title: Effectiveness of multi-channel unilateral cochlear implants for profoundly deaf children: a systematic review.
abstract: BACKGROUND
  Annually an estimated 223 children in the UK are born with or acquire permanent profound bilateral deafness (PBHL >or= 95 dB). These children may gain little or no benefit from acoustic hearing aids. However, cochlear implants might enable them to hear.
  
  
  OBJECTIVE
  To bring together the diverse research in this area under the rigor of a systematic review to discover the strength of evidence when comparing the effectiveness of unilateral cochlear implants with non-technological support or acoustic hearing aids in children with PBHL.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  This examined 16 electronic data bases, plus bibliographies and references for published and unpublished studies.
  
  
  METHODS
  Abstracts were independently assessed against inclusion criteria by two researchers, results 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 abstracts and titles 15 studies were included. These were of moderate to poor quality. The large amount of heterogeneity in design and outcomes precluded meta-analysis. However, all studies reported that unilateral cochlear implants improved scores on all outcome measures. Additionally five economic evaluations found unilateral cochlear implants to be cost-effective for profoundly deaf children at UK implant centres.
  
  
  CONCLUSIONS
  The robustness of systematic review methods gives weight to the positive findings of 15 papers reporting on this subject that they individually lack; while an RCT to show this would be unethical.
authors.affiliation: Peninsula Medical School, University of Exeter, Plymouth, UK. mary.bond@pms.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Bond
authors.forename: J
authors.initials: J
authors.lastname: Elston
authors.forename: S
authors.initials: S
authors.lastname: Mealing
authors.forename: R
authors.initials: R
authors.lastname: Anderson
authors.forename: G
authors.initials: G
authors.lastname: Weiner
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
authors.forename: Z
authors.initials: Z
authors.lastname: Liu
authors.forename: K
authors.initials: K
authors.lastname: Stein
mesh_terms: D002648:Child; D019929:Cochlear Implantation / Q000295:instrumentation*; D003638:Deafness / Q000534:rehabilitation*; D006801:Humans; D011474:Prosthesis Design; D011788:Quality of Life; D012720:Severity of Illness Index