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Published on: January 23, 2017
Overcoming difficulties in implementing a universal newborn hearing screening program
Stavros Korres1, Dimitrios G Balatsouras, Stamatia Vlachou
1Department of Ear, Nose and Throat Diseases, Athens National University Hippokration Hospital, Athens, Greece.
Insights
This study evaluated a universal newborn hearing screening program using transiently evoked otoacoustic emissions (TEOAE). The protocol successfully reduced initial screening failures and lost follow-ups, achieving low refer rates.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Early detection of hearing loss in newborns is critical for developmental outcomes.
- Universal newborn hearing screening programs aim to identify infants with hearing impairment shortly after birth.
- Implementing and optimizing screening protocols presents logistical challenges.
Purpose of the Study:
- To report on the experience and efficiency of a universal newborn hearing screening program.
- To identify and address challenges encountered since the program's inception.
- To assess the effectiveness of protocol modifications in improving screening outcomes.
Main Methods:
- Analysis of screening data from 22,195 newborns.
- Utilized transiently evoked otoacoustic emissions (TEOAE) for hearing screening.
- Implemented protocol modifications to reduce non-screening and lost follow-up rates.
Main Results:
- 84.8% of newborns passed the initial TEOAE test.
- An additional 12.15% passed upon rescreening before discharge, yielding a total pass rate of 96.95%.
- The overall "not pass" rate was 3.05%, with reductions observed in newborns not undergoing screening and those lost to follow-up over time.
Conclusions:
- The implemented screening protocol proved effective in achieving low refer rates for follow-up.
- Protocol modifications successfully decreased the incidence of newborns not screened and lost to follow-up.
- A significant unresolved issue remains the lack of effective follow-up mechanisms for infants identified with potential hearing loss.
Abstract:
The aim of this paper was to present our experience with a universal newborn hearing screening program, including the specific problems and difficulties faced since its beginning, along with the measures used to overcome them and to improve its efficiency. We analyzed data from 22,195 newborns screened by transiently evoked otoacoustic emissions (TEOAE) performed during the first days after birth. 84.8% of the newborns passed on the first test and another 12.15% passed on rescreening before hospital discharge. This produced a "not pass" rate (false-positive and true positive) of 3.05%. The rate of newborns who did not undergo screening and the rate of "lost to follow-up" newborns were reduced in time, due to various applied modifications to the protocol. It may be thus concluded that our protocol proved to be successful in attaining low refer rates for follow-up screening. A major problem that remains unresolved is the absence of effective follow-up.
