Conclusions
After cochlear implantation there was a statistically significant group gain in HUI3 scores at one year which was maintained at years 2 and 3. Those who did not use the telephone at baseline were 1.5 times more likely to get a clinically important gain of ≥0.1 in HUI3 multi-attribute score from cochlear implantation. Those with lower hearing, speech or emotion HUI3 single-attribute levels prior to implantation were also more likely to obtain clinically important gains in HUI3 scores. An incapacity to use the telephone may be a useful biomarker for cochlear implant candidacy prior to formal audiological evaluation.
For those the subjects who obtained less than 0.1-point gain in HUI3, this could often be attributed to a lack of change in the hearing attribute level. However, mean hearing performance measured by the SSQ still increased significantly for that group after CI. The HUI3 scale stands in good stead as a health-utility instrument to measure the benefits of cochlear implantation for those with severe handicap due to hearing impairment, but lacks sensitivity to changes in hearing performance compared with a disease specific measure such as the Speech, Spatial Qualities (SSQ) scale.