EXECUTIVE SUMMARY Academic in Confidence data removed
|
|
- May Gibson
- 5 years ago
- Views:
Transcription
1 EXECUTIVE SUMMARY Academic in Confidence data removed Cochlear Europe Limited supports this appraisal into the provision of cochlear implants (CIs) in England and Wales. Inequity of access to CIs is a critical issue, with demonstrable differences between regions and disparity occurring based on age. Evidence clearly supports the clinical and cost effectiveness of CIs in adults and children with bilateral severe to profound sensorineural hearing loss who receive limited or no benefit from hearing aids (HAs). Despite this, the current level and method of provision remains inadequate. Many children and adults who could benefit from CIs are unable to gain access within the NHS current target waiting time of 18-weeks. Lack of funding is of major concern, even for unilateral implants and particularly for adults. Many centres in England are provided with insufficient funds by budget holders to cover CIs for both adults and children, resulting in the prioritisation of children over adults. Of particular concern, the Welsh Assembly Government has completely stopped funding adult cochlear implantation. Virtually no bilateral implants are funded for children or adults. Due to the current level of funding, penetration (in terms of prevalence) is low, at 1% for adults and 50% for children, and overall only 5% of these are bilaterals. In an examination of CI recipients per million population, the UK has 52 implanted children per million population and 45 implanted adults. These overall numbers are significantly lower than that of other major European countries, with 52 children and 78 adults for Sweden, and 65 children and 53 adults for Germany. When looking specifically at the availability of paediatric bilaterals, the rate of 5% for this group compares unfavourably with estimated rates of 70% in Sweden and 85% in Norway, where bilateral implantation, rather than unilateral implantation, is now rapidly becoming the default for children. There is an urgent requirement for these issues to be addressed in England and Wales. In order to improve patient care, it is essential that the current level of service provision is increased and postcode variation removed. Improving provision over the next 5 years to ensure that all eligible children are funded for implantation and the provision for adults is increased by approximately 30% would result in a total increase in the NHS budget of 9.5 million in Year 1 rising to 65.8 million in Year 5. Penetration would then start to rise towards 7.5% for eligible adults and approach 100% for eligible children. Introduction to deafness There are approximately 613,000 severely or profoundly deaf adults in England and Wales. Prevalence increases with age, with 3% of those over 50 years of age and 8% of those over 70 being severely to profoundly deaf. It is likely that these figures will increase in line with the current ageing population. An estimated 646 children are born in the UK with severe to profound deafness. In children prevalence increases with age with approximately one in every 1,000 children being severely or profoundly deaf at 3 years of age, rising to 2 in every 1,000 children aged 9 to 16 years. Burden of deafness Severe to profound deafness has an impact on a number of areas for both children and adults. Disability ranges from being unable to hear everyday sounds to difficulty in understanding speech at conversational levels and in any level of background noise. A child with severe to profound hearing loss does not receive sufficient sound input and as a consequence, experiences difficulty in hearing language (receptive skills) and developing spoken language (expressive skills), both of which severely impact on the child s communication skills, educational placement and attainment and quality of life. Adults with moderate to profound deafness experience high levels of unemployment and one third rely on government benefits. In addition, in adults who become profoundly deaf the loss of hearing and the associated loss in the ability to communicate have a major impact on their quality of life including their ability to participate in family and community life. Cochlear Implants CIs are individually programmed devices designed to increase the patient s audible threshold level and provide the patient with hearing sensitivity within the normal speech range. A major objective of cochlear implantation is to improve the patient s capacity for understanding speech (speech perception) and for being understood while speaking. A further objective in children is to enable acquisition and retention of speech and language at an age appropriate rate.
2 A range of CIs are currently available that vary on a range of factors including: the reliability of the internal device, processing of sound input, coding of this sound into speech signals, the safety and design of the electrode that delivers these sounds to the cochlea and the cosmetic appearance and usability of the speech processor. Of these, reliability is an important issue for patients, clinicians and budget holders. A high degree of reliability required to avoid both patient distress and the issues and costs associated with device failure and subsequent. Reliability for CIs as a collective group is approximately 92% but does vary considerably between devices. Binaural hearing is an essential goal in providing patients access to sound. The current practice of funding only unilateral implantation provides a unilateral hearing solution for what is a bilateral hearing loss condition. For those patients for whom a contralateral HA is not suitable, bilateral CIs are the only way to provide effective binaural hearing. Bilateral implants can provide significant benefits over a unilateral implant in both adults and children. Speech perception is improved in typical noisy environments as it enables the patient to localise sound, which is critical in employment and educational settings. Benefits of CIs The benefits of CIs in children and adults are considerable and in both groups include improved hearing, speech perception and quality of life. In children additional benefits include improvements in speech production, expressive and receptive language and reading. Studies have also demonstrated the benefits of cochlear implantation in enabling children to enter and succeed in mainstream schooling. A deaf child attending a mainstream school limits the additional cost of educational support required compared with attendance at a special (non mainstream) school. Long term benefits relate to the superior educational outcomes achieved by children and improvements in the level of employment in adults. In both adults and children duration of deafness inversely correlates with outcome; the longer the duration of deafness the poorer the outcome. Patients therefore need to be implanted as soon as possible following diagnosis. In children, strong evidence supports implantation at an early age with children implanted before the age of 2 years both outperforming children implanted at an older age and having the capacity to produce and understand language at a rate and level equal to that of their normally-hearing peers. Current service provision Within England and Wales CIs are currently provided by 20 centres. Within each of these centres clinical management involves four phases: patient selection, surgical implantation, initial tuning and rehabilitation and ongoing maintenance. Patients receive all four phases at a single centre with treatment provided by a multidisciplinary team comprising of physicians, audiologists speech-language therapists, pathologists and rehabilitation specialists. As aforementioned, there is a disparity in the level of service provision across England and Wales. No guidelines exist for service provision and future emphasis must be placed on ensuring a consistent quality of service throughout all centres. Nucleus cochlear implants Nucleus CIs were the first of the multichannel CIs to be developed and commercially released and as a result have the longest efficacy and reliability history. To date over 84,000 patients have received a Nucleus implant worldwide. Following the development of the first Nucleus implant in 1978 there has been a continual improvement of implant systems and speech processor programmes. New systems have been designed with the capacity to implement advanced speech processing technology, to work with improved battery technologies and with options for miniaturising the external sound processor. Cochlear has demonstrated a commitment to developing new speech processors that are compatible with older implants, providing existing patients with the opportunity to upgrade and achieve improved audiological outcomes, an important consideration for budget holders. Currently marketed Nucleus systems include: Nucleus Freedom implant with a straight or curly electrode array, together with Freedom Speech processor (BTE and/or BWP option) Nucleus 24 Double Array implant with a split electrode array, together with SPrint, ESPrit 3G or Freedom Speech processor. This implant is indicated only for patients with cochlear ossification/obliteration.
