Evidence gaps in economic analyses of hearing healthcare: A systematic review.

Journal Article (Journal Article)

BACKGROUND: Hearing loss is a common and costly medical condition. This systematic review sought to identify evidence gaps in published model-based economic analyses addressing hearing loss to inform model development for an ongoing Lancet Commission. METHODS: We searched the published literature through 14 June 2020 and our inclusion criteria included decision model-based cost-effectiveness analyses that addressed diagnosis, treatment, or prevention of hearing loss. Two investigators screened articles for inclusion at the title, abstract, and full-text levels. Data were abstracted and the studies were assessed for the qualities of model structure, data assumptions, and reporting using a previously published quality scale. FINDINGS: Of 1437 articles identified by our search, 117 unique studies met the inclusion criteria. Most of these model-based analyses were set in high-income countries (n = 96, 82%). The evaluated interventions were hearing screening (n = 35, 30%), cochlear implantation (n = 34, 29%), hearing aid use (n = 28, 24%), vaccination (n = 22, 19%), and other interventions (n = 29, 25%); some studies included multiple interventions. Eighty-six studies reported the main outcome in quality-adjusted or disability-adjusted life-years, 24 of which derived their own utility values. The majority of the studies used decision tree (n = 72, 62%) or Markov (n = 41, 35%) models. Forty-one studies (35%) incorporated indirect economic effects. The median quality rating was 92/100 (IQR:72-100). INTERPRETATION: The review identified a large body of literature exploring the economic efficiency of hearing healthcare interventions. However, gaps in evidence remain in evaluation of hearing healthcare in low- and middle-income countries, as well as in investigating interventions across the lifespan. Additionally, considerable uncertainty remains around productivity benefits of hearing healthcare interventions as well as utility values for hearing-assisted health states. Future economic evaluations could address these limitations. FUNDING: NCATS 3UL1-TR002553-03S3.

Full Text

Duke Authors

Cited Authors

  • Borre, ED; Diab, MM; Ayer, A; Zhang, G; Emmett, SD; Tucci, DL; Wilson, BS; Kaalund, K; Ogbuoji, O; Sanders, GD

Published Date

  • May 1, 2021

Published In

Volume / Issue

  • 35 /

Start / End Page

  • 100872 -

PubMed ID

  • 34027332

Pubmed Central ID

  • PMC8129894

Electronic International Standard Serial Number (EISSN)

  • 2589-5370

Digital Object Identifier (DOI)

  • 10.1016/j.eclinm.2021.100872


  • eng

Conference Location

  • England