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Frontiers in Public Health 2023This research aims to assess the effectiveness and cost-effectiveness of pre-pregnancy deafness screening policies.
OBJECTIVES
This research aims to assess the effectiveness and cost-effectiveness of pre-pregnancy deafness screening policies.
METHODS
Married couples from Shanghai, Beijing, and Suzhou in China were enrolled. We conducted high-throughput, pre-pregnancy genetic screenings for deafness in women and their partners. We compared the cost-effectiveness of deafness genetic screening with the status quo. The two-step screening (wife then partner) and following treatments and interventions were included in the decision tree model. We conducted a cost-effectiveness analysis based on the decrease in deaf newborns, healthy newborn births, and cost-utility analysis of pre-pregnancy deafness genetic screening separately. Cost, utility, and probability data used in the three models were collected from a survey combined with literature and expert consultants. A 5% discount rate and a series of one-way sensitivity analyses along with a Monte Carlo simulation were used to test the reliability of this research.
RESULTS
Between Jan 1, 2019, and Dec 31, 2021, we recruited 6,200 females and 540 male spouses from community health service centers in Shanghai, Beijing, and Suzhou. The incremental cost-effectiveness ratio (ICER) for reducing deaf newborn births was USD 32,656 per case and USD 1,203,926 per case for increasing one healthy newborn birth. This gap exists because of the overall decrease of newborn births. From the perspective of the whole society, deafness genetic screening is not cost-effective for reducing the overall quality-adjusted life years (QALY) in the population.
DISCUSSION
Pre-pregnancy genetic testing is effective in decreasing the occurrence of congenital deafness. It is a cost-saving measure when compared with the costs of future medical expenditure and income loss for the affected families. However, such screening and preventive avoidance of pregnancy will decrease the population size and QALY. Only post-screening ART with PGT was shown to increase the birth of healthy newborns. Focusing on key groups such as premature births or consanguineous couples may improve the societal effects of screening.
Topics: Pregnancy; Humans; Infant, Newborn; Female; Cost-Effectiveness Analysis; Reproducibility of Results; China; Deafness; Genetic Testing
PubMed: 38131025
DOI: 10.3389/fpubh.2023.1081339 -
The Indian Journal of Medical Research Nov 2020
Topics: Deafness; Humans; Osteogenesis Imperfecta
PubMed: 35345159
DOI: 10.4103/ijmr.IJMR_2196_19 -
PloS One 2017Emotions are commonly recognized by combining auditory and visual signals (i.e., vocal and facial expressions). Yet it is unknown whether the ability to link emotional... (Clinical Trial)
Clinical Trial
Emotions are commonly recognized by combining auditory and visual signals (i.e., vocal and facial expressions). Yet it is unknown whether the ability to link emotional signals across modalities depends on early experience with audio-visual stimuli. In the present study, we investigated the role of auditory experience at different stages of development for auditory, visual, and multisensory emotion recognition abilities in three groups of adolescent and adult cochlear implant (CI) users. CI users had a different deafness onset and were compared to three groups of age- and gender-matched hearing control participants. We hypothesized that congenitally deaf (CD) but not early deaf (ED) and late deaf (LD) CI users would show reduced multisensory interactions and a higher visual dominance in emotion perception than their hearing controls. The CD (n = 7), ED (deafness onset: <3 years of age; n = 7), and LD (deafness onset: >3 years; n = 13) CI users and the control participants performed an emotion recognition task with auditory, visual, and audio-visual emotionally congruent and incongruent nonsense speech stimuli. In different blocks, participants judged either the vocal (Voice task) or the facial expressions (Face task). In the Voice task, all three CI groups performed overall less efficiently than their respective controls and experienced higher interference from incongruent facial information. Furthermore, the ED CI users benefitted more than their controls from congruent faces and the CD CI users showed an analogous trend. In the Face task, recognition efficiency of the CI users and controls did not differ. Our results suggest that CI users acquire multisensory interactions to some degree, even after congenital deafness. When judging affective prosody they appear impaired and more strongly biased by concurrent facial information than typically hearing individuals. We speculate that limitations inherent to the CI contribute to these group differences.
