Systematic reviews of the effectiveness and cost-effectiveness of multi-channel unilateral cochlear implants for adults

Clin. Otolaryngol. 2010, 35 , 87–96 Objective: In the UK approximately 3% of over 50 years olds and 8% of over 70 year olds have severe (794–94 dBHL) to deafness. As deafness increased, hearing aids become increasingly ineffective. Cochelear implants can provide an alternative treatment. Objective of review: To bring together the research evidence through the robustness of a systematic review of the effectiveness of unilateral cochlear implants for adults. We also sought to systematically review the published literature on cost-effectiveness. Types of review: Systematic review. Search strategy: This examined 16 electronic databases, plus bibliographies and references for published and unpublished studies from inception to june 2009. Evaluation method: Abstracts were independently assessed against inclusion criteria by two researchers were compared and disagreements resolved. Included papers were then retrieved and further independently assessed in a similar way. Remaining studies had their data independently extracted by one of five reviewers and checked by another reviewer. Results: From 1,580 titles and abstracts nine studies were included. These were of variable quality; some study's results should be viewed with caution. The studies were too hetrogeneous to pool the data. However, overall the results firmly supported the use of unilateral cochler implants for severe to profoundly deaf adults. Additionally, four UK based economic evaluations found unilateral cochlear implants to be cost-effectivene in adults at UK implants centres. Conclusion: The methodologically weak but universally positive body of effectiveness evidence supports the use of unilateral cochlear implants in adults. Previous economic evaluations indicate that such implants are likely to be cost-effective.