Cochlear Implant Atlas
CI Atlas · Was It Worth It? Measuring Quality of Life and the Cost of an Implant · Module 01

1Beyond the Audiogram: Why Outcomes and Value Matter

An audiogram tells you a sound was detected; it does not tell you whether a life got better.

FGap

A booth speech score measures detection, not conversation. Outcomes run from biology to quality of life.[1995]

FHelp

Disease-specific tools detect gains generic tools miss. SF-36 underestimates hearing-specific benefit.[2019]

What a QALY is: utility × time = area

0.000.250.500.751.005.2 QALYs040 yryears the gain is sustained →

A cochlear implant lifts health utility by roughly +0.26 on a 0–1 scale. Multiply that lift by the number of years it lasts and you get QALYs gained — the green area. Divide the implant’s cost by this area and you get the cost per QALY that decides whether it is judged good value. The longer the gain is sustained, the larger the area and the cheaper each QALY becomes — which is why a child gains far more than an adult. Illustrative.

FWorth

Utility runs 0.00 to 1.00; deafness costs 0.46; implantation gains 0.26. Adult implantation sits near $12,847 per QALY.[1986]

Case 20.1 · Beyond the Audiogram
A man reviewed after implantation.

Which measures answer both questions?

Self-assessment — Module 12 questions
Question 1

What do 0.00 and 1.00 mean?

Question 2

Why disease-specific over SF-36?

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