Topics: Adolescent; Adult; Auditory Perception; Child; Child, Preschool; Cochlear Implants; Deafness; Emotions; Facial Expression; Female; Humans; Infant; Male; Visual Perception
PubMed: 29023525
DOI: 10.1371/journal.pone.0185821 -
Minerva Surgery Apr 2023
Topics: Humans; Aged; Hearing; Deafness; Hearing Tests
PubMed: 34342410
DOI: 10.23736/S2724-5691.21.09044-4 -
Gene Therapy Dec 2013Hearing loss is the most common sensory deficit in humans and can result from genetic, environmental or combined etiologies that prevent normal function of the cochlea,... (Review)
Review
Hearing loss is the most common sensory deficit in humans and can result from genetic, environmental or combined etiologies that prevent normal function of the cochlea, the peripheral sensory organ. Recent advances in understanding the genetic pathways that are critical for the development and maintenance of cochlear function, as well as the molecular mechanisms that underlie cell trauma and death, have provided exciting opportunities for modulating these pathways to correct genetic mutations, to enhance the endogenous protective pathways for hearing preservation and to regenerate lost sensory cells with the possibility of ameliorating hearing loss. A number of recent animal studies have used gene-based therapies in innovative ways toward realizing these goals. With further refinement, some of the protective and regenerative approaches reviewed here may become clinically applicable.
Topics: Animals; Cochlea; Combined Modality Therapy; Deafness; Genetic Therapy; Hearing Aids; Humans; Mutation
PubMed: 23864018
DOI: 10.1038/gt.2013.39 -
The Journal of Laryngology and Otology Sep 2008This paper attempts to review changes in the lives of hearing-impaired patients within the developing world, brought about by globalisation and development. The paper... (Review)
Review
INTRODUCTION
This paper attempts to review changes in the lives of hearing-impaired patients within the developing world, brought about by globalisation and development. The paper also explores limitations to improved care and addresses the collective moral responsibility of developed nations.
METHODS
Analysis of literature.
RESULTS
Within developing nations, large populations have emerged with a similar pattern of problems, access to information and aspirations as those living in developed nations. However, marked differences in income have persisted. These trends have resulted in a relative increase in the proportion of the hearing-impaired population in need of cochlear implantation, while at the same time restricting their access to such treatment.
CONCLUSIONS
The emergence of global markets and media and a shared sense of destiny amongst the people of this planet should translate into a concerted, worldwide effort to assist the deaf in developing countries. Much more can be done within existing resources and frameworks to improve the quality of these peoples' lives.
Topics: Cochlear Implants; Deafness; Developed Countries; Developing Countries; Humans; Moral Obligations; Persons With Hearing Impairments; Socioeconomic Factors
PubMed: 18416879
DOI: 10.1017/S0022215108002272 -
Hearing Research Jan 2017With the advances of cochlear implant (CI) technology, many deaf individuals can partially regain their hearing ability. However, there is a large variation in the level... (Review)
Review
With the advances of cochlear implant (CI) technology, many deaf individuals can partially regain their hearing ability. However, there is a large variation in the level of recovery. Cortical changes induced by hearing deprivation and restoration with CIs have been thought to contribute to this variation. The current review aims to identify these cortical changes in postlingually deaf CI users and discusses their maladaptive or adaptive relationship to the CI outcome. Overall, intra-modal and cross-modal reorganization patterns have been identified in postlingually deaf CI users in visual and in auditory cortex. Even though cross-modal activation in auditory cortex is considered as maladaptive for speech recovery in CI users, a similar activation relates positively to lip reading skills. Furthermore, cross-modal activation of the visual cortex seems to be adaptive for speech recognition. Currently available evidence points to an involvement of further brain areas and suggests that a focus on the reversal of visual take-over of the auditory cortex may be too limited. Future investigations should consider expanded cortical as well as multi-sensory processing and capture different hierarchical processing steps. Furthermore, prospective longitudinal designs are needed to track the dynamics of cortical plasticity that takes place before and after implantation.