3 Nucleus Freedom Device benefits and features Nucleus Freedom is the most recent Nucleus system, consisting of a new implant, a new range of external modular speech processors and advanced programming software. Both the implant and speech processor have a number of key features that provide additional benefits to the patient and/or clinician. The implant demonstrates a high level of reliability with cumulative survival percentages of 100% in adults and 99.8% in children at 1.5 years. In addition, the Nucleus Freedom implant is the only CI to provide the clinician with automated Neural Response Telemetry (AutoNRT TM ) that automatically measures electrical thresholds from the auditory nerve in situ and allows the clinician to create an audible program (MAP) before the patient s first programming session and removes reliance on the patient having to provide feedback on threshold levels. AutoNRT is useful for children and difficult-to-fit patients where it is difficult to obtain the required threshold and comfort levels for MAP creation. Both NRT and AutoNRT have been shown to reduce the clinic time required to produce a MAP for the speech processor. The modular Freedom speech processor is available as a body worn, behind the ear (BTE) or mini BTE and provides the patient with a range of flexible speech processing options including SmartSound TM pre-processing, a range of stimulation rates and modes, and a range of speech coding strategies. In clinical studies 67% of patients preferred using slower rates of stimulation when compared to higher rates of stimulation for speech understanding with no statistical difference observed in speech perception scores with the different rates of stimulation. SmartSound TM is a collection of four intelligent input processing technology options which gives patients access to clearer sound in a range of noisy and quiet everyday situations providing additional listening advantages over standard programmes. Each of these options can be tailored to suit the individual s listening needs ensuring maximum hearing benefit in a wide range of listening environments. In clinical studies 85% of patients demonstrated a preference for using SmartSound pre-processing options in noisy situations in order to improve their speech perception. Nucleus Clinical Effectiveness Post-lingual Adults Unilateral CIs Nucleus unilateral implants are clinically effective in improving patients speech perception with patients showing an increase both in word and sentence recognition score tests after implantation. The benchmark study for the current Nucleus implant system (Nucleus Freedom) evaluated postlinguistic adults with bilateral severe-to-profound sensorineural hearing loss with no congenital component. Selection criteria for the trial included: Consonant-Nucleus-Consonant (CNC) word recognition scores of 30% in the best aided condition or Hearing in Noise Test in quiet (HINT-Q) scores of 50% in the ear to be implanted and 60% in the best aided condition. This was the first trial where candidacy inclusion was based on pre-operative CNC word scores rather than sentence scores and as a consequence. CNC word scores in quiet (at 60 db SPL) increased from XXXXXXXXXXXX 3-months postimplantation. The Freedom study was the first time in the history of CIs that CNC word scores above 50% have been achieved by severe to profound users after only 3-months of device use. In line with Cochlear s continuing development programme, the audiological outcomes achieved with Nucleus Freedom were superior compared with the previous Nucleus 24 Contour system: o o Speech understanding (defined as CNC monosyllabic word scores presented at 70 db SPL) in quiet was significantly higher with Nucleus Freedom compared with Nucleus 24 Contour at both 3- XXXXXXXXXXXXXXXXXXXXXXXXX post-implantation. The results for Nucleus Freedom at 3-months were significantly superior to the 6-month scores achieved with Nucleus 24 Contour (p<0.05). In addition to achieving improvements in speech perception, Nucleus implants have also been shown to improve patients quality of life compared with pre-implant levels. Bilateral implants Normal hearing listeners use binaural hearing everyday to understand speech in noisy or reverberant environments and to locate where sound is coming from. It is considered the standard of care to fit suitable patients with bilateral amplification however, while bilateral fittings in children and adults are accepted as standard in the provision of hearing aid (HAs), the provision of bilateral CIs is not. The
4 current practice of providing a unilateral solution for a bilateral condition is in stark contrast to other bilateral conditions as such orthopaedics and corneal grafts. In unilateral CI patients who have good performance with a HA in the non-implanted ear, bilateral auditory input can be obtained by fitting a conventional HA. For CI patients who have poor or no residual hearing in their non-implanted ear the only way to provide effective binaural hearing is with bilateral CIs. The benefits of Nucleus bilateral implants have been shown in adults, with bilateral implants resulting in improved subjective performance and speech recognition (in quiet and in noise) with improvements in speech perception over the unilateral ear in certain noisy listening conditions of up to 50%. Localisation ability is improved from a level where it is only possible to tell which side the sound is from to accuracy within 24 degrees of the actual sound location. Nucleus Clinical Effectiveness Pre-Lingual Children Unilateral CIs In profoundly hearing-impaired children Nucleus implants have been shown to improve speech perception, speech production, intelligibility and language development. In the original Nucleus 24 Contour study following 3-months of implant use: The mean scores for a closed-set speech perception test (ESP test) for children aged 25 months to 4 years (n=75) improved by 36.5% on pattern perception, 44.2% on spondee identification and 35.4% on monosyllable identification. In children 5 years and above (n=98) mean performance for a range of more challenging open-set speech perception tasks improved by 37.1% for the Glendonald Auditory Screening Procedure(GASP), 34.5% for the Lexical Neighbourhood Test (LNT) word recognition and 49.5% for the Hearing in Noise Test (HINT). In addition compared with children with no pre-operative speech perception ability, children with residual hearing pre-operatively demonstrated significantly greater improvements in LNT word recognition post-operatively (p=0.28 at 3-months and p=0.038 