Objective Hearing Screening Measures: An Exploration of a Suitable Combination for Risk-Based Newborn Hearing Screening

2018 ◽  
Vol 29 (06) ◽  
pp. 495-502 ◽  
Author(s):  
Amisha Kanji ◽  
Katijah Khoza-Shangase
Keyword(s):  
Otoacoustic Emissions ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Paired Data ◽  
Distortion Product ◽  
Repeated Measures Design ◽  
Automated Auditory Brainstem Response ◽  
Newborn Hearing ◽  
Brainstem Response ◽  
Screening Measures

AbstractThe ideal hearing screening measure is yet to be defined, with various newborn hearing screening protocols currently being recommended for different contexts. Such diverse recommendations call for further exploration and definition of feasible and context-specific protocols.The aim of the study was to establish which combinations of audiological screening measures provide both true-positive (TP) and true-negative (TN) results for risk-based hearing screening, at and across time.A longitudinal, repeated-measures design was employed.Three-hundred and twenty-five participants comprised the initial study sample. These participants comprised newborns and infants who were discharged from the neonatal intensive care unit and high care wards to “step down” wards at two public sector hospitals within an academic hospital complex.Transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), and automated auditory brainstem response (AABR) were conducted at the initial and repeat hearing screening. Diagnostic audiological assessments were also conducted. Results from combinations of audiological screening measures at the initial and repeat hearing screening were analyzed in relation to the final diagnostic outcome (n = 91). Participants were classified as presenting with an overall “refer” if the outcome for any one test was “refer.” The overall screening outcomes for different test combinations were compared using McNemar’s test for paired data. Proportions across different test combinations were compared by the z-test for proportions.Because of the absence of participants with hearing loss in the current study sample, analysis could only be conducted in relation to TN findings (specificity) and not TP findings (sensitivity). The percentage of TN findings was highest at the repeat hearing screening using any test or combination of tests when compared with findings from the initial hearing screening. TEOAE combined with AABR (TEOAE/AABR) (p < 0.0001), DPOAE combined with AABR (DPOAE/AABR) (p < 0.0001), and the combination of all three screening measures (p < 0.0001) yielded the highest percentage specificity at the repeat hearing screening when compared with the initial hearing screening.The best specificity was noted at the repeat hearing screening. Within a resource stricken context, where availability of all screening measures options may not be feasible, current study findings suggest the use of a two-stage AABR protocol or TEOAE/AABR protocol.

scholarly journals Newborn Hearing Screening in Bavaria—Is It Possible to Reach the Quality Parameters?

2018 ◽  
Vol 4 (3) ◽  
pp. 26
Author(s):  
Inken Brockow ◽  
Kristina Söhl ◽  
Uta Nennstiel
Keyword(s):  
Screening Test ◽  
Otoacoustic Emissions ◽  
Tracking System ◽  
Quality Criteria ◽  
Hearing Screening ◽  
Screening Methods ◽  
Newborn Hearing Screening ◽  
Automated Auditory Brainstem Response ◽  
Newborn Hearing ◽  
Brainstem Response

Since the 1 January, 2009, newborn hearing screening (NHS) has been obligatory for every child in Germany. NHS is part of the Pediatrics Directive of the Federal Joint Committee. In this directive, details of the procedures and screening quality to be achieved are given. We evaluate if these quality criteria were met in Bavaria in 2016. The NHS data of children born in 2016 in Bavaria were evaluated for quality criteria, such as screening coverage in screening facilities, screening methods, referral rate (rate of failed tests at discharge) and a child’s age at the diagnosis of a hearing disorder. NHS was documented for 116,776 children born in Bavaria in 2016. In the first step, 78,904 newborns were screened with transient evoked otoacoustic emissions and 37,865 with automated auditory brainstem response. Of these, 9182 (7.8%) failed the first test in one or both ears. A second screening before discharge was performed on 53.3% of the newborns with a refer result in the first test, out of which 58.7% received a pass result. After the screening process, 4.6% of the newborns were discharged with a refer result. Only 18% of the first controls after discharge were performed by a pediatric audiologist. In 37.9% of the newborns, the screening center intervened to assure the control of any failed screening test. The median age of diagnosis for bilateral hearing loss was 5.3 months. In Bavaria, NHS was implemented successfully. A tracking system for all children who failed the hearing screening test is pivotal for early diagnosis and therapy of children with hearing deficiency.

The Impact of Pass/Refer Criteria in the Use of Otoacoustic Emission Technology for Newborn Hearing Screening

2021 ◽  
pp. 1-7
Author(s):  
Amisha Kanji ◽  
Alida Naudé
Keyword(s):  
Repeated Measures ◽  
Otoacoustic Emissions ◽  
Screening Program ◽  
Otoacoustic Emission ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Distortion Product ◽  
Repeated Measures Design ◽  
Newborn Hearing ◽  
The Impact

Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.

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