Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements

Azadeh Ebrahimi-Madiseh; Mansoureh Nickbakht; Robert H Eikelboom; Rebecca J Bennett; Peter L Friedland; Marcus D Atlas; Rebecca L Jessup

doi:10.1371/journal.pone.0285443

Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements

PLoS One. 2023 May 10;18(5):e0285443. doi: 10.1371/journal.pone.0285443. eCollection 2023.

Authors

Azadeh Ebrahimi-Madiseh^{1

2

3}, Mansoureh Nickbakht⁴, Robert H Eikelboom^{3

5

6}, Rebecca J Bennett^{3

4

5}, Peter L Friedland^{1

7}, Marcus D Atlas^{3

5}, Rebecca L Jessup^{8

9

10}

Affiliations

¹ UWA Medical School, The University of Western Australia, Perth, Australia.
² Telethon Speech and Hearing, Perth, Australia.
³ Ear Science Institute Australia, Perth, Australia.
⁴ Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
⁵ Center for Ear Sciences, The University of Western Australia, Perth, Australia.
⁶ Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
⁷ University of Notre Dame Australia, Perth, Australia.
⁸ School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
⁹ School of Medicine, Nursing and Health Sciences, Rural Health, Monash University, Melbourne, Australia.
¹⁰ Northern Health, Hospital Without Walls Service, Melbourne, Australia.

Abstract

Background: This study aimed to describe available evidence of cochlear implantation delivery arrangements in adults and the outcomes by which these service models are measured.

Methods: Scoping review of English language, primary studies conducted on adults (≥18 years) with ten or more subjects, published between January 2000 and June 2022, which assessed the effects of delivery arrangements of cochlear implantation were included. MEDLINE, EMBASE, CINAHL Plus, AMED, PsycINFO, LILACS, KoreaMed, IndMed, Cochrane CRCT, ISRCTN registry, WHO ICTRP and Web of Science were systematically searched. Included studies had to have a method section explicitly measure at least one of the Cochrane Effective Practice and Organization of Care (EPOC) outcome category. Criteria for systematic reviews and delivery arrangement category based on EPOC taxonomy was included in data extraction. Data was narratively synthesized based on EPOC categories.

Results: A total of 8135 abstracts were screened after exclusion of duplicates, of these 357 studies fulfilled the inclusion criteria. Around 40% of the studies investigated how care is delivered, focusing on quality and safety systems. New care pathways to coordinate care and the use of information and communication technology were emerging areas. There was little evidence on continuity, coordination and integration of care, how the workforce is managed, where care is provided and changes in the healthcare environment. The main outcome measure for various delivery arrangements were the health status and performance in a test.

Conclusion: A substantial body of evidence exists about safety and efficacy of cochlear implantation in adults, predominantly focused on surgical aspects and this area is rapidly growing. There is a lack of evidence on aspects of care delivery that may have more impact on patients' experience such as continuity, coordination and integration of care and should be a focus of future research. This would lead to a better understanding of how patient's view CI experience, associated costs and the value of different care models.

Copyright: © 2023 Ebrahimi-Madiseh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Review

MeSH terms

Adult
Cochlear Implantation*
Costs and Cost Analysis
Delivery of Health Care
Humans
Outcome Assessment, Health Care
Systematic Reviews as Topic

Grants and funding

The authors did not receive funding for this work. RJ Bennett and M Nickbakht were funded by a Raine/Cockell Fellowship grant through the Raine Medical Research Foundation, The University of Western Australia during completion of this study. The funding source has had no impact on the integrity of the outcome. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.