population. Additionally, our longitudinal study is innovative as it evaluates the degree to which each CI-QOL domain relates to functional abilities and the impact of cochlear implantation on general health-related QOL. The results will also provide critical preliminary data for future research aimed at identifying individual patient characteristics that impact CI outcomes, developing patient-specific strategies and rationale for performance improvements (such as new implantation techniques, listening modalities, and processing strategies), and making better estimates of the health utility and economic impact of CIs.