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  1. Fang TY, Cheng LJ, Wu DB, Wang PC
    Int J Audiol, 2020 01;59(1):39-44.
    PMID: 31498005 DOI: 10.1080/14992027.2019.1658907
    Objective: The value of cochlear implantation (CI) has not been established in Taiwan. The purpose of this study was to evaluate the cost-effectiveness of paediatric CI within the context of Taiwan's national health insurance (NHI) programme.Design: A Markov model-based cost-utility analysis (CUA) was conducted to evaluate the cost-effectiveness of a unilateral CI (UCI) with a contralateral acoustic hearing aid (UCI-HA) compared with a bilateral HA. We performed one-way sensitivity analyses to identify the cost variables that affected the incremental cost-effectiveness ratio (ICER) the most. Monte Carlo simulation was used to explore the simultaneous effect of all uncertain parameters on cost-effectiveness.Study sample: Not applicable.Results: Compared with bilateral HAs, the ICER for UCI-HA was $6487 per quality-adjusted life year (QALY) gained. The ICERs were consistently below $7000 per QALY gained and were most sensitive to the selling price of the external CI device. When this selling price increased by 10%, the ICER of UCI-HA would increase to $6954 per QALY gained. UCI-HA has a probability greater than 50% of being cost-effective if the cost-effectiveness threshold exceeds approximately $10,000 per QALY.Conclusions: Our analysis suggested that within the context of Taiwan's NHI programme, UCI is highly cost-effective for deaf children.
    Matched MeSH terms: Deafness/surgery
  2. Anis FN, Umat C, Ahmad K, Hamid BA
    Cochlear Implants Int, 2019 01;20(1):12-22.
    PMID: 30293522 DOI: 10.1080/14670100.2018.1530420
    OBJECTIVE: This study examined the patterns of recognition of Arabic consonants, via information transmission analysis for phonological features, in a group of Malay children with normal hearing (NH) and cochlear implants (CI).

    METHOD: A total of 336 and 616 acoustic tokens were collected from six CI and 11 NH Malay children, respectively. The groups were matched for hearing age and duration of exposure to Arabic sounds. All the 28 Arabic consonants in the form of consonant-vowel /a/ were presented randomly twice via a loudspeaker at approximately 65 dB SPL. The participants were asked to repeat verbally the stimulus heard in each presentation.

    RESULTS: Within the native Malay perceptual space, the two groups responded differently to the Arabic consonants. The dispersed uncategorized assimilation in the CI group was distinct in the confusion matrix (CM), as compared to the NH children. Consonants /ħ/, /tˁ/, /sˁ/ and /ʁ/ were difficult for the CI children, while the most accurate item was /k/ (84%). The CI group transmitted significantly reduced information, especially for place feature transmission, then the NH group (p 

    Matched MeSH terms: Deafness/surgery
  3. Goh BS, Fadzilah N, Abdullah A, Othman BF, Umat C
    Int J Pediatr Otorhinolaryngol, 2018 Feb;105:27-32.
    PMID: 29447813 DOI: 10.1016/j.ijporl.2017.11.024
    OBJECTIVES: Cochlear implant (CI) greatly enhances auditory performance as compared to hearing aids and has dramatically affected the educational and communication outcomes for profoundly deaf children. Universiti Kebangsaan Malaysia (UKM) pioneered CI program in 1995 in the South East Asia. We would like to report the long-term outcomes of UKM paediatric cochlear implantation in terms of: the proportion of children who were implanted and still using the device, the children's modes of communication, their educational placements, and their functional auditory/oral performance. We also examined the factors that affected the outcomes measured.

    STUDY DESIGN: This was a cross sectional observational study.

    METHODS: Two sets of questionnaires were given to 126 parents or primary caregivers of the implantees. The first set of questionnaire contained questions to assess the children's usage of CI, their types of education placement, and their modes of communication. The second set of questionnaire was the Parent's Evaluation Of Aural/Oral Performance of Children (PEACH) to evaluate the children's auditory functionality.

    RESULTS: Our study showed that among the implantees, 97.6% are still using their CI, 69.8% communicating orally, and 58.5% attending mainstream education. For implantees that use oral communication and attend mainstream education, their mean age of implantation is 38 months. This is significantly lower compared to the mean age of implantation of implantees that use non-oral communication and attend non-mainstream education. Simple logistic regression analysis shows age of implantation reliably predicts implantees (N = 126) would communicate using oral communication with odds ratio of 0.974, and also predict mainstream education (N = 118) with odds ratio of 0.967. The median score of PEACH rating scale is 87.5% in quiet, and this significantly correlates with an earlier age of implantation (r = -0.235 p = 0.048).

    CONCLUSIONS: UKM Cochlear Implant Program has achieved reasonable success among the pediatric implantees, with better outcomes seen in those implanted at the age of less than 4 years old.

    Matched MeSH terms: Deafness/surgery*
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