at 6-months). Age at implantation has been shown to inversely correlate strongly with the degree of outcome benefits achieved. Children implanted with a Nucleus implant before the age of 2 years show better speech perception and production when compared with those implanted at an older age and may attain normal language skills. However, children implanted after the age of 2 years still gain benefit from a Nucleus implant with evidence that over 50% of those implanted before the age of 5 years exhibit age appropriate language skills similar to those of normal hearing children. Bilateral implants Bilaterally implanted children demonstrate binaural auditory abilities only possible through binaural hearing ability. Studies show improved benefits of bilateral Nucleus implants compared with either a unilateral implant or a unilateral CI plus a HA with regard to speech understanding in quiet and noise and sound localisation. Children fitted with bilateral implants show improved speech perception in quiet and in noise and for sound localisation, this is particularly important when moving into more challenging environments such as secondary schooling. Nucleus Clinical Effectiveness Special patient groups In addition to post-lingual adults and pre-lingual children, Nucleus implants have also been shown to significantly improve open-set speech perception in both pre-lingual adolescents and adults. Children and adults with additional disabilities have also demonstrated to gain significant benefits from implantation compared with their pre-operative baseline. Nucleus Reliability Reliability is a key feature of any CI and must be an essential consideration in the choice of device for both the patient and clinic. A high level of reliability ensures avoidance of additional surgery for removal of a failed device and re-implantation of a new device. The cumulative survival percentage (CSP) for the Nucleus Freedom over a 1.5 year period is 100% for adults and 99.8% for children with cumulative failure percentages of 0% and 0.2% (i.e. for children only 2 in every 1000 implants fail after 1.5 years). Each successive device has shown improved reliability reflecting Cochlear s continuing commitment to development and improvement.
5 Comparison of devices using percentage failures demonstrates the superior reliability of Cochlear s Nucleus implants over other CIs available, with percentage failure rates of 1.97% for Nucleus, 3.23% for Neurelec, 6.98% for Advanced Bionics and 9.01% for MED-EL. Cost Effectiveness An economic analysis, incorporating previous published work, comparing unilateral implantation with standard of care and bilateral implantation in adults and children was conducted. The model used clinical trial data from the main Nucleus studies and mapped the word scores from these to estimate expected changes in utility. The cost per QALY for unilateral Nucleus implants (compared with standard care) was estimated to be 7,145 in adults and 10,542 in children. The cost savings of special schooling in the model for children would reduce the cost per QALY for children to around 5,000. The cost per QALY for Nucleus implants of bilateral implantation compared with unilateral implantation was estimated to be 32,909 in adults and 39,049 in children. The costs for children would be lower taking into account the education cost savings. Budget impact In order to address the current levels of inequity of treatment and reduce the length of waiting times, the level of service provision for CIs needs to be urgently addressed and increased to meet patient demand and improve patient outcomes. All eligible children rather than the current 50% should have access to and receive a CI within the critical time period required to achieve optimum outcomes, while the poor level of penetration for adults should be radically increased. Increasing the level of service provision over the next 5 years to ensure that all eligible children (with bilateral to severe to profoundly sensorineural hearing loss) are funded for implantation and that the level of service provision for adults (with severe to profoundly sensorineural hearing loss) is increased by around 30% will cost the NHS an additional 9.5 million in year 1 increasing to 65.8 in Year 5. This level of provision, if sustained, would allow around 7.5 times as many eligible adults to benefit from implants as is possible at the currently level of implantation and around 100% of eligible children. Conclusion Cochlear Europe supports this appraisal into the provision of CIs in England and Wales. Inequity of access to CIs is a critical issue, with demonstrable differences between regions and disparity occurring based on age. Many children and adults who could benefit from CIs are unable to gain access within the NHS current target waiting time of 18-weeks. Lack of funding is of major concern particularly for adults. Many centres in England are provided with insufficient funds to cover CIs for both adults and children, resulting in the prioritisation of children over adults. Of particular concern, the Welsh Assembly Government has completely stopped funding adult cochlear implantation. Due to the current level of funding, penetration in terms of prevalence is low, at 1% for adults and 50% for children, a rate significantly lower than that of other major European countries. In order to improve patient care there is an urgent requirement for access and funding issues to be addressed and resolved. Improving provision over the next 5 years to ensure that all eligible children are implanted and the provision for adults is increased by around 30% each year would cost the NHS an additional 9.5 million in Year 1 increasing to 65.8 million in Year 5. This would improve current penetration from 1% to 7.5% for adults and would ensure that both adults and children have increased access to both unilateral and bilateral implants. Evidence clearly supports the clinical and cost-effectiveness of CIs in adults and children with bilateral severe to profound sensorineural hearing loss who receive little or no benefit from hearing aids (HAs). Of the CI systems available Nucleus implants have the longest effectiveness and reliability data. The recently released Nucleus Freedom system, consisting of a new implant and external speech processor, provides patients with an advanced implant which has superior reliability when compared with other CIs and a speech processor which, via a range of flexible speech processing options, optimises the potential for maximum hearing benefit in a wide range of listening environments.
