The Impact of Hearing Loss and Its Treatment on Health-Related Quality of Life Utility: a Systematic Review with Meta-analysis

Ethan D Borre; Kamaria Kaalund; Nicholas Frisco; Gloria Zhang; Austin Ayer; Margot Kelly-Hedrick; Shelby D Reed; Susan D Emmett; Howard Francis; Debara L Tucci; Blake S Wilson; Andrzej S Kosinski; Osondu Ogbuoji; Gillian D Sanders Schmidler

doi:10.1007/s11606-022-07795-9

The Impact of Hearing Loss and Its Treatment on Health-Related Quality of Life Utility: a Systematic Review with Meta-analysis

J Gen Intern Med. 2023 Feb;38(2):456-479. doi: 10.1007/s11606-022-07795-9. Epub 2022 Nov 16.

Authors

Ethan D Borre^{1

2

3}, Kamaria Kaalund², Nicholas Frisco¹, Gloria Zhang¹, Austin Ayer¹, Margot Kelly-Hedrick¹, Shelby D Reed^{3

4}, Susan D Emmett^{5

6}, Howard Francis⁶, Debara L Tucci⁷, Blake S Wilson^{5

6

8

9}, Andrzej S Kosinski¹⁰, Osondu Ogbuoji^{2

5

11}, Gillian D Sanders Schmidler^{12

13

14

15}

Affiliations

¹ Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA.
² Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA.
³ Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
⁴ Duke University Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
⁵ Duke Global Health Institute, Duke University, Durham, NC, USA.
⁶ Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA.
⁷ National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
⁸ Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
⁹ Department of Electrical & Computer Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA.
¹⁰ Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
¹¹ Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, USA.
¹² Department of Medicine, Duke University School of Medicine, 100 Fuqua Drive, Box 90120, Durham, NC, 27708, USA. gillian.sanders@duke.edu.
¹³ Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA. gillian.sanders@duke.edu.
¹⁴ Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA. gillian.sanders@duke.edu.
¹⁵ Duke University Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. gillian.sanders@duke.edu.

Abstract

Background: Hearing loss significantly impacts health-related quality of life (QoL), yet the effects of current treatments on QoL utility remain uncertain. Our objective was to describe the impact of untreated and treated hearing loss on QoL utility to inform hearing healthcare policy.

Methods: We searched databases for articles published through 02/01/2021. Two independent reviewers screened for articles that reported elicitation of general QoL utility values for untreated and treated hearing loss health states. We extracted data and quality indicators from 62 studies that met the inclusion criteria.

Results: Included studies predominately used observational pre/post designs (61%), evaluated unilateral cochlear implantation (65%), administered the Health Utilities Index 3 (HUI3; 71%), and were conducted in Europe and North America (84%). In general, treatment of hearing loss improved post-treatment QoL utility when measured by most methods except the Euro-QoL 5 dimension (EQ-5D). In meta-analysis, hearing aids for adult mild-to-moderate hearing loss compared to no treatment significantly improved HUI3-estimated QoL utility (3 studies; mean change=0.11; 95% confidence interval (CI): 0.07 to 0.14) but did not impact EQ-5D-estimated QoL (3 studies; mean change=0.0; 95% CI: -0.03 to 0.04). Cochlear implants improved adult QoL utility 1-year post-implantation when measured by the HUI3 (7 studies; mean change=0.17; 95% CI: 0.11 to 0.23); however, pediatric VAS-estimated QoL utility was non-significant (4 studies; mean change=0.12; 95% CI: -0.02 to 0.25). The quality of included studies was limited by failure to report missingness of data and low survey response rates. Our study was limited by heterogeneous study populations and designs.

Findings: Treatment of hearing loss significantly improves QoL utility, and the HUI3 and VAS were most sensitive to improvements in hearing. Improved access to hearing healthcare should be prioritized. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42021253314.

Keywords: cochlear implant; health state utility values; hearing aid; hearing loss; systematic review.

Publication types

Meta-Analysis
Systematic Review
Research Support, N.I.H., Extramural

MeSH terms

Adult
Child
Cochlear Implantation*
Cochlear Implants*
Hearing Loss*
Humans
Quality of Life

Abstract

Publication types

MeSH terms

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