實證醫學為基礎之人工耳蝸植入評估臨床指引

Evidence-Based Clinical Practice Guideline for Cochlear Implant

對於重度或極重度之聽力損失患者而言，植入人工耳蝸可有效協助他們使用殘存聽力，然現階段人工耳蝸的植入之成效，主要取決於臨床專業醫師之臨床經驗，包括耳鼻喉科醫師、語言治療師與聽力檢查師之臨床經驗、知識與臨床專業技能，因此建置人工耳蝸植入臨床評估指引，能有效協助臨床專業醫師之經驗傳承，提升人工耳蝸植入術前評估的便利性與準確性，進而促進人工耳蝸植入後之使用成效。本研究藉由跨領域合作，整合具人工耳蝸植入經驗之耳鼻喉科臨床醫師、聽力檢查師、語言治療師及工程領域之人員，以實證醫學為基礎，進行相關研究文獻之搜尋，尋找醫學證據以建置人工耳蝸植入評估指引，透過系統性回顧方式整合臨床人員經驗與臨床病歷資訊，發展人工耳蝸植入之電子病歷系統，以驗證人工耳蝸植入臨床評估指引；最後利用AGREE評估臨床指引工具進行臨床指引的評估。

A cochlear implant can help children with moderate or severe hearing loss use their residual hearing ability. The performance of cochlear implants for hearing loss children with a hearing loss is usually affected by the clinician’s experience, education, and clinical skills. Therefore, to develop evidence-based clinical practice guidelines for cochlear implants will effectively share clinical experience and help ensure the proper performance of a cochlear implant. We developed evidence-based clinical practice guidelines for cochlear implants by integrating the experiences of clinicians, speech-language pathologists, and audiologists. Evidence-based medicine procedures were used to guide our effort. Non-structured interviews and the PICO (Patient or problem; Intervention, prognostic factor, or exposure; Comparison; Outcomes) process were used to find the clinical questions. Based on the clinical medical records of patients with cochlear implants, electronic medical records were developed to acquire and verify the evidence of clinical questions. Published studies and textbooks were used to find the answers to clinical questions. Finally, the Appraisal of Guidelines for Research and Evaluation (AGREE) tool was used to assess the clinical recommendations of our evidence-based clinical practice guidelines for cochlear implants.