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Hearing screening in a well-infant nursery: profile of automated ABR-fail/OAE-pass
Abbey L Berg1, Beth A Prieve, Yula C Serpanos
1Department of Biology and Health Sciences, Dyson College of Arts and Sciences, Pace University, New York, New York 10038, USA. aberg@pace.edu
Insights
The auditory brainstem response fail/otoacoustic emission pass (ABR-F/OAE-P) screening outcome is rare in well-infant nurseries (WINs). Otoacoustic emission (OAE) testing is a reasonable screening tool for infants in WINs.
Area of Science:
- Neonatal care
- Audiology
- Screening protocols
Background:
- Auditory neuropathy spectrum disorder (ANSD) screening is crucial for early intervention.
- Well-infant nurseries (WINs) present unique challenges for auditory screening.
- The ABR-F/OAE-P pattern requires specific diagnostic consideration.
Purpose of the Study:
- To determine the prevalence of the ABR-F/OAE-P screening outcome in WIN infants.
- To identify risk factors for ANSD in this population.
- To compare the costs of two distinct auditory screening protocols.
Main Methods:
- A cohort of 20,529 infants in WINs was screened using an experimental protocol (ABR first, then OAE).
- A second cohort of 281 infants was screened using the standard protocol (OAE first, then ABR).
- Preparation and testing times, along with personnel costs, were compared between protocols.
Main Results:
- The ABR-F/OAE-P outcome occurred in 0.92% of inpatients and 0% of outpatients.
- The experimental protocol required 4x longer preparation and 2.6x longer administration time.
- Inpatient costs were 3x higher for the experimental protocol due to personnel time.
Conclusions:
- The prevalence of ABR-F/OAE-P outcomes in WIN infants is low (<1%).
- Otoacoustic emission (OAE) testing is a viable initial screening tool in WIN settings.
- The standard OAE-first protocol is more cost-effective and efficient than the experimental ABR-first protocol.
Objectives:
The goals were to examine the prevalence of a screening outcome pattern of auditory brainstem response fail/otoacoustic emission pass (ABR-F/OAE-P) in a cohort of infants in well-infant nurseries (WINs), to profile children at risk for auditory neuropathy spectrum disorder, and to compare inpatient costs for 2 screening protocols using automated auditory brainstem response (ABR) and otoacoustic emission (OAE) screening.
Methods:
A total of 10.6% (n = 2167) of 20 529 infants admitted to WINs in 2006-2009 were screened for auditory neuropathy spectrum disorder risk by using an experimental protocol (automated ABR testing first, followed by OAE testing if the automated ABR test was not passed). A second WIN cohort (n = 281) was screened by using the standard WIN protocol for the facility (OAE testing first, followed by automated ABR testing if the OAE test was not passed). Comparisons were made regarding preparation and testing times and personnel costs.
Results:
The ABR-F/OAE-P outcome was found for 0.92% of infants in WINs in inpatient testing and none in outpatient rescreening. The time for test preparation was 4 times longer and that for test administration was 2.6 times longer for the experimental protocol, compared with the standard protocol. Inpatient costs for the experimental protocol included 3 times greater personnel time costs.
Conclusions:
Less than 1% of infants in WINs had ABR-F/OAE-P screening outcomes as inpatients and none as outpatients. These results suggest that prevalence is low for infants cared for in WINs and use of OAE testing as a screening tool in WINs is not unreasonable.
