Exam Preview for 33210: 20Q: An Overview of the New Cochlear Implan

20Q: An Overview of the New Cochlear Implant Practice Guidelines

Please note: exam questions are subject to change.

1. What is the purpose of a clinical practice guideline? to provide evidence-based recommendations to clinicians for use in clinical care to provide a legal document to serve as the basis for state licensure laws to determine the way in which clinical care can be provided at the lowest cost possible to provide a precise step-by-step protocol for a given clinical activity
2. A clinical practice guideline: Provides the evidence base from which clinicians can make individualized decisions Can help inform professionals, reimbursement agencies, patients and families about the research basis for current best practices Involves reviewing scientific evidence as well as indirect evidence and consensus practice All of the above
3. How do clinical practice guidelines differ from standards? Clinical practice guidelines do not differ from standards; the terms are interchangeable. A clinical practice guideline is a step-by-step protocol, like a cookbook, whereas a standard is a summary of evidence on a topic. Standards are rigid and provide a specific process whereas clinical practice guidelines provide evidence and research-based information to inform clinical decisions. Clinical practice guidelines are based on evidence and research, while standards are based on how typical care is actually implemented in real world clinical situations.
4. The highest level of evidence (at the top of the hierarchy of study types) includes: expert opinion case studies systematic reviews and meta-analysis of randomized controlled trials descriptive studies (e.g. cohort studies, case-control designs)
5. To appraise published research when developing a clinical practice guideline: all studies on a topic must always be considered, both lower quality studies and higher quality studies all published articles on a topic must always be considered, both peer reviewed and those that are not peer reviewed only studies that are rated at the highest level of evidence are considered studies at the top of the hierarchy of study types are identified - the search is extended to lower quality studies only if there are no higher quality studies
6. According to the new cochlear implant guidelines, which of the following statements is TRUE in regard to candidacy? Candidacy criteria for cochlear implants has not changed since CIs were first available in 1984 CIs should be considered for individuals whose hearing loss cannot be adequately addressed through acoustic amplification alone, and candidacy criteria has changed over time Candidacy for a cochlear implant should be the sole decision of the CI surgeon according to the new guidelines The criteria for cochlear implantation should focus on audiometric thresholds, and only those with no measurable hearing should be considered candidates
7. Why is it important for the audiologist to be aware of surgical considerations for cochlear implantation? the audiologist is responsible for assessing for surgical contraindications and reporting to the surgeon and anesthesioloigst knowledge of the procedure will allow the audiologist to better guide the patient through the process, and the audiologist may be involved intra-operatively during device monitoring the audiologist can recommend specific devices and surgical techniques that have worked best for other patients so that audiologists can conduct initial activation of the cochlear implant in the operating room so that the patient can immediately begin using it
8. In regard to CI programming, which of the following is true according to the new CI practice guidelines? the guidelines provide specific recommendations for each manufacturer's device currently available the market. counseling is only recommended at initial activation but is not required at subsequent appointments. upper stimulation (C/M) levels should always be set to device maximum since overestimating upper stimulation levels has no negative impact. when possible, both psychophysical and objective measures should be used to establish the dynamic range on selected electrodes.
9. The new CI clinical practices guidelines: may change as technology advances and new research becomes available contain a comprehensive step by step billing and coding section to ensure audiologists receive optimum reimbursement for their time are not expected to change over time as they are intended to only be a very high level summary of research may be controversial because of the new, emerging protocols put forth in the guidelines
10. The new cochlear implant clinical practice guidelines were authored by: Hearing Industries Association (HIA) American Academy of Audiology (AAA) Task Force on Cochlear Implant Practices H. Gustav Mueller, PhD American Cochlear Implant Alliance