Patient-Reported Outcome Measures for Quality of Life in Adult Cochlear Implant Users: ICF-Based Systematic Review

To identify the most commonly used patient-reported outcome measures (PROMs) for assessing quality of life (QoL) in adults with cochlear implants (CIs) and to examine how well these PROMs reflect domains defined by the International Classification of Functioning, Disability, and Health (ICF) framework.

A systematic search was conducted in PubMed and Web of Science. Studies were included if they were in English, involved adults with bilateral severe-to-profound sensorineural hearing loss, and used standardized PROMs to assess QoL. Studies including patients with residual hearing (e.g., bimodal users, SSD (Single side deafness), or AHL (Asymmetric Hearing Loss)), using non-validated tools or focusing solely on aspects like depression or hearing handicap were excluded. Identified PROMs were linked to ICF categories for analysis.

Of 935 records, 40 studies met inclusion criteria. Thirteen different PROMs were identified. The Nijmegen Cochlear Implant Questionnaire (NCIQ) was most frequently used, followed by the Glasgow Benefit Inventory (GBI) and Health Utilities Index-Mark 3 (HUI-3). The most frequently covered ICF domain was "activities and participation." The NCIQ addressed the widest range of sub-domains, while GBI and HUI-3 addressed the fewest. Four PROMs, including GBI and EQ-5D, lacked any coverage of environmental factors.

The NCIQ is the most used PROM for QoL assessment in CI users. However, many PROMs neglect key areas like environmental factors. Patient-reported outcome measures not aligned with the ICF may miss important real-life challenges. Using the ICF framework can improve the relevance and completeness of PROMs in this population.