The effectiveness of the promotion of newborn hearing screening in Taiwan

Huang, Chun-Wei; Yang, I-Ying; Julie, Ying-Chuan; Lin, Grace; Yang, Chang‐Hsien; Tsai, Hsen-Tien; Lin, Hung-Ching

doi:10.1016/j.ijporl.2013.10.005

Cited by 16 publications

(14 citation statements)

References 11 publications

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“…In the WBN group, 31 babies did not undergo hearing screening (30 died; for 1, no test result was available); in the NICU group, 7 babies did not undergo hearing screening because of poor health conditions. The hearing screening coverage rate close to 100% observed in our study was also evident in another study conducted in Taiwan[ 9 ] and the U.S. [ 20 ]. The near 100% of coverage rate were achieved because of the implementation of the free national UNHS program in Taiwan in 2012 [ 9 ].…”

Section: Discussionsupporting

confidence: 89%

Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU

Chen

Huang

et al. 2016

PLoS ONE

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ObjectivesTo determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICUMaterials and MethodsIt examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital’s institutional review board (13MMHISO23).ResultsThe screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference.ConclusionThe screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.

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Section: Discussionsupporting

confidence: 89%

Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU

Chen

Huang

et al. 2016

PLoS ONE

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“…The average ages at detection of HL and implantation in the 171 patients were 1.7 y and 4.2 y, respectively ( Table 3 ). A possible explanation for the late detection and implantation is that the coverage rate of newborn hearing screening in Taiwan had not increased to 90% until 2012 [ 34 ], resulting in delayed diagnosis in certain hearing-impaired children.…”

Section: Resultsmentioning

confidence: 99%

Long-Term Cochlear Implant Outcomes in Children with GJB2 and SLC26A4 Mutations

Tsou

et al. 2015

PLoS ONE

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ObjectivesTo investigate speech and language outcomes in children with cochlear implants (CIs) who had mutations in common deafness genes and to compare their performances with those without mutations.Study DesignProspective study.MethodsPatients who received CIs before 18 years of age and had used CIs for more than 3 years were enrolled in this study. All patients underwent mutation screening of three common deafness genes: GJB2, SLC26A4 and the mitochondrial 12S rRNA gene. The outcomes with CIs were assessed at post-implant years 3 and 5 using the Categories of Auditory Performance (CAP) scale, Speech Intelligibility Rating (SIR) scale, speech perception tests and language skill tests.ResultsForty-eight patients were found to have confirmative mutations in GJB2 or SLC26A4, and 123 without detected mutations were ascertained for comparison. Among children who received CIs before 3.5 years of age, patients with GJB2 or SLC26A4 mutations showed significantly higher CAP/SIR scores than those without mutations at post-implant year 3 (p = 0.001 for CAP; p = 0.004 for SIR) and year 5 (p = 0.035 for CAP; p = 0.038 for SIR). By contrast, among children who received CIs after age 3.5, no significant differences were noted in post-implant outcomes between patients with and without mutations (all p > 0.05).Conclusion GJB2 and SLC26A4 mutations are associated with good post-implant outcomes. However, their effects on CI outcomes may be modulated by the age at implantation: the association between mutations and CI outcomes is observed in young recipients who received CIs before age 3.5 years but not in older recipients.

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“… 66 The average implantation age in the 12 cases with poor outcomes was 3.2 years, which is close to the upper limit of the optimal time period and already beyond the best time to implant a child. A possible explanation for the late implantation is that the coverage rate of newborn hearing screening in Taiwan had not increased to 90% until 2012, 67 resulting in delayed diagnosis in certain hearing-impaired children. Although we used a “matched controls” study design to control for the confounding effects of the implantation age on the CI outcomes, we could not exclude the possibility that poor performers in the present study might have done better if they were implanted earlier in life.…”

Section: Discussionmentioning

confidence: 99%

Identifying Children With Poor Cochlear Implantation Outcomes Using Massively Parallel Sequencing

Lin

Liu

et al. 2015

Medicine

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Cochlear implantation is currently the treatment of choice for children with severe to profound hearing impairment. However, the outcomes with cochlear implants (CIs) vary significantly among recipients. The purpose of the present study is to identify the genetic determinants of poor CI outcomes. Twelve children with poor CI outcomes (the “cases”) and 30 “matched controls” with good CI outcomes were subjected to comprehensive genetic analyses using massively parallel sequencing, which targeted 129 known deafness genes. Audiological features, imaging findings, and auditory/speech performance with CIs were then correlated to the genetic diagnoses. We identified genetic variants which are associated with poor CI outcomes in 7 (58%) of the 12 cases; 4 cases had bi-allelic PCDH15 pathogenic mutations and 3 cases were homozygous for the DFNB59 p.G292R variant. Mutations in the WFS1, GJB3, ESRRB, LRTOMT, MYO3A, and POU3F4 genes were detected in 7 (23%) of the 30 matched controls. The allele frequencies of PCDH15 and DFNB59 variants were significantly higher in the cases than in the matched controls (both P < 0.001). In the 7 CI recipients with PCDH15 or DFNB59 variants, otoacoustic emissions were absent in both ears, and imaging findings were normal in all 7 implanted ears. PCDH15 or DFNB59 variants are associated with poor CI performance, yet children with PCDH15 or DFNB59 variants might show clinical features indistinguishable from those of other typical pediatric CI recipients. Accordingly, genetic examination is indicated in all CI candidates before operation.

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The effectiveness of the promotion of newborn hearing screening in Taiwan

Cited by 16 publications

References 11 publications

Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU

Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU

Long-Term Cochlear Implant Outcomes in Children with GJB2 and SLC26A4 Mutations

Identifying Children With Poor Cochlear Implantation Outcomes Using Massively Parallel Sequencing

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