Ten-year health-related quality of life in cochlear implant recipients: prospective SF-36 data with SF-6D conversion.

Abstract

To evaluate the long-term impact of cochlear implantation on quality of life measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Scores were also converted to the SF-6D to derive health utility scores. Prospective cohort study. Thirty-two patients undergoing cochlear implantation completed the SF-36 preoperatively, 1 year, and 10 years after cochlear implantation. SF-36 results showed improvements in seven of the eight attributes when preoperative scores where compared with 1- and 10-year results. Between 1 and 10 years postoperatively, six of eight domains deteriorated in scores. When converted to the SF-6D, the mean preoperative utility scores were 0.592 for standard gamble, 0.636 using the ordinal health state paradigm, and 0.579 using the Bayesian technique. Ten years postoperatively, health utility scores were 0.643 (standard gamble), 0.684 (ordinal health state), and 0.6 (Bayesian). Between preoperatively and 10-year postoperatively, improvements were therefore 0.051, 0.048, and 0.021 for standard gamble, ordinal health state, and Bayesian paradigm, respectively. This study establishes the long-term sustained benefits of cochlear implantation on quality of life. Nevertheless, both the SF-36 and SF-6D seem to underestimate the benefit accrued through this intervention. Our data are consistent with others regarding the unsuitability of the SF-36 in benefit assessment, notwithstanding that conversion to the SF-6D is feasible, and the SF-6D seemed to better depict possible benefits from cochlear implantation as compared to the SF-36.