An audit of cochlear implant referral in the UK: pilot data suggests health inequalities
An audit of cochlear implant referral in the UK: pilot data suggests health inequalities
Introduction: in March 2019, NICE criteria for CI were extended¹. The uptake of CI among adults is low², despite social and economic benefits³.
Methods: an AuditBase Crystal Report developed by Auditdata and Cochlear®, with additional input from the clinics that piloted the report, was run between 1 July 2019 and 1 January 2020. 727 adults meeting the NICE audiometric criteria were retrospectively placed into a category:
1 = referred for CI assessment
2 = unsuitable for a CI
3 = further assessment needed
4= referral declined
5= CI not discussed
Data were compared in Audiology services in the South East (SE, n=195), South West (SW, n=109), and Audiology services linked to CI teams in South London (L, n=184) and the North East (NE, n=239).
Results: the proportion of eligible adults referred for CI assessment varied by site; 3% (SE), 19% (SW) 45% (L) and 33% (NE). Patients declining a CI assessment showed the largest variability between services: 92% (SE), 58% (SW) 26% (L) and 36% (NE). The percentage of eligible patients offered a CI assessment was lower at the Audiology sites not linked to a CI team: 33% (SE), 45% (SW), compared to the CI-linked sites: 61% (L) and 51% (NE).
Discussion: on average 48% of eligible adults were offered a CI referral, but considerable inequality exists. Evidence suggests referral rates are affected by a number professional and patient factors⁴. Health inequalities may be linked to rates of decline⁵. Pilot results support a national Audit of CI referral.
References
1 = NICE (2019) https://www.nice.org.uk/guidance/ta566
2 = Buchman et al. (2020) doi:10.1001/jamaoto.2020.0998
3 = Archbold et al (2014) https://www.heartogether.org.uk/research/adult-strategy-reports/the-real-cost-of-adult-hearing-loss-2014
4 = Bierbaum et al (2020) DOI: 10.1097/AUD.0000000000000762
5 = Gov.uk (2019) English indices of deprivation. https://www.gov.uk/government/statistics/english-indices-of-deprivation-2019
Conflict of interest: Cochlear® funded the development of the Crystal Report and supported Audiologists to run the report but they did not have access to the data once collected and did not contribute to the analysis or write up of the results.
Martinez de Estibariz, Unai
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Dickinson, AnnMarie
73a10f23-22f5-4b57-953e-13db125debbd
Kennedy, Lisa
d4bc9cca-4a84-4db7-841a-4f891814da95
Blackaby, Joseph
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McNeill, Katie
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O'Neill, Sara
797b7ce6-15d2-437f-8fda-3166774a738a
Cullington, Helen
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Martinez de Estibariz, Unai
f2c93527-07a1-40cb-a34f-a47abdce59a6
Dickinson, AnnMarie
73a10f23-22f5-4b57-953e-13db125debbd
Kennedy, Lisa
d4bc9cca-4a84-4db7-841a-4f891814da95
Blackaby, Joseph
86487378-cc42-4277-924d-046e714ce4a6
McNeill, Katie
29e371fa-9791-44d3-924a-48717dd7f131
O'Neill, Sara
797b7ce6-15d2-437f-8fda-3166774a738a
Cullington, Helen
a8b72e6d-2788-406d-aefe-d7f34ee6e10e
Martinez de Estibariz, Unai, Dickinson, AnnMarie, Kennedy, Lisa, Blackaby, Joseph, McNeill, Katie, O'Neill, Sara and Cullington, Helen
(2021)
An audit of cochlear implant referral in the UK: pilot data suggests health inequalities.
British Academy of Audiology Conference 2021.
18 - 19 Nov 2021.
(In Press)
Record type:
Conference or Workshop Item
(Poster)
Abstract
Introduction: in March 2019, NICE criteria for CI were extended¹. The uptake of CI among adults is low², despite social and economic benefits³.
Methods: an AuditBase Crystal Report developed by Auditdata and Cochlear®, with additional input from the clinics that piloted the report, was run between 1 July 2019 and 1 January 2020. 727 adults meeting the NICE audiometric criteria were retrospectively placed into a category:
1 = referred for CI assessment
2 = unsuitable for a CI
3 = further assessment needed
4= referral declined
5= CI not discussed
Data were compared in Audiology services in the South East (SE, n=195), South West (SW, n=109), and Audiology services linked to CI teams in South London (L, n=184) and the North East (NE, n=239).
Results: the proportion of eligible adults referred for CI assessment varied by site; 3% (SE), 19% (SW) 45% (L) and 33% (NE). Patients declining a CI assessment showed the largest variability between services: 92% (SE), 58% (SW) 26% (L) and 36% (NE). The percentage of eligible patients offered a CI assessment was lower at the Audiology sites not linked to a CI team: 33% (SE), 45% (SW), compared to the CI-linked sites: 61% (L) and 51% (NE).
Discussion: on average 48% of eligible adults were offered a CI referral, but considerable inequality exists. Evidence suggests referral rates are affected by a number professional and patient factors⁴. Health inequalities may be linked to rates of decline⁵. Pilot results support a national Audit of CI referral.
References
1 = NICE (2019) https://www.nice.org.uk/guidance/ta566
2 = Buchman et al. (2020) doi:10.1001/jamaoto.2020.0998
3 = Archbold et al (2014) https://www.heartogether.org.uk/research/adult-strategy-reports/the-real-cost-of-adult-hearing-loss-2014
4 = Bierbaum et al (2020) DOI: 10.1097/AUD.0000000000000762
5 = Gov.uk (2019) English indices of deprivation. https://www.gov.uk/government/statistics/english-indices-of-deprivation-2019
Conflict of interest: Cochlear® funded the development of the Crystal Report and supported Audiologists to run the report but they did not have access to the data once collected and did not contribute to the analysis or write up of the results.
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More information
Accepted/In Press date: 2021
Venue - Dates:
British Academy of Audiology Conference 2021, 2021-11-18 - 2021-11-19
Identifiers
Local EPrints ID: 451608
URI: http://eprints.soton.ac.uk/id/eprint/451608
PURE UUID: 7193bba1-5008-4738-8c9c-138c186620e7
Catalogue record
Date deposited: 14 Oct 2021 16:31
Last modified: 24 Jul 2022 01:41
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Contributors
Author:
Unai Martinez de Estibariz
Author:
AnnMarie Dickinson
Author:
Lisa Kennedy
Author:
Joseph Blackaby
Author:
Katie McNeill
Author:
Sara O'Neill
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