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      Design, implementation, and management of an international medical device registry

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          Abstract

          Background

          Registries are powerful clinical investigational tools. Although in hospitals registries may be mandated, industry-sponsored, international registries are voluntary and therefore can require clearer objectives and more planning. The registry also needs sufficient resources and appropriate measurement tools to motivate long-term participation and ensure success.

          Methods

          We summarize our learnings from 10 years of running a medical device registry that surveys patient-reported benefits of hearing implants.

          Results

          We enlisted 77 participating clinics globally, who actively recruited a total of more than 1500 hearing implant users. We identified the stages in developing a registry specific to hearing loss. Furthermore, we report the challenges and successes in design and implementation and make recommendations for future registries.

          Conclusions

          Data collection infrastructure needs to be kept up to date throughout the defined registry lifetime, and it is essential to oversee data quality and completeness. Compliance at registry sites is important for data quality and needs to be weighed against the cost of site monitoring. To motivate sites to enter data accurately and expeditiously, we facilitated easy access to their own data which helped to support their clinical routine.

          Trial registration

          ClinicalTrials.gov NCT02004353. 9 th December 2013.

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          Most cited references31

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          Multiattribute and single-attribute utility functions for the health utilities index mark 3 system.

          The Health Utilities Index Mark 3 (HUI3) is a generic multiattribute preference-based measure of health status and health-related quality of life that is widely used as an outcome measure in clinical studies, in population health surveys, in the estimation of quality-adjusted life years, and in economic evaluations. HUI3 consists of eight attributes (or dimensions) of health status: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain with 5 or 6 levels per attribute, varying from highly impaired to normal. The objectives are to present a multiattribute utility function and eight single-attribute utility functions for the HUI3 system based on community preferences. Two preference surveys were conducted. One, the modeling survey, collected preference scores for the estimation of the utility functions. The other, the direct survey, provided independent scores to assess the predictive validity of the utility functions. Preference measures included value scores obtained on the Feeling Thermometer and standard gamble utility scores obtained using the Chance Board. A random sample of the general population (> or =16 years of age) in Hamilton, Ontario, Canada. Estimates were obtained for eight single-attribute utility functions and an overall multiattribute utility function. The intraclass correlation coefficient between directly measured utility scores and scores generated by the multiattribute function for 73 health states was 0.88. The HUI3 scoring function has strong theoretical and empirical foundations. It performs well in predicting directly measured scores. The HUI3 system provides a practical way to obtain utility scores based on community preferences.
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            The Speech, Spatial and Qualities of Hearing Scale (SSQ)

            The Speech, Spatial and Qualities of Hearing Scale (SSQ) is designed to measure a range of hearing disabilities across several domains. Particular attention is given to hearing speech in a variety of competing contexts, and to the directional, distance and movement components of spatial hearing. In addition, the abilities both to segregate sounds and to attend to simultaneous speech streams are assessed, reflecting the reality of hearing in the everyday world. Qualities of hearing experience include ease of listening, and the naturalness, clarity and identifiability of different speakers, different musical pieces and instruments, and different everyday sounds. Application of the SSQ to 153 new clinic clients prior to hearing aid fitting showed that the greatest difficulty was experienced with simultaneous speech streams, ease of listening, listening in groups and in noise, and judging distance and movement. SSQ ratings were compared with an independent measure of handicap. After differences in hearing level were controlled for, it was found that identification, attention and effort problems, as well as spatial hearing problems, feature prominently in the disability–handicap relationship, along with certain features of speech hearing. The results implicate aspects of temporal and spatial dynamics of hearing disability in the experience of handicap. The SSQ shows promise as an instrument for evaluating interventions of various kinds, particularly (but not exclusively) those that implicate binaural function.
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              A short form of the Speech, Spatial and Qualities of Hearing scale suitable for clinical use: the SSQ12.

              To develop and evaluate a 12-item version of the Speech, Spatial and Qualities of Hearing scale for use in clinical research and rehabilitation settings, and provide a formula for converting scores between the full (SSQ49) and abbreviated (SSQ12) versions. Items were selected independently at the three centres (Eriksholm Research Centre, MRC Institute of Hearing Research, University of New England) to be representative of the complete scale. A consensus was achieved after discussion. The data set (n = 1220) used for a factor analysis (Akeroyd et al, submitted) was re-analysed to compare original SSQ scores (SSQ49) with scores on the short version (SSQ12). A scatter-plot of SSQ12 scores against SSQ49 scores showed that SSQ12 score was about 0.6 of a scale point lower than the SSQ49 (0-10 scale) in the re-analysis of the Akeroyd et al data. SSQ12 scores lay on a slightly steeper slope than scores on the SSQ49. The SSQ12 provides similar results to SSQ49 in a large clinical research sample. The slightly lower average SSQ12 score and the slightly steeper slope reflect the composition of this short form relative to the SSQ49.
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                Author and article information

                Contributors
                hmauch@cochlear.com
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                25 November 2021
                25 November 2021
                2021
                : 22
                : 845
                Affiliations
                [1 ]GRID grid.420231.6, ISNI 0000 0004 0612 3458, Cochlear AG, ; Basel, Switzerland
                [2 ]Cochlear France SAS, Toulouse, France
                [3 ]GRID grid.450634.0, ISNI 0000 0004 0636 1245, Cochlear Ltd., ; Sydney, Australia
                Author information
                http://orcid.org/0000-0002-0186-7859
                Article
                5821
                10.1186/s13063-021-05821-5
                8613936
                34823566
                8f0a3fdc-8858-491a-a9fd-20ca3f20b760
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 June 2021
                : 12 November 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100008626, cochlear;
                Award ID: N/A
                Categories
                Methodology
                Custom metadata
                © The Author(s) 2021

                Medicine
                international registry,medical device,cochlear implant,quality of life,ssq,iros
                Medicine
                international registry, medical device, cochlear implant, quality of life, ssq, iros

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