Related Experiment Video
Updated: Aug 29, 2026
Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
The effect of different 'pass-fail' criteria on the results of a newborn hearing screening program
Stavros Korres1, Dimitrios Balatsouras, Eleftherios Ferekidis
1ENT Department of Athens National University, Ippokration Hospital, Athens, Greece.
Insights
A lower signal-to-noise ratio (SNR) of 3 dB is as effective as a 6 dB criterion for newborn hearing screening. This finding supports using the 3 dB SNR, especially when rescreening is unavailable.
Area of Science:
- Audiology
- Neonatal care
- Public health screening
Background:
- Newborn hearing screening programs are crucial for early detection of hearing loss.
- The 'pass' criteria significantly influence the operating characteristics and effectiveness of these screening programs.
- Different signal-to-noise ratio (SNR) thresholds may impact screening outcomes.
Purpose of the Study:
- To compare the effectiveness of two different 'pass' criteria for newborn hearing screening.
- To evaluate the validity of a 3 dB SNR criterion against a 6 dB SNR criterion.
- To determine the optimal 'pass' criterion for neonatal hearing screening programs.
Main Methods:
- Two study groups of newborns were screened consecutively over six months.
- Both groups underwent identical testing procedures, differing only in the 'pass' criteria.
- Group 1 used a 3 dB SNR (at 1-2, 2-3, 3-4 kHz) for 'pass', while Group 2 used a 6 dB SNR.
Main Results:
- No statistically significant differences were observed in the 'pass-refer' results between the two groups.
- The 3 dB SNR criterion demonstrated comparable validity to the 6 dB SNR criterion.
- Screening outcomes were consistent across both tested signal-to-noise ratio thresholds.
Conclusions:
- A 3 dB signal-to-noise ratio is a valid 'pass' criterion for newborn hearing screening.
- The 3 dB SNR can be confidently employed, particularly in settings lacking rescreening capabilities.
- This finding may enhance the efficiency and accessibility of neonatal hearing screening programs.
Abstract:
'Pass' criteria in newborn hearing screening programs are important, since they affect the operating characteristics of the programs. In the present study, we intended to compare the results of two screening procedures, using different 'pass' criteria, in two samples from the same pool of screened newborns. The subjects were divided into two study groups, screened consecutively during 6 months. Testing and all procedures were exactly the same in both groups, differing only in the 'pass' criteria. In the first group a signal-to-noise ratio of at least 3 dB in the frequency bands of 1-2, 2-3 and 3-4 kHz was considered necessary for a 'pass', whereas a signal-to-noise ratio > or =6 dB was used in the second group, at the same frequency bands. During the period of the study, no other minor or major modification of the protocol was applied. The comparison of the screening predischarge results between the two groups showed no statistically significant differences in the 'pass-refer' results. Thus, it appears that the 3-dB signal-to-noise ratio is as valid as the 6-dB criterion, and it may be confidently used, especially in settings where rescreening is not available.
