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Evaluating a prediction model for infant hearing loss
Judith E C Lieu1, Felicia Ratnaraj, Banan Ead
1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
Insights
A new model identifies infants at high risk for hearing loss after failing newborn screening. Four key risk factors predict the likelihood of diagnosed hearing loss, enabling earlier intervention.
Area of Science:
- Pediatrics
- Audiology
- Neonatal Care
Background:
- Newborn hearing screening is crucial for early detection of hearing loss.
- Infants failing initial screening require further diagnostic testing.
- Predictive models can aid in identifying high-risk infants for targeted follow-up.
Purpose of the Study:
- To develop and validate a prognostic model for predicting hearing loss in infants who fail newborn hearing screening.
- To identify independent risk factors associated with hearing loss diagnosed by auditory brainstem response (ABR) testing.
Main Methods:
- Retrospective case-control study involving 229 infants with hearing loss and 458 with normal hearing.
- Auditory brainstem response (ABR) testing was used for diagnosis.
- Medical records were reviewed to extract risk factors, birth history, and other relevant data.
- Multiple logistic regression analysis was employed to identify independent predictors of hearing loss.
Main Results:
- Four risk factors independently predicted hearing loss: prematurity, low 5-minute APGAR score (≤6), intracranial complication, and craniofacial abnormality.
- A prognostic model demonstrated increasing rates of hearing loss across stages: Stage I (15%), Stage II (52%), and Stage III (96%).
- The presence of any one risk factor was associated with a 50% hearing loss rate, while three or more indicated a 90% rate.
Conclusions:
- A prognostic model incorporating four key risk factors effectively predicts the likelihood of hearing loss in infants failing newborn screening.
- Early identification of high-risk infants can encourage timely diagnostic ABR testing and subsequent intervention.
- This model supports targeted follow-up strategies for infants at increased risk of hearing impairment.
Objectives/Hypothesis:
The objective of this study was to determine whether a prognostic model using risk factors for hearing loss could predict the chance that infants who failed a newborn hearing screen would subsequently be found to have hearing loss diagnosed by auditory brainstem response testing.
Study Design:
Individual retrospective case-control study.
Methods:
We studied 229 infants with hearing loss compared with 458 infants with normal hearing. All infants had undergone natural sleep or sedated auditory brainstem response, predominantly for not passing a newborn hearing screen. Risk factors, birth history, and other information were extracted via medical record review. Multiple logistic regression analyses identified independent predictors of hearing loss.
Results:
Four risk factors were independently predictive of hearing loss diagnosed by sleep or sedated auditory brainstem response: prematurity, 5-minute APGAR score ≤ 6, intracranial complication, and craniofacial abnormality. A prognostic model developed from these risk factors was associated with a 15% rate of hearing loss in stage I, 52% rate of hearing loss in stage II, and 96% rate of hearing loss in stage III.
Conclusions:
The presence of any one of four independently predictive risk factors in infants who did not pass newborn hearing screen was associated with a 50% rate of hearing loss; having three or more was associated with a 90% rate of hearing loss. Knowing that an infant is at high risk of hearing loss can motivate parents to follow up with diagnostic auditory brainstem response testing so that early identification can lead to early intervention.
