Hearing loss screening tool (COBRA score) for newborns in primary care setting

Abstract

PurposeTo develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool.MethodsThis cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score.ResultsFive clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69–43.26), 58.52 (95% CI, 36.26–94.44), and 51.56 (95% CI, 33.74–78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59–34.66).ConclusionA simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

Early hearing detection and intervention (EHDI) programmes for infants and young children in low-income and middle-income countries in Asia: a systematic review

“…This is comparable to HICs where PTA screening is mandatory for children over the age of 3 94 95. In contrast, the current review found a few public initiatives75 87 96 that used questionnaire methods, and this implies that mass screening was being done by low-cost tools like questionnaires where resources were limited.…”

Retrospective Evaluation of Results of Newborn Hearing Screening and Importance of Patient Record System

“…Globally, 32 millions of children are estimated to have impaired hearing all around the world and a great majority of them are known to live in countries with low and middle income (1). Prevalence of newborn hearing loss has been stated to be 1-6/1000 infants in every live birth, 3/1000 infants in average, this rate increases up to 10/1000 in infants of risk group in neonatal intensive care units (2,3).…”