Cochlear implants for children and adults with severe to profound deafness
Issue date: January 2009 Review date: February 2011 Cochlear implants for children and adults with severe to profound deafness National Institute for Health and Clinical Excellence Page 1 of 41 Final appraisal
More informationCorporate Medical Policy
Corporate Medical Policy Cochlear Implant File Name: Origination: Last CAP Review: Next CAP Review: Last Review: cochlear_implant 2/1996 2/2017 2/2018 2/2017 Description of Procedure or Service A cochlear
More informationImplants. Slide 1. Slide 2. Slide 3. Presentation Tips. Becoming Familiar with Cochlear. Implants
Slide 1 Program Becoming Familiar with Cochlear Implants Hello and thanks for joining us to learn more about cochlear implants. Today s presentation provides a basic overview about cochlear implants candidacy,
More informationCochlear Implants. What is a Cochlear Implant (CI)? Audiological Rehabilitation SPA 4321
Cochlear Implants Audiological Rehabilitation SPA 4321 What is a Cochlear Implant (CI)? A device that turns signals into signals, which directly stimulate the auditory. 1 Basic Workings of the Cochlear
More informationPaediatric cochlear implantation
Paediatric cochlear implantation A M U MÜLLER BA (Log), MSc (Sp&H) Senior Lecturer Department of Speech, Language and Hearing Therapy University of Stellenbosch D J H WAGENFELD MB ChB, MMed (L et O), FCS
More information9/13/2017. When to consider CI or BAHA evaluation? Krissa Downey, AuD, CCC A
When to consider CI or BAHA evaluation? Krissa Downey, AuD, CCC A FDA Regulations Unilateral or bilateral cochlear implantation of an FDA approved cochlear implant device may be considered medically necessary
More informationCochlear Implants: The Role of the Early Intervention Specialist. Carissa Moeggenberg, MA, CCC-A February 25, 2008
Cochlear Implants: The Role of the Early Intervention Specialist Carissa Moeggenberg, MA, CCC-A February 25, 2008 Case Scenario 3 month old baby with a confirmed severe to profound HL 2 Counseling the
More informationComparing Speech Perception Abilities of Children with Cochlear Implants and Digital Hearing Aids
Comparing Speech Perception Abilities of Children with Cochlear Implants and Digital Hearing Aids Lisa S. Davidson, PhD CID at Washington University St.Louis, Missouri Acknowledgements Support for this
More informationCan You Hear Me Now? Learning Objectives 10/9/2013. Hearing Impairment and Deafness in the USA
Can You Hear Me Now? An update on the latest technology and solutions for hearing impairment Linda S. MacConnell, PA-C ENT Specialists of AZ ASAPA Fall CME Conference ctober, 03 Learning bjectives. Differentiate
More informationCochlear Implant Corporate Medical Policy
Cochlear Implant Corporate Medical Policy File Name: Cochlear Implant & Aural Rehabilitation File Code: UM.REHAB.06 Origination: 03/2015 Last Review: 01/2019 Next Review: 01/2020 Effective Date: 04/01/2019
More informationAdvances in Implantable Technologies. Huw Cooper BAA 2014
Advances in Implantable Technologies Huw Cooper BAA 2014 Huw.cooper@uhb.nhs.uk Implantable technologies for hearing Aim: to provide access to sound when conventional amplification no longer useful For
More informationSpeaker s Notes: AB is dedicated to helping people with hearing loss hear their best. Partnering with Phonak has allowed AB to offer unique
1 General Slide 2 Speaker s Notes: AB is dedicated to helping people with hearing loss hear their best. Partnering with Phonak has allowed AB to offer unique technological advances to help people with
More informationCochlear Implant The only hope for severely Deaf
Cochlear Implant The only hope for severely Deaf By: Dr. M. Sohail Awan, FCPS (ENT) Aga Khan University Hospital, Karachi - Pakistan For centuries, people believed that only a miracle could restore hearing
More informationSlide 1 REVISITING CANDIDACY: EXPANDING CRITERIA FOR COCHLEAR IMPLANTS. Slide 2. Slide 3. Cochlear Implant History. Cochlear Implant History
Slide 1 REVISITING CANDIDACY: EPANDING CRITERIA FR CCHLEAR IMPLANTS Jordan King, Au.D. CCC-A Cochlear Implant Audiologist Arkansas Children s Hospital kingje@archildrens.org Slide 2 Cochlear Implant History
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE GUIDANCE EXECUTIVE (GE)
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE GUIDANCE EXECUTIVE (GE) Technology Appraisal Review Proposal paper Review of TA166; Cochlear implants for children and adults with severe to profound deafness
More informationAMPLIFICATION AND TECHNOLOGY
AMPLIFICATION AND TECHNOLOGY Your child s needs for amplification and assistive technologies will depend on his/her type and degree of hearing loss, and the communication approach(es) your family will
More informationSpecialised Services Policy:
Specialised Services Policy: CP35 Cochlear Implants Document Author: Specialised Planner for Women & Children s Services Executive Lead: Director of Planning Approved by: Executive Board Issue Date: 05
More informationMEDICAL POLICY SUBJECT: COCHLEAR IMPLANTS AND AUDITORY BRAINSTEM IMPLANTS. POLICY NUMBER: CATEGORY: Technology Assessment
MEDICAL POLICY PAGE: 1 OF: 5 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.
