Résumé :
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[BDSP. Notice produite par INIST o9R0x0su. Diffusion soumise à autorisation]. Context Barriers to the use of cochlear implants in children with profound deafness include device costs, difficulty assessing benefit, and lack of data to compare the implant with other medical interventions. Objective To determine the quality of life and cost consequences for deaf children who receive a cochlear implant. Design Cost-utility analysis using preintervention, postintervention, and cross-sectional surveys conducted from July 1998 to May 2000. Setting Hearing clinic at a US academic medical center. Participants Parents of 78 profoundly deaf children (average age, 7.5 years) who received cochlear implants. Main Outcome Measures Direct and total cost to society per quality-adjusted life-year (QALY) using the time-trade-off (TTO), visual analog scale (VAS), and Health Utilities Index-Mark III (HUI), discounting costs and benefits 3% annually. Parents rated their child's health state at the time of the survey and immediately before and 1 year before implantation. Results Recipients had an average of 1.9 years of implant use. Mean VAS scores increased by 0.27, from 0.59 before implantation to 0.86 at survey. In a subset of participants, TTO scores increased by 0.22, from 0.75 to 0.97 (n=40) and HUI scores increased by 0.39, from 0.25 to 0.64 (n=22). Quality-of-life scores were no different 1 year before and immediately before implantation. (...)
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