TY - JOUR
T1 - Models of service delivery in adult cochlear implantation and evaluation of outcomes
T2 - A scoping review of delivery arrangements
AU - Ebrahimi-Madiseh, Azadeh
AU - Nickbakht, Mansoureh
AU - Eikelboom, Robert H.
AU - Bennett, Rebecca J.
AU - Friedland, Peter L.
AU - Atlas, Marcus D.
AU - Jessup, Rebecca L.
N1 - Publisher Copyright:
© 2023 Ebrahimi-Madiseh et al.
PY - 2023/5
Y1 - 2023/5
N2 - 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.
AB - 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.
KW - Cochlear implant, service delivery, adults, delivery arrangement, model of care, outcome measurement, Cochrane Effective Practice and Organisation of Care (EPOC), scoping review.
UR - http://www.scopus.com/inward/record.url?scp=85158899006&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0285443
DO - 10.1371/journal.pone.0285443
M3 - Review article
C2 - 37163533
AN - SCOPUS:85158899006
SN - 1932-6203
VL - 18
JO - PLoS One
JF - PLoS One
IS - 5 MAY
M1 - e0285443
ER -