More informationANNUAL REPORT
Surgical Hearing Implant Program Otolaryngology ANNUAL REPORT 2012-2013 Department Name 1 Executive Summary Vision To enrich communication and quality of life for Manitobans by delivering safe, accessible
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE GUIDANCE EXECUTIVE (GE) Consideration of consultation responses on review proposal
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE GUIDANCE EXECUTIVE (GE) Consideration of consultation responses on review proposal Review of TA166; Deafness (severe to profound) - cochlear implants
More informationCochlear Implant Candidacy Programming Protocol, Adult Ear & Hearing Center for Neurosciences
Cochlear Implant Candidacy Programming Protocol, Adult Ear & Hearing Center for Neurosciences Activation of the Cochlear Implant (CI) is performed by the Audiologist 2-6 weeks following surgery. While
More information9/27/2018. Type of Hearing Loss. Type of Hearing Loss. Type of Hearing Loss
MED-EL Mission To overcome hearing loss as a barrier to communication and quality of life. We effectively yet gently restore hearing by offering a comprehensive set of intact-skin hearing implant solutions.
More informationCochlear Implant Technology
Cochlear Implant Technology BAA student conference Leicester July 2015 Suzanne Harrigan; Specialist Speech & Language Therapist The Ear Foundation business: Family programme Education programme Sound Advice
More informationCochlear Implantation for Single-Sided Deafness in Children and Adolescents
Cochlear Implantation for Single-Sided Deafness in Children and Adolescents Douglas Sladen, PhD Dept of Communication Sciences and Disorders Western Washington University Daniel M. Zeitler MD, Virginia
More informationMEDICAL POLICY SUBJECT: COCHLEAR IMPLANTS AND AUDITORY BRAINSTEM IMPLANTS
MEDICAL POLICY. PAGE: 1 OF: 6 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.
More informationOutline ANATOMY OF EAR. All about Cochlear implants/why does this child not have a Cochlear Implant?
All about Cochlear implants/why does this child not have a Cochlear Implant? Dr.S.Rangan Consultant Audiovestibular Physician (Paediatrics) St Catherine s Health Centre WUTH/BAPA Outline How does the ear
More informationCochlear implants. Carol De Filippo Viet Nam Teacher Education Institute June 2010
Cochlear implants Carol De Filippo Viet Nam Teacher Education Institute June 2010 Controversy The CI is invasive and too risky. People get a CI because they deny their deafness. People get a CI because
More informationCochlear Implant. Description
Subject: Cochlear Implant Page: 1 of 24 Last Review Status/Date: December 2014 Cochlear Implant Description Cochlear implant is a device for individuals with severe-to-profound hearing loss who only receive
More information1 Cochlear and the elliptical logo are trademarks of Cochlear Limited. Registred in UK No
Eloise Saile Technology Appraisal Project Manager National Institute for Health and Clinical Excellence Midcity Place 71 High Holborn London WC1V 6NA 01 November 2007 Dear Eloise, Appraisal of cochlear
More informationBilateral Cochlear Implant Guidelines Gavin Morrison St Thomas Hearing Implant Centre London, UK
Bilateral Cochlear Implant Guidelines Gavin Morrison St Thomas Hearing Implant Centre London, UK Overview Audiometric Candidacy UK (NICE) & World Practices Auditory Implant Neurophysiology Results and
More informationRobert 11 years old, has a hearing impairment*
EHCP Example containing Health input only This is not a complete example of an EHCP. It has been created to provide an example of the sort of health input that might be included in an EHCP around needs,
More informationUniversity of Southampton Auditory Implant Service Activity Report 2015/16
University of Southampton Auditory Implant Service Activity Report 2015/16 2 University of Southampton Auditory Implant Service (USAIS) provides services to hearing impaired patients in the South of England.
More informationClinical Policy Bulletin: Cochlear Implants and Auditory Brainstem Implants
Close Window Enter CPB Search Term: Go Clinical Policy Bulletin: Cochlear Implants and Auditory Brainstem Implants Number: 0013 Policy *Pleasesee amendment forpennsylvaniamedicaidattheendofthiscpb. I.
More informationCochlear Implants 2016: Advances in Technology, Candidacy and Outcomes
Cochlear Implants 2016: Advances in Technology, Candidacy and Outcomes Howard W. Francis MD, Director The Johns Hopkins Listening Center Donna L. Sorkin MA, Execu8ve Director American Cochlear Implant
More informationKaitlin MacKay M.Cl.Sc. (AUD.) Candidate University of Western Ontario: School of Communication Sciences and Disorders
1 C ritical Review: Do adult cochlear implant (C I) recipients over 70 years of age experience similar speech perception/recognition gains postoperatively in comparison with adult C I recipients under
More informationHearing Screening, Diagnostics and Intervention
JCIH Newborn Hearing Screening Guidelines 1-3-6 Model By 1 month Screenhearing Hearing Screening, Diagnostics and Intervention By 3 months: Evaluate hearing and complete diagnosticaudiology and otolaryngology
More informationTo learn more, visit the website and see the Find Out More section at the end of this booklet.
