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Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...

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Rurality Effect on Michigan Newborn Hearing Screening.

Robert M Conway1, Kylie Perreault2, Jason Schomer3

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|December 19, 2023
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Rurality impacts newborn hearing screening outcomes. More rural areas show higher rates of screening refusal and equipment failure, but follow-up rates after failed screens are similar across rurality levels.

Keywords:
newborn hearing screeningrurality

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Area of Science:

  • Public Health
  • Audiology
  • Rural Health Disparities

Background:

  • Newborn hearing screening (NBHS) is crucial for early detection of hearing loss.
  • Understanding factors influencing screening outcomes is essential for improving access and effectiveness.
  • Rurality may present unique challenges to healthcare access and adherence.

Purpose of the Study:

  • To evaluate the impact of rurality on newborn hearing screen outcomes in Michigan.
  • To compare hearing screen outcomes based on U.S. Department of Agriculture Rural-Urban Continuum Codes (RUCC).

Main Methods:

  • Analysis of the Michigan Department of Health and Human Services (MDHHS) Newborn Hearing Screening database (2015-2020).
  • Categorization of patients into rurality levels (RUCC codes 1-9) based on zip code population.
  • Comparison of outcomes including screening refusal, failed screens, and follow-up testing across different rurality levels.

Main Results:

  • A total of 34,928 patients were initially identified.
  • Patients in more rural areas (higher RUCC) were significantly more likely to refuse screening (mean RUCC 4.2) compared to those with failed initial screens (mean RUCC 2.1).
  • Equipment failure was also more common in more rural areas (mean RUCC 2.8) compared to completed screenings.

Conclusions:

  • Increased rurality is associated with higher rates of newborn hearing screen refusal and equipment failure.
  • No significant difference in rurality was observed between patients who had follow-up testing after a failed screen and those who did not.
  • Targeted interventions may be needed to address rural disparities in newborn hearing screening.