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A data collection system to audit post-newborn hearing surveillance programme: problems and possibilities
1Bradford Teaching Hospitals Foundation NHS Trust, St Luke's Hospital, Little Horton Lane, Bradford, UK. soo.yoong@bradfordhospitals.nhs.uk
Insights
Establishing a robust childhood hearing loss surveillance system is achievable, though data analysis has limitations. This system aids in identifying hearing impairments post-newborn screening.
Area of Science:
- Public Health
- Audiology
- Pediatrics
Background:
- Previous guidance highlighted the need for improved systems to track childhood hearing loss after neonatal screening.
- Recommendations emphasized the importance of recording screening activities and auditing school entry hearing screens for coverage, referral, and yield.
Purpose of the Study:
- To develop a data collection system for auditing childhood hearing screening.
- To assess local service performance in identifying children with hearing loss.
Main Methods:
- Data collection focused on children eligible for universal infant and school entry hearing screening.
- Information was linked from a pediatric register of hearing-impaired children to analyze birth cohort data for new sensorineural hearing loss diagnoses.
- Audit data, including coverage, referral, and yield rates, were extracted from the child health system and pediatric register for multiple birth cohorts.
Main Results:
- Coverage rates for recent cohorts ranged from 64.7% to 78.1%, while older cohorts showed 71.4% to 75.6%.
- Referral rates varied, with lower percentages (1.2%-2.6%) in recent cohorts compared to older ones (4.2%-6.6%).
- The overall yield from universal hearing screens was found to be low.
Conclusions:
- Collecting and analyzing childhood hearing loss data within routine surveillance is feasible.
- Limitations in data analysis necessitate careful interpretation of findings.
- The developed system provides usable information to inform current practices in hearing loss surveillance.
Background:
Guidance documents on post-newborn hearing surveillance and screen (Sutton et al.2006; Bamford et al. 2007) indicated the need for a wider system to identify children with hearing loss after neonatal hearing screening. Recommendations were made for systems to be in place for recording screening activity and audit of the school entry hearing screen to provide information on coverage, referral and yield.
Method:
This project has two phases: * development of the data collection system for audit; * assess local service performance.The focus of the work was on data entered into the child health system from children eligible for universal infant and school entry hearing screen. Linking information from a paediatric register of hearing impaired children allowed analysis of birth cohort data related to new diagnoses of sensorineural hearing loss. Available guidelines have not specified gold standards for coverage rates and locally endorsed benchmarks were set at 80% as minimum standards. Analysis of data was carried out on 2003, 2004, 2005, 1998, 1999 and 2000 birth cohorts. The child health system and the paediatric register were the main data sources for the audit exercises. Data extracted were computed for coverage, referral and yield.
Results:
Factors and situations contributing to difficulties in establishing a robust system were identified and addressed. Usable information could be obtained to influence current practice.Coverage rates for 2003, 2004 and 2005 cohort were 64.7%, 78.1% and 73.1%. Their respective referral rates were 1.4%, 1.2% and 2.6%. Coverage rates for 1998, 1999 and 2000 cohort were 74.9%,75.6% and 71.4%. Their respective referral rates were 5.2%, 4.2% and 6.6%. The overall yield from universal screens was low.
Conclusion:
Our study showed that it was achievable to collect and analyse data on childhood hearing loss in the context of routine surveillance. There were, however, limitations to analysis of data and findings have to be interpreted with this in mind.
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