Loving Your Child, Learning How to Help Congratulations! As a parent of a precious baby or young child, you have a wonderful journey ahead. The fact that your child has a hearing loss is only one part
More informationClinical Policy: Cochlear Implant Replacements
Clinical Policy: Reference Number: CP.MP.14 Last Review Date: 07/18 Revision Log Coding Implications See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationPeter S Roland M.D. UTSouthwestern Medical Center Dallas, Texas Developments
Peter S Roland M.D. UTSouthwestern Medical Center Dallas, Texas Developments New electrodes New speech processing strategies Bilateral implants Hybrid implants ABI in Kids MRI vs CT Meningitis Totally
More informationCONVENTIONAL AND DIGITAL HEARING AIDS
CONVENTIONAL AND DIGITAL HEARING AIDS Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical
More informationCochlear Implant. Policy Number: Last Review: 9/2018 Origination: 10/1988 Next Review: 9/2019
Cochlear Implant Policy Number: 7.01.05 Last Review: 9/2018 Origination: 10/1988 Next Review: 9/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for cochlear implants
More informationPolicy #: 018 Latest Review Date: June 2014
Name of Policy: Cochlear Implants Policy #: 018 Latest Review Date: June 2014 Category: Surgery Policy Grade: A Background/Definitions: As a general rule, benefits are payable under Blue Cross and Blue
More informationAHM Cochlear Implant and Auditory Brainstem Implant
AHM Cochlear Implant and Auditory Brainstem Implant AC- AHMCOCHL2016 Auditory Brainstem Implant I. Auditory brainstem implant (ABI) is considered medically necessary in members 12 years of age or older
More informationClinical Policy: Cochlear Implant Replacements Reference Number: CP.MP.14
Clinical Policy: Reference Number: CP.MP.14 Effective Date: 02/09 Last Review Date: 09/17 Revision Log Coding Implications See Important Reminder at the end of this policy for important regulatory and
More informationProgram. Setting Appropriate Expectations and Communication Goals with a Cochlear Implant. Name Title
Program Setting Appropriate Expectations and Communication Goals with a Cochlear Implant Name Title Mission At Advanced Bionics we are dedicated to improving lives by developing technologies and services
More informationMedical Affairs Policy
Medical Affairs Policy Service: Cochlear Implants, Bone Anchored Hearing Aids (BAHA), Auditory Brainstem Implants, and Other Hearing Assistive Devices PUM 250-0014 Medical Policy Committee Approval 06/15/18
More informationNucleus cochlear implants Physician's Package Insert
Nucleus cochlear implants Physician's Package Insert Contents This document contains important information such as indications and contraindications that applies to the following cochlear implant systems:
More informationGlossary For Parents. Atresia: closure of the ear canal or absence of an ear opening.
Glossary For Parents This is not a complete or comprehensive glossary of audiologic and medical terms. It does include many technical and often unfamiliar terms that parents may hear used in connection
More informationQuality standards for cochlear implantation in children and young adults
Quality standards for cochlear implantation in children and young adults J Martin, C H Raine Bradford Royal Infirmary, Bradford, UK 1. Introduction Cochlear implantation is a multidisciplinary therapy
More informationExpanded Cochlear Implant Candidacy Guidelines and Technology Advances
Expanded Cochlear Implant Candidacy Guidelines and Technology Advances University of Michigan Cochlear Implant Program Caroline Arnedt, AuD, CCC-A Financial- Employed by University of Michigan and receives
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Cochlear Implant Page 1 of 30 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Cochlear Implant Professional Institutional Original Effective Date: February 1, 2002
More informationhearlife Clinic Toronto Hear, Communicate, Participate
hearlife Clinic Toronto Hear, Communicate, Participate Welcome Hearing is an essential part of communication. Hearing loss can create an invisible barrier between people affected by hearing loss and those
More information16:30-18:30 WS #52: Paediatric Forum (120mins - not repeated)
Dr Kate Gibson Clinical Geneticist Genetic Health Service NZ, Children s Specialist Centre, Christchurch Hospital, Christchurch Dr Antony Bedggood Ophthalmologist Children s Specialist Centre, Christchurch
More informationPaediatric Hearing aid Passport for single sided deafness
Bone Anchored Hearing Aid CROS Hearing Aids Paediatric Hearing aid Passport for single sided deafness Information for patients, relatives and carers For more information, please contact: Audiology Department
More informationManchester Paediatric Cochlear Implant Programme
Manchester Royal Infirmary Manchester Paediatric Cochlear Implant Programme Information for Patients and Professionals Contents Introduction 3 The normal ear 4 The cochlear implant 5-7 The assessment process
More informationHearing the Universal Language: Music and Cochlear Implants
Hearing the Universal Language: Music and Cochlear Implants Professor Hugh McDermott Deputy Director (Research) The Bionics Institute of Australia, Professorial Fellow The University of Melbourne Overview?
More information(Thomas Lenarz) Ok, thank you, thank you very much for inviting me to be here and speak to you, on cochlear implant technology.
(Thomas Lenarz) Ok, thank you, thank you very much for inviting me to be here and speak to you, on cochlear implant technology. I want to briefly mention what hearing loss is. And what a cochlear implant
More informationNHS HDL(2004) 24 abcdefghijklm
NHS HDL(2004) 24 abcdefghijklm Health Department Health Planning and Quality Division St Andrew's House Directorate of Service Policy and Planning Regent Road EDINBURGH EH1 3DG Dear Colleague CANDIDATURE
More informationEffects of Setting Thresholds for the MED- EL Cochlear Implant System in Children
Effects of Setting Thresholds for the MED- EL Cochlear Implant System in Children Stacy Payne, MA, CCC-A Drew Horlbeck, MD Cochlear Implant Program 1 Background Movement in CI programming is to shorten
More informationIntroduction. Performance Outcomes for Borderline Cochlear Implant Candidates. Introduction. Introduction. Introduction.
Performance Outcomes for Borderline Cochlear Implant Candidates Michelle L. Hughes, Ph.D., CCC-A Donna L. Neff, Ph.D. Jeffrey L. Simmons, M.A., CCC-A Initial candidacy criteria, 1985: Post-lingually deafened
More informationIntroduction to Cochlear Implants, Candidacy Issues, and Impact on Job Functioning. Definitions. Definitions (continued) John P. Saxon, Ph. D.
