Referral rate and false-positive rates in a hearing screening program among high-risk newborns

Abstract

Aim More studies exploring referral rates and false-positive rates are needed to make hearing screening programs in newborns better and cost-effective. Our aim was to study the referral and false-positivity rates among high-risk newborns in our hearing screening program and to analyze the factors potentially associated with false-positive hearing screening test results. Methods A retrospective cohort study was done among the newborns hospitalized at a university hospital from January 2009 to December 2014 that underwent hearing screening with a two-staged AABR screening protocol. Referral rates and false-positivity rates were calculated and possible risk factors for false-positivity were analyzed. Results 4512 newborns were screened for hearing loss in the neonatology department. The referral rate for the two-staged AABR-only screening was 3.8% with false-positivity being 2.9%. Our study showed that the higher the birthweight or gestational age of the newborn, the lower the odds of the hearing screening results being false-positive, and the higher the chronological age of the infant at the time of screening, the higher the odds of the results being false-positive. Our study did not show a clear association between the mode of delivery or gender and false-positivity. Conclusion Among high-risk infants, prematurity and low-birthweight increased the rate of false-positivity in the hearing screening, and the chronological age at the time of the test seems to be significantly associated with false-positivity.

Universal Newborn Hearing Screening Program: 10-Year Outcome and Follow-Up from a Screening Center in Germany

“…The Children’s Directive prescribes that 95% of children who failed the initial screening should receive an AABR rescreening at the same hospital before being discharged. This also proved to be an important problem in our setting, because a lot of birth facilities did not have trained personnel to perform the test [ 21 ]. This became a separate step in the process (S2), which was taken over by the so-called DSFC, adding to the burden of the system.…”

“…Referral rates seem to vary considerably based on the type of screening program and the population involved, especially between low- and high-risk newborns. They have been reported to be lower when only AABR was used instead of the two-step TEOAE and AABR protocol [ 21 , 32 , 33 ]. We believe that the main reason for such referral rates at the hospital was due to the presence of increased high-risk newborns, which is evident from both the transfer of many sick infants and the use of two-step TEOAE and AABR protocol.…”

“…The second phase of follow-up (FU2) involves infants who failed FU1 and shows the referral rate to the hearing screening center [ 21 ]. FU2 takes place in specialized pediatric audiology centers, where a protocol of diagnostic tests performed by pediatric audiologists follows to ascertain the etiology of the failed hearing screening.…”

“…In this study, we assessed and reported the coverage rate 'Follow-up' in turn includes two phases (FU1 and FU2). The first phase (FU1) involves re-testing of the infants who failed 'screening' and is performed at the DSFC, using AABR at 35 dB HL [21]. The DSFC notifies the TC about the results of their examination.…”

Prevalence of Ocular Morbidity and Associated Factors Among Hearing Impaired Children at Embangweni School of the Deaf in Mzimba District, Malawi

“…9 Individuals with HI use vision to compensate for auditory information, 10,11 and hearing impairment can negatively impact their quality of life and social and academic performance; hence, a sense of vision compensates for these effects. 12,13 Blindness caused by various ocular diseases poses a major threat to people with HI. 14 Ocular disorders, such as refractive errors and cataracts, are common in HI.…”