Universal Newborn Hearing Screening Program: 10-Year Outcome and Follow-Up from a Screening Center in Germany
Kruthika Thangavelu1, Kyriakos Martakis2,3, Silke Feldmann4
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany.
Insights
Newborn hearing screening programs in Germany show high coverage and low loss-to-follow-up rates. Quality control is essential for early diagnosis and intervention, requiring centralized tracking and facility participation.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Effective newborn hearing screening is crucial for early detection and intervention of hearing loss.
- Quality control in screening programs ensures accurate data and optimal patient outcomes.
- This study evaluates two newborn hearing screening programs in Germany from 2007-2016.
Purpose of the Study:
- To assess the quality control and performance of population-based and hospital-based newborn hearing screening programs.
- To analyze coverage rates, referral rates, and follow-up timeliness.
- To identify factors influencing screening program effectiveness.
Main Methods:
- Analysis of data from a population-based screening program in North-Rhine and a hospital-based program at a University Hospital.
- Utilized a two-stage screening and follow-up process employing Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Response (AABR).
- Data analyzed based on recommended quality benchmarks and regional tracking center reports.
Main Results:
- Population-based screening coverage increased from 1.4% to 57.5% between 2007 and 2016, with a 10-year coverage rate of 98.7%.
- Referral rates were 3.4% (population-based) and 5% (hospital-based), with lost-to-follow-up rates of 1% and 64% referred within 3 months, respectively.
- Median screening completion was 6 days, referral 74 days, and diagnosis 55 days post-birth.
Conclusions:
- Regional-centralized tracking centers with uniform structures are vital for effective quality control in newborn hearing screening.
- Mandatory participation of birthing facilities and regular quality reports can enhance program performance.
- Achieving recommended quality criteria necessitates significant financial and infrastructural investment.
Abstract:
Regular reporting of quality control is important in newborn hearing screening, ensuring early diagnosis and intervention. This study reports on a population-based newborn hearing screening program in North-Rhine, Germany and a hospital-based screening at a University Hospital for 2007-2016. The two-staged 'screening' and 'follow-up' program involving TEOAE and AABR recruited newborns through participating birth facilities. Results were sent to the regional tracking center, and the data were analyzed based on recommended benchmarks. The percentage of newborns from the participating birth facilities in the region increased from 1.4% in 2007 to 57.5% in 2016. The 10-year coverage rate for these newborns was 98.7%, the referral rate after a failed two-step screening was 3.4%, and the lost-to-follow-up rate was 1%. At the hospital, >95% of the screened newborns completed screening within 30 days, the 10-year referral rate was 5%, and 64% were referred within 3 months of age. The median time for screening completion was 6 days after birth, for referral it was 74 days after birth, and for diagnosis it was 55 days after birth. Regional-centralized tracking centers with uniform structure are necessary for proper quality control. Obligatory participation of birthing facilities and quality reports may improve performance, but the recommended quality criteria need considerable financial and infrastructural expenditure.
