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Related Experiment Videos

Minimizing false-positives in universal newborn hearing screening: a simple solution.

C J Clemens1, S A Davis

  • 1Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA. conrad.clemens@mosescone.com

Pediatrics
|March 7, 2001
PubMed
Summary
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Rescreening newborns before hospital discharge significantly reduces false-positive rates in universal newborn hearing screening (UNHS). This simple intervention lowers the false-positive rate from 3.9% to 0.8%, minimizing unnecessary stress and costs associated with hearing loss diagnosis.

Area of Science:

  • Audiology
  • Neonatal Care
  • Public Health Screening

Background:

  • Universal newborn hearing screening (UNHS) programs aim to detect hearing loss early.
  • Previous UNHS programs reported high false-positive rates (2.5%-8%), leading to concerns about infant stress and unnecessary costs.
  • A preliminary study suggested that rescreening infants before discharge could significantly improve accuracy.

Purpose of the Study:

  • To evaluate the effectiveness of a rescreening protocol for infants who initially failed UNHS.
  • To determine the impact of this intervention on false-positive rates and positive predictive value.
  • To assess the feasibility of implementing this protocol in UNHS programs.

Main Methods:

  • A 7-month study involving 3142 non-NICU infants screened using automated auditory brainstem response (AABR).

Related Experiment Videos

  • Infants who failed the initial AABR were rescreened with AABR before hospital discharge.
  • Data collected included initial and rescreening pass/fail rates, confirmed hearing loss, and risk factors.

    • Main Results:

    • Rescreening before discharge reduced the false-positive rate to 0.8% (compared to 3.9% without rescreening).
    • Eighty percent of infants who initially failed passed the rescreening.
    • Confirmed hearing loss occurred in 2.5 per 1000 infants, with a positive predictive value of 24% after rescreening.

    Conclusions:

    • A simple, inexpensive intervention of rescreening infants before hospital discharge effectively reduces UNHS false-positive rates.
    • This protocol minimizes unnecessary follow-up testing, parental anxiety, and healthcare costs.
    • Implementing this rescreening strategy is recommended for all UNHS programs.