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Published on: January 23, 2017
The feasibility of hospital-based universal newborn hearing screening in the United Kingdom
1St Helier & Epsom NHS Trust, and the Institute of Laryngology & Otology, United Kingdom. wendyalbuquerque@btinternet.com
Insights
Hospital-based universal newborn hearing screening (UNHS) is feasible in the UK. A 7-day screening protocol achieved 89% coverage, demonstrating viability for early detection of hearing loss.
Area of Science:
- Audiology
- Public Health
- Neonatal Care
Background:
- Current UK hearing screening programs are inadequate.
- Universal newborn hearing screening (UNHS) proposed as a more effective solution.
- Concerns exist regarding feasibility due to early postnatal discharge.
Purpose of the Study:
- To assess the viability of hospital-based UNHS in a UK district general hospital.
- To determine optimal screening times and protocols for UNHS.
- To evaluate screening coverage and false positive rates.
Main Methods:
- Study 1: Retrospective analysis of discharge data for 3021 newborns to determine optimal screening times.
- Study 2: Prospective testing of a 7-day screening protocol (9 am-2 pm) using otoacoustic emissions.
- Data collected on screening coverage and false positive rates.
Main Results:
- Most newborns were discharged at times suitable for predischarge hearing screening.
- Predicted maximal screening coverage was 92.68%.
- The tested protocol achieved 89.06% coverage with a 6.2% false positive rate.
Conclusions:
- Hospital-based UNHS is a viable option in the UK.
- A 7-day screening protocol from 9 am-2 pm is effective.
- The protocol can likely be adapted for successful implementation in other UK hospitals.
Abstract:
Current hearing screening programmes in the United Kingdom are performing unacceptably poorly. Davies et al. (1997) suggested that universal newborn hearing screening (UNHS) would be more effective and cheaper to run. However, there is concern that hospital-based UNHS would not be feasible because of early postnatal discharge, and thus babies not staying in hospital long enough to be screened. Two studies were designed to determine the viability of hospital-based UNHS in a district general hospital in the United Kingdom. Study 1 retrospectively determined the discharge age and time of discharge of all 3021 well babies born at St Helier hospital, Carshalton, and the number of babies born at home in the area, from 19 October 1997-18 October 1998. Most well babies were found to pass through hospital at a convenient time for predischarge hearing screening, and the optimal protocol was screening from 9 am-2 pm, 7 days a week. The predicted maximal screening coverage was 92.68%. Study 2 tested the calculated optimal protocol over 1 week. It was found that UNHS with otoacoustic emissions on the maternity ward from 9 am-2 pm, 7 days a week, achieved a coverage of 89.06%, with an acceptable false positive rate of 6.2%. It is likely that a similar protocol with slight modifications could be implemented successfully in other hospitals in the United Kingdom.
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