Improving newborn hearing screening: Are automated auditory brainstem response ear inserts an effective option?

Area of Science:

• Audiology
• Neonatal Care
• Public Health

Background:

• Universal newborn hearing screening is standard in Hong Kong using a 2-stage automated auditory brainstem response (AABR) protocol.
• A potential cost reduction was explored by replacing the initial ear coupler screening with a more economical ear insert-based procedure.

Purpose of the Study:

• To evaluate the effectiveness of an insert-based AABR initial screening.
• To project the cost-effectiveness of a combined probe-based and follow-up ear coupler AABR screening procedure.

Main Methods:

• A cross-sectional, repeated measures study involved 167 healthy neonates undergoing sequential AABR screening.
• Both ear coupler and ear probe (insert) procedures were used with comparable AABR instruments in both ears.

Main Results:

• Insert-based AABR screening resulted in a five-fold higher rescreen rate and 50% longer screening time compared to coupler-based screening.
• While consumable costs could decrease by 9.87%, the utility of ear probe screening was found to be lower than conventional ear coupler screening.

Conclusions:

• Changes in screening methods, such as using ear inserts, can significantly alter outcomes.
• A 2-stage AABR screening protocol using ear inserts may be impractical due to higher false positive rates and increased time requirements.