Introduction to Cochlear Implants, Candidacy Issues, and Impact on Job Functioning John P. Saxon, Ph. D., CRC Definitions Hearing impairment: means any degree and type of auditory disorder. Deafness: means
More informationMs Melissa Babbage. Senior Audiologist Clinic Manager Dilworth Hearing
Ms Melissa Babbage Senior Audiologist Clinic Manager Dilworth Hearing 14:00-14:55 WS #30: Sudden Sensorineural Hearing Loss and Management of Single Sided Deafness 15:05-16:00 WS #40: Sudden Sensorineural
More informationHearing Impaired K 12
Hearing Impaired K 12 Section 20 1 Knowledge of philosophical, historical, and legal foundations and their impact on the education of students who are deaf or hard of hearing 1. Identify federal and Florida
More informationIMPORTANT REMINDER DESCRIPTION
Medical Policy Manual Surgery, Policy No. 08 Cochlear Implant Next Review: September 2018 Last Review: May 2018 Effective: June 1, 2018 IMPORTANT REMINDER Medical Policies are developed to provide guidance
More informationManchester Adult Cochlear Implant Programme
Manchester Royal Infirmary Manchester Adult Cochlear Implant Programme Information for Patients and Professionals Contents Introduction 3 The normal ear 4 The cochlear implant 5 The assessment procedure
More informationAcoustic and Electric Same Ear Hearing in Patients with a Standard Electrode Array
Acoustic and Electric Same Ear Hearing in Patients with a Standard Electrode Array Sue Karsten, AuD, Camille Dunn, PhD, Marlan Hansen, MD & Bruce Gantz, MD University of Iowa American Cochlear Implant
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Cochlear Implant Page 1 of 30 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Cochlear Implant Professional Institutional Original Effective Date: February 1, 2002
More informationEvaluation of Speech Recognition in Noise with Cochlear Implants and Dynamic FM DOI: /jaaa
J Am Acad Audiol 2: (29) Evaluation of Speech Recognition in Noise with Cochlear Implants and Dynamic FM DOI: 1.3766/jaaa.2.6.7 Jace Wolfe* Erin C. Schafer{ Benjamin Heldner{ Hans Mulder{ Emily Ward1 Brandon
More informationA Sound Foundation Through Early Amplification
11 A Sound Foundation Through Early Amplification Proceedings of the 7th International Conference 2016 Hear well or hearsay? Do modern wireless technologies improve hearing performance in CI users? Jace
More informationEHDI in Michigan. Introduction. EHDI Goals and Communication Options. Review of EHDI Goals. Effects of Universal Newborn Hearing Screening (UNHS)
EHDI Goals and Communication Options Anita Vereb,, MS, CCC-A University of Michigan Division of Audiology Introduction Hearing loss is the most frequently occurring birth defect 2 out of every 1000 babies
More informationLong-Term Performance for Children with Cochlear Implants
Long-Term Performance for Children with Cochlear Implants The University of Iowa Elizabeth Walker, M.A., Camille Dunn, Ph.D., Bruce Gantz, M.D., Virginia Driscoll, M.A., Christine Etler, M.A., Maura Kenworthy,
More informationBAEA Roles and Competencies. 1. Child and Family Support.
BAEA Roles and Competencies 1. Child and Family Support. 1.1 The Educational Audiologists Role may involve the following: 1.1.1 Act as a key member of a multi-professional team offering a seamless family
More informationLindsay De Souza M.Cl.Sc AUD Candidate University of Western Ontario: School of Communication Sciences and Disorders
Critical Review: Do Personal FM Systems Improve Speech Perception Ability for Aided and/or Unaided Pediatric Listeners with Minimal to Mild, and/or Unilateral Hearing Loss? Lindsay De Souza M.Cl.Sc AUD
More informationCochlear Implantation for Pediatric Patients with Single-Sided Deafness
Cochlear Implantation for Pediatric Patients with Single-Sided Deafness Janet Green, AuD, Kaitlyn Coscione Tona, AuD, William Shapiro, AuD, Susan Waltzman, PhD, J. Thomas Roland Jr., MD Children with Single-Sided
More informationWho gets a Cochlear Implant? Special Report No. 3. Basic Information on Hearing
Special Report No. 3 Basic Information on Hearing Who gets a Cochlear Implant? An overview of international criteria for cochlear implantation Germany, United Kingdom, France, Western Australia, Saudi
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Cochlear Implant Page 1 of 25 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Cochlear Implant Professional Institutional Original Effective Date: February 1, 2002
More informationImplantable Treatments for Different Types of Hearing Loss. Margaret Dillon, AuD Marcia Adunka, AuD
Implantable Treatments for Different Types of Hearing Loss Margaret Dillon, AuD Marcia Adunka, AuD Implantable Technologies Types of hearing loss Bone-anchored devices Middle ear implantation Cochlear
More informationHearing Aids. Bernycia Askew
Hearing Aids Bernycia Askew Who they re for Hearing Aids are usually best for people who have a mildmoderate hearing loss. They are often benefit those who have contracted noise induced hearing loss with
More informationTitle: Preliminary speech recognition results after cochlear implantation in patients with unilateral hearing loss: a case report
Author's response to reviews Title: Preliminary speech recognition results after cochlear implantation in patients with unilateral hearing loss: a case report Authors: Yvonne Stelzig (yvonnestelzig@bundeswehr.org)
More informationAudiology Services. Table of Contents. Audiology Services Guidelines : Hearing services
Audiology Services Table of Contents Audiology Services Guidelines... 2 317:30-3-65.9 Hearing services... 3-4 Audiology Services- General Considerations for Prior Authorization... 5-6 Audiogram and other
More informationSonia Grewal, Au.D Professional Education Manager Hearing HealthCare Providers 2017 Conference WIDEX CROS & BICROS
Sonia Grewal, Au.D Professional Education Manager Hearing HealthCare Providers 2017 Conference WIDEX CROS & BICROS AGENDA Overview of CROS/BiCROS CROS Solutions CROS Applications CROS Validation Considerations
More informationCochlear implants. Aaron G Benson MD Board Certified Otolaryngologist Board Certified Neurotologist
Cochlear implants Aaron G Benson MD Board Certified Otolaryngologist Board Certified Neurotologist 1 OBJECTIVES WHAT IS A NEUROTOLOGIST WHAT MAKES AN INDIVIDUAL A COCHLEAR IMPLANT CANDIDATE WHAT IS THE
More informationThe Auditory Brainstem Implant. Manchester Royal Infirmary
The Auditory Brainstem Implant Manchester Royal Infirmary What is an auditory brainstem implant (ABI)? An auditory brainstem implant (ABI) is a device that may allow a person to hear if they have had damage
More informationClinical Commissioning Policy: Auditory brainstem implant with congenital abnormalities of the auditory nerves of cochleae
Clinical Commissioning Policy: Auditory brainstem implant with congenital abnormalities of the auditory nerves of cochleae Reference: NHS England: 16062/P NHS England INFORMATION READER BOX Directorate
More information2/25/2013. Context Effect on Suprasegmental Cues. Supresegmental Cues. Pitch Contour Identification (PCI) Context Effect with Cochlear Implants
Context Effect on Segmental and Supresegmental Cues Preceding context has been found to affect phoneme recognition Stop consonant recognition (Mann, 1980) A continuum from /da/ to /ga/ was preceded by
More informationBilateral cochlear implantation in children identified in newborn hearing screening: Why the rush?
