The Impact of Post-Birth Timing on OAE Test Efficacy: An Observational Analysis of Neonatal Hearing Screening
Sanjay Kumar1,2, Rashmi Natraj3, Angshuman Dutta4
1Department of Ear, Throat - Head and Neck Surgery, ENT-HNS), Command Hospital Airforce, Bangalore, Karnataka 560007 India.
Insights
Early newborn hearing screenings using Otoacoustic Emