Abstract：
OBJECTIVE: To determine the cost-effectiveness or cost-utility of cochlear implants (CI) in adults with severe to profound bilateral hearing loss.
UNASSIGNED: PubMed (Medline), The Cochrane Library, Embase via Elsevier, EBSCOhost CINAHL, and Scopus.
METHODS: The study included adult participants with severe to profound bilateral neurosensory hearing loss. The analysis encompassed quality of life improvements, costs, cost-effectiveness, cost-utility, cost-benefit, quality-adjusted life year (QALY), incremental cost-effectiveness ratio (ICER), and incremental cost-utility ratio (ICUR). Systematic reviews, meta-analyses, case series, and prospective or retrospective cohort studies published in English between 2010 and 2023 were retrieved. Exclusion criteria included incomplete studies, abstracts, clinical cases, editorials, letters, studies involving pediatric populations, single-side deafness, methodology research, noneconomic aspects of CI, mixed child and adult data, and studies published before 2010. The risk of bias was assessed following the criteria outlined in Appendix I of the economic evaluation\'s quality assessment as per the NICE Guideline Development Method.
RESULTS: Ten articles met the criteria and were included in the qualitative synthesis. One study conducted a prospective cost-utility analyses, one carried out a cost-benefit analyses, one was a randomized controlled clinical trial focusing on cost-utility, and another was a clinical trial addressing cost-effectiveness. Six studies employed Markov models, and one study utilized uniquely the Monte Carlo method. None quantified the economic impact of improved hearing on cognitive function.
CONCLUSIONS: The heterogeneity of sources impacted data quality. Unilateral and sequential bilateral CI appeared to be cost-effective when compared with bilateral hearing aids or nontechnological support. When properly indicated, simultaneous bilateral CIs are cost-effective compared to no interventions and to unilateral cochlear implantation through differential discounting or variations from the base cases, especially with a life expectancy of 5-10 years or longer.
UNASSIGNED: PubMed (Medline), The Cochrane Library, Embase via Elsevier, EBSCOhost CINAHL, and Scopus.
METHODS: The study included adult participants with severe to profound bilateral neurosensory hearing loss. The analysis encompassed quality of life improvements, costs, cost-effectiveness, cost-utility, cost-benefit, quality-adjusted life year (QALY), incremental cost-effectiveness ratio (ICER), and incremental cost-utility ratio (ICUR). Systematic reviews, meta-analyses, case series, and prospective or retrospective cohort studies published in English between 2010 and 2023 were retrieved. Exclusion criteria included incomplete studies, abstracts, clinical cases, editorials, letters, studies involving pediatric populations, single-side deafness, methodology research, noneconomic aspects of CI, mixed child and adult data, and studies published before 2010. The risk of bias was assessed following the criteria outlined in Appendix I of the economic evaluation\'s quality assessment as per the NICE Guideline Development Method.
RESULTS: Ten articles met the criteria and were included in the qualitative synthesis. One study conducted a prospective cost-utility analyses, one carried out a cost-benefit analyses, one was a randomized controlled clinical trial focusing on cost-utility, and another was a clinical trial addressing cost-effectiveness. Six studies employed Markov models, and one study utilized uniquely the Monte Carlo method. None quantified the economic impact of improved hearing on cognitive function.
CONCLUSIONS: The heterogeneity of sources impacted data quality. Unilateral and sequential bilateral CI appeared to be cost-effective when compared with bilateral hearing aids or nontechnological support. When properly indicated, simultaneous bilateral CIs are cost-effective compared to no interventions and to unilateral cochlear implantation through differential discounting or variations from the base cases, especially with a life expectancy of 5-10 years or longer.
摘要：
目的：确定成人重度至重度双侧听力损失的人工耳蜗（CI）的成本效益或成本效用。
■PubMed（Medline），科克伦图书馆,Embase通过Elsevier，EBSCOhostCINAHL,还有Scopus.
方法：该研究包括患有严重至深度双侧神经感觉性听力损失的成年参与者。分析包括生活质量的改善，成本,成本效益，成本效用，成本效益,质量调整寿命年(QALY)，增量成本效益比(ICER)，和增量成本效用比(ICUR)。系统审查，荟萃分析，案例系列,并检索了2010年至2023年间以英文发表的前瞻性或回顾性队列研究.排除标准包括不完整的研究，摘要,临床病例,社论,信件,涉及儿科人群的研究，单侧耳聋,方法论研究，CI的非经济方面，儿童和成人混合数据，和2010年之前发表的研究。根据NICE指南开发方法，按照经济评估质量评估附录I中概述的标准评估偏差风险。
结果：十篇文章符合标准，被纳入定性综合。一项研究进行了前瞻性成本效用分析，一个人进行了成本效益分析，一项是随机对照临床试验，重点是成本效用，另一项是针对成本效益的临床试验.六项研究采用马尔可夫模型，一项研究独特地利用了蒙特卡罗方法。没有人量化听力改善对认知功能的经济影响。
结论：来源的异质性影响了数据质量。与双侧助听器或非技术支持相比，单侧和序贯双侧CI似乎具有成本效益。当正确指示时，与没有干预措施和通过差异折扣或基础病例的差异进行单侧人工耳蜗植入相比，同时进行双侧CI具有成本效益，特别是预期寿命为5-10年或更长。
■PubMed（Medline），科克伦图书馆,Embase通过Elsevier，EBSCOhostCINAHL,还有Scopus.
方法：该研究包括患有严重至深度双侧神经感觉性听力损失的成年参与者。分析包括生活质量的改善，成本,成本效益，成本效用，成本效益,质量调整寿命年(QALY)，增量成本效益比(ICER)，和增量成本效用比(ICUR)。系统审查，荟萃分析，案例系列,并检索了2010年至2023年间以英文发表的前瞻性或回顾性队列研究.排除标准包括不完整的研究，摘要,临床病例,社论,信件,涉及儿科人群的研究，单侧耳聋,方法论研究，CI的非经济方面，儿童和成人混合数据，和2010年之前发表的研究。根据NICE指南开发方法，按照经济评估质量评估附录I中概述的标准评估偏差风险。
结果：十篇文章符合标准，被纳入定性综合。一项研究进行了前瞻性成本效用分析，一个人进行了成本效益分析，一项是随机对照临床试验，重点是成本效用，另一项是针对成本效益的临床试验.六项研究采用马尔可夫模型，一项研究独特地利用了蒙特卡罗方法。没有人量化听力改善对认知功能的经济影响。
结论：来源的异质性影响了数据质量。与双侧助听器或非技术支持相比，单侧和序贯双侧CI似乎具有成本效益。当正确指示时，与没有干预措施和通过差异折扣或基础病例的差异进行单侧人工耳蜗植入相比，同时进行双侧CI具有成本效益，特别是预期寿命为5-10年或更长。