Bilateral cochlear implantation in children identified in newborn hearing screening: Why the rush? 7 th Australasian Newborn Hearing Screening Conference Rendezous Grand Hotel 17 th 18 th May 2013 Maree
More informationIMPLANTABLE BONE-CONDUCTION AND BONE-ANCHORED HEARING AIDS
Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical Coverage Guideline must be read in its
More informationMeasuring Auditory Performance Of Pediatric Cochlear Implant Users: What Can Be Learned for Children Who Use Hearing Instruments?
Measuring Auditory Performance Of Pediatric Cochlear Implant Users: What Can Be Learned for Children Who Use Hearing Instruments? Laurie S. Eisenberg House Ear Institute Los Angeles, CA Celebrating 30
More informationEnginEars - the hearing implant program for kids
EnginEars - the hearing implant program for kids PART THREE EASC039_Learn Children_Part 3.indd 1 Welcome to EnginEars EnginEars is a hearing implant program that helps babies, children and teenagers with
More informationBone conduction hearing solutions from Sophono
Bone conduction hearing solutions from Sophono Sophono Inc. was launched in October 2009, following five years of research and with a vision and dedication to improving the bone anchored hearing device
More informationCochlear Implant, Bone Anchored Hearing Aids, and Auditory Brainstem Implant
Origination: 06/23/08 Revised: 10/15/16 Annual Review: 11/10/16 Purpose: To provide cochlear implant, bone anchored hearing aids, and auditory brainstem implant guidelines for the Medical Department staff
More informationSpeech, Language, and Hearing Sciences. Discovery with delivery as WE BUILD OUR FUTURE
Speech, Language, and Hearing Sciences Discovery with delivery as WE BUILD OUR FUTURE It began with Dr. Mack Steer.. SLHS celebrates 75 years at Purdue since its beginning in the basement of University
More informationINTRODUCTION TO AUDIOLOGY Hearing Balance Tinnitus - Treatment
INTRODUCTION TO AUDIOLOGY Hearing Balance Tinnitus - Treatment What is Audiology? Audiology refers to the SCIENCE OF HEARING AND THE STUDY OF THE AUDITORY PROCESS (Katz, 1986) Audiology is a health-care
More informationTeenagers and cochlear implants: opportunities and challenges. Sue Archbold Feapda, Slovenia, Sep 2013
Teenagers and cochlear implants: opportunities and challenges Sue Archbold Feapda, Slovenia, Sep 2013 Adolescence A time of change. For all teenagers For deaf teenagers a time of great change Over the
More informationThe Two I s in EHDI: Intervention and Impact. Teresa H. Caraway, Ph.D., CCC-SLP, LSLS Cert. AVT Hearts for Hearing Oklahoma City, OK
The Two I s in EHDI: Intervention and Impact Teresa H. Caraway, Ph.D., CCC-SLP, LSLS Cert. AVT Hearts for Hearing Oklahoma City, OK Hearing Loss Facts: Brief Overview The most common birth anomaly: 2 to
More informationPosition Paper on Cochlear Implants in Children
Position Paper on Cochlear Implants in Children Position: The Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) supports cochlear implantation in children where appropriate
More informationAudiological Manual. Ponto TM The Bone Anchored Hearing System
Audiological Manual Ponto TM The Bone Anchored Hearing System Contents Appendix Paediatrics Follow-up Fitting Introduction Introduction... 3 Fitting...4 Checking the abutment site... 5 Practise operating
More informationCombining Residual Hearing with Electric Stimulation: Results from Pediatric & Adult CI Recipients
Combining Residual Hearing with Electric Stimulation: Results from Pediatric & Adult CI Recipients Lisa Park, AuD Meredith Anderson Rooth, AuD Research Assistant Professors Department of Otolaryngology/Head
More informationGetting the Most Out of Your N6 Cochlear Implant. Katie Neal, BASc Adv (Neuroscience), BhlthSc, Mclin AuD, AudSA, CCP Cochlear Clinical Specialist
Getting the Most Out of Your N6 Cochlear Implant Katie Neal, BASc Adv (Neuroscience), BhlthSc, Mclin AuD, AudSA, CCP Cochlear Clinical Specialist Who is Cochlear? Professor Graeme Clark Prof. Graeme Clark
More informationLocalization Abilities after Cochlear Implantation in Cases of Single-Sided Deafness
Localization Abilities after Cochlear Implantation in Cases of Single-Sided Deafness Harold C. Pillsbury, MD Professor and Chair Department of Otolaryngology/Head and Neck Surgery University of North Carolina
More information