title: Quality of life in cochlear implantees: comparing utility values obtained through the Medical Outcome Study Short-Form Survey-6D and the Health Utility Index Mark 3.
abstract: OBJECTIVE
  To evaluate the changes in health-related quality of life in unilateral adult cochlear implant patients using the Medical Outcome Study Short-Form Survey-36 (SF-36) and the Health Utility Index Mark 3 (HUI-3). To do so, a health utility index was obtained by converting the SF-36 to the Medical Outcome Study Short-Form Survey-6D (SF-6D) to permit comparison with HUI-3 scores in the context of health preference as measured by quality-adjusted life years.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Eighty-one postlingually deaf adult patients undergoing cochlear implantation completed the SF-36 and HUI-3 preoperatively and at a median of 1.4 years (range, 11 months-5 years) after cochlear implantation.
  
  
  RESULTS
  The SF-36 improvement was statistically significant in two domains. The SF-36 data were converted to SF-6D. Preoperatively, the mean SF-6D utility score was 0.575 ± 0.056. One year postoperatively this score increased to 0.590 ± 0.064. The improvement of 0.015 ± 0.082 was not statistically significant (P = .1118). Of the HUI-3 attributes, two showed improvement between preoperative and postoperative evaluations. The overall HUI-3 score increased from 0.464 ± 0.207 preoperatively to 0.611 ± 0.190 postoperatively. The gain of 0.146 ± 0.19 was statistically significant (P < .0001). The intraclass correlation coefficient between the SF-6D and HUI-3 showed a very small correlation, both pre- and postoperatively.
  
  
  CONCLUSIONS
  Against the backdrop of diminishing resources for healthcare, cost-effective analysis is fast becoming an important tool. There remains a strong need for health-related quality-of-life instruments that can truly reflect the benefit of cochlear implantation, in which utility estimates are fundamentally important. The SF-36 scores, when converted to SF-6D, do not correlate well with HUI-3 scores in a cohort of adult cochlear implant recipients. The HUI-3 remains the most appropriate tool for this patient group.
  
  
  METHODS
  4
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Christoph
authors.initials: C
authors.lastname: Arnoldner
authors.forename: Vincent Y
authors.initials: VY
authors.lastname: Lin
authors.forename: Richard
authors.initials: R
authors.lastname: Bresler
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kaider
authors.forename: Jafri
authors.initials: J
authors.lastname: Kuthubutheen
authors.forename: David
authors.initials: D
authors.lastname: Shipp
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019929:Cochlear Implantation / Q000379:methods* / Q000523:psychology*; D003054:Cochlear Implants; D015331:Cohort Studies; D003638:Deafness / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Hearing; cochlear implant; cost benefit; quality of life; questionnaire