Cost–Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial example

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Cost–Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial


The article under consideration is called “Cost–Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial”, written by the team of authors, including Smulders, Zon and Grolman. The goal of the article was to analyze two opposite approaches to treatment of adults in the health care industry. These two approaches are cost-utility of simultaneous bilateral cochlear implantation and unilateral cochlear implantation.

Analysis of the article

First of all, it is important to mention that the title of the article was clearly identified. It is possible to get knowledge about the essence of the article and its objective from the title. The objective of the article has been mentioned above. It is comparison of cost of efficiency of two approaches to cochlear implantation – simultaneous bilateral and unilateral.

These two approaches to cochlear implantation are the most widespread nowadays. They are manly used by adult patients. On the other hand, they generate the highest costs for the hospitals. That is why it can be said that the article includes all significant alternatives. The article is written from the perspective of hospitals, since it analyzes cost efficiency for the hospitals. For example, the authors concluded that direct costs for unilateral and bilateral CI were $43,883 + $11,513(SD) and $87,765 + $23,027(SD) respectively. Annual costs from the second year onward were $3,435 + $1,085(SD) and $6,871 + $2,169(SD), respectively (Smulders).

The type of the article can be considered as the research paper. The research paper compares three important elements of the study: theoretical background, methodology and analysis of statistics. A special attention should be paid the last element of the research paper, since it defines efficiency of the whole research. The authors included all the relevant costs. For example, they included costs of visits to speech therapist, costs of audiometry and even travel expenses, etc. Also, an appropriate number of patients and years of analysis have been chosen.

The only negative size of financial analysis is that the authors merely used discounting in their calculations. Discounting is an important factor that allows defining value of money in time. Not using a discounting factor is going to distort the value of real costs. As a result, the efficiency of the different methods will be also distorted.

Despite this disadvantage of the article, its outcomes can be considered as relevant. First of all, the authors have made reasonable assumptions. Mainly, these assumptions were related to the methods, used in the article. Also, the authors have conducted a sensitivity analysis. Sensitivity analysis is a method that defines the way and the character in which independent variable influences the dependant one. The dependant variable is the costs of implantation in the case under consideration. The independent variables are all the factors that affect costs of implantation.


The article under consideration analyzes the problem of cochlear implantation in quite an effective way. It has been proven that cost …

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