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Updated: Aug 18, 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
[Controlling retests in a universal hearing screening program]
G Trinidad Ruiz1, C G Pantoja Hernández, G Trinidad Ramos
1Servicio de ORL, Complejo Hospitalario Universitario Infanta Cristina, Badajoz. gtrinidadr@papps.org
Insights
Early auditory screening for newborns significantly impacts retesting rates, with public systems showing higher needs. Delaying auditory screening beyond 3 days post-birth reduces retesting, but may affect overall program coverage.
Area of Science:
- Neonatal care
- Audiology
- Public health
Context:
- Universal auditory screening programs are crucial for early detection of hearing loss in newborns.
- Differences in healthcare systems (public vs. private) may influence screening protocols and outcomes.
- 18,073 infants born between 1999-2004 were studied to assess factors influencing retesting needs.
Purpose:
- To evaluate the influence of various factors on the necessity for retesting in the initial phase of universal auditory screening.
- To compare retesting rates between public and private healthcare systems.
- To determine the impact of age at testing on retesting rates and program coverage.
Summary:
- A study of 18,073 infants found significant differences in retesting rates between public (7.3%) and private (2.4%) healthcare systems.
- Higher retesting rates in public systems were linked to testing within 3 days of birth.
- Testing between 4-10 days post-birth in other groups resulted in lower retesting rates (4.9%).
Impact:
- Retesting rates are a key factor in estimating the cost-effectiveness of auditory screening protocols.
- Testing infants before hospital discharge can increase program coverage.
- Delaying auditory screening may be considered by systems needing to conserve resources, but not at the expense of maximum coverage.
Introduction:
To evaluate the influence of several factors in the need for retesting in the first stage of a universal auditory screening program, a prospective and statistic study is presented, specially remarking the differences found between two health systems (public and private).
Patients And Methods:
18,073 children born in the 1999-2004 period were included in the study, in the context of a universal screening protocol based on Otoacoustic emissions and ABR, and distributed into three groups depending on their place of birth (A: public hospital; B: private hospital; C: children from other region).
Results:
Significant differences were found between the groups (7.3% retesting in the public system and 2.4% in the private), explained by the fact that in the first group the test was performed in 74.9% of cases within 3 days after birth (when the need for repetition was 7,7%), and in the other groups the exploration was delayed up to 4-10 days in most cases (when retesting was performed only in 4.9%).
Discussion And Conclusions:
Proportion of retesting in the first stage of a universal screening program is an important factor for the cost estimation of these protocols. We assume that the age at testing varies significantly this factor, and on the contrary, we know that precocious exploration (before the child leaves the hospital) increases the program covering. Therefore we conclude that the test should be delayed only in health systems needing to save resources or not able to test before discharge, and not in those wanting to guarantee the maximum covering.