Topics: Adaptation, Physiological; Adaptation, Psychological; Auditory Cortex; Auditory Pathways; Cochlear Implantation; Cochlear Implants; Deafness; Hearing; Humans; Neuronal Plasticity; Persons With Hearing Impairments; Recognition, Psychology; Recovery of Function; Speech Intelligibility; Speech Perception
PubMed: 27473503
DOI: 10.1016/j.heares.2016.07.005 -
Canadian Medical Association Journal Sep 1979Although the incidence of congenital deafness is high, routine neonatal screening for this problem is not practised, and early identification of congenital or early... (Review)
Review
Although the incidence of congenital deafness is high, routine neonatal screening for this problem is not practised, and early identification of congenital or early acquired deafness is relatively rare. Delaying therapy until a child is 3 or more years old severely limits speech development, language acquisition and learning. The commonest causes of delay in diagnosis are the refusal of physicians to listen to the parents' observations, their failure to screen children for hearing and speech problems, and their reluctance to arrange prompt referral for audiologic assessment. Diagnostic delay occurs even though half the children who have impaired hearing are known to be at increased risk. A plea is made for the setting up of a register of infants known to be at risk for impaired hearing. First-contact physicians should be alert to the possibility of hearing problems, particularly in children at high risk. Screening methods for use by nonspecialist practitioners are outlined.
Topics: Age Factors; Audiometry, Evoked Response; Canada; Child, Preschool; Deafness; Diagnostic Errors; Female; Hearing Aids; Humans; Infant; Infant, Newborn; National Health Programs; Physician's Role; Physician-Patient Relations; Physicians, Family; Pregnancy; Prenatal Care; Registries
PubMed: 387194
DOI: No ID Found -
Journal of Speech, Language, and... Apr 2023Verbal fluency tasks assess the ability to quickly and efficiently retrieve words from the mental lexicon by requiring subjects to rapidly generate words within a...
PURPOSE
Verbal fluency tasks assess the ability to quickly and efficiently retrieve words from the mental lexicon by requiring subjects to rapidly generate words within a phonological or semantic category. This study investigated differences between cochlear implant users and normal-hearing peers in the clustering and time course of word retrieval during phonological and semantic verbal fluency tasks.
METHOD
Twenty-eight children and adolescents (aged 9-17 years) with cochlear implants and 33 normal-hearing peers completed measures of verbal fluency, nonverbal intelligence, speech perception, and verbal short-term/working memory. Phonological and semantic verbal fluency tests were scored for total words generated, words generated in each 10-s interval of the 1-min task, latency to first word generated, number of word clusters, average cluster size, and number of word/cluster switches.
RESULTS
Children and adolescents with cochlear implants generated fewer words than normal-hearing peers throughout the entire 60-s time interval of the phonological and semantic fluency tasks. Cochlear implant users also had slower start latency times and produced fewer clusters and switches than normal-hearing peers during the phonological fluency task. Speech perception and verbal working memory scores were more strongly associated with verbal fluency scores in children and adolescents with cochlear implants than in normal-hearing peers.
CONCLUSIONS
Cochlear implant users show poorer phonological and semantic verbal fluency than normal-hearing peers, and their verbal fluency is significantly associated with speech perception and verbal working memory. These findings suggest deficits in fluent retrieval of phonological and semantic information from long-term lexical memory in cochlear implant users.
Topics: Humans; Child; Adolescent; Cochlear Implants; Cochlear Implantation; Semantics; Memory, Short-Term; Linguistics; Speech Perception; Deafness
PubMed: 36857026
DOI: 10.1044/2022_JSLHR-22-00383 -
British Medical Journal Nov 1974
Topics: Adolescent; Deafness; Hearing Loss, Noise-Induced; Humans; Music
PubMed: 4434129
DOI: 10.1136/bmj.4.5943.532-c