Implementation of the International Classification of Functioning, Disability and Health model in cochlear implant recipients: a multi-center prospective follow-up cohort study

E. Andries, A. Lorens, P. Skarżyński, H. Skarżyńśki, M. Calvino, Javier Gavilán, L. Lassaletta, Dayse Tȧvora-Vieira, A. Acharya, A. Kurz, Rudolf Hagen, Ilona Anderson, Edda Amann, P. Van de Heyning, V. van Rompaey, G. Mertens
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Abstract

No standard protocol based on a multidisciplinary framework currently exists for the evaluation, follow-up and interpretation of Cochlear Implant (CI) outcomes in clinical routine. Therefore, this study aimed to develop and clinically implement a multidimensional Cochlear Implant (CI) outcome assessment protocol for adult CI users based on the International Classification of Functioning, Disability and Health (ICF).An international multidisciplinary core group of CI experts selected the most relevant ICF categories and codes for adult CI users out of the existing ICF core set for hearing loss. A well-known, commonly used instrument or method was identified and assigned to each ICF category along with quantified ICF qualifiers. These qualifiers facilitate the interpretation of CI outcomes by categorizing the outcome on a rating scale between 0 and 4, based on the severity of participants' impairment/restriction/limitation/barrier. The ICF-based CI outcome assessment protocol was applied in clinical routine in a prospective longitudinal multicenter study assessing a consecutive sample of 72 adult CI candidates before and 6 months after implantation. For each relevant ICF category, the participants' improvement, stability or deterioration was specified in a descriptive approach using ICF qualifiers.Participants either showed improved or stable ICF qualifiers after cochlear implantation across all ICF domains (e.g., Body Functions and Structures, Activities, and Participation and Environmental factors). The ICF qualifiers for environmental sound tolerance (n = 30 [45%]) and vestibular functions (n = 21 [33%]) deteriorated most frequently after implantation. ICF qualifiers for falling (n = 53 [83%]) and dizziness (n = 40 [62%]) remained stable in most participants. Auditory perception-related and communication-related categories generally improved in most participants after cochlear implantation, with 46 to 73% (n = 34 to n = 48) of CI users perceiving an improvement postoperatively.This study is the first to propose and apply a ready-to-use CI outcome assessment protocol based on the ICF model, which provides a common language and comprehensive assessment protocol for the description and measurement of CI outcomes worldwide. Its straightforward outcome description and rating enables CI outcome interpretation by non-experts, enhancing multidisciplinary communication and knowledge on individual healthcare needs in CI users.
国际功能、残疾和健康分类模型在人工耳蜗受者中的实施:一项多中心前瞻性随访队列研究
目前还没有基于多学科框架的标准方案来评估、随访和解释临床常规人工耳蜗(CI)的结果。因此,本研究旨在根据国际功能、残疾和健康分类(ICF)为成人人工耳蜗使用者制定并临床实施一项多维度人工耳蜗(CI)结果评估方案。一个由CI专家组成的国际多学科核心小组从现有的听力损失ICF核心集中为成人CI用户选择了最相关的ICF类别和代码。确定了一种众所周知的常用仪器或方法,并将其与量化的ICF限定符一起分配给每个ICF类别。这些限定词通过根据参与者的损伤/限制/限制/障碍的严重程度,在0到4之间对结果进行分类,从而促进了CI结果的解释。在一项前瞻性纵向多中心研究中,基于icf的CI结果评估方案应用于临床常规,评估了72名成人CI候选人在植入前和植入后6个月的连续样本。对于每个相关的ICF类别,参与者的改善、稳定或恶化使用ICF限定词以描述性方法指定。受试者在人工耳蜗植入后的所有ICF领域(如身体功能和结构、活动、参与和环境因素)均表现出改善或稳定的ICF资格。ICF环境声音耐受性(n = 30[45%])和前庭功能(n = 21[33%])在植入后最常恶化。跌倒(n = 53[83%])和头晕(n = 40[62%])的ICF限定值在大多数参与者中保持稳定。大多数参与者在人工耳蜗植入后,听觉感知相关和沟通相关的类别普遍改善,46%至73% (n = 34至n = 48)的CI使用者术后感觉有所改善。本研究首次提出并应用了基于ICF模型的即用型CI结果评估方案,为全球CI结果的描述和测量提供了一种通用语言和综合评估方案。其直接的结果描述和评级使非专家能够解释CI结果,从而增强了CI用户中关于个人医疗保健需求的多学科交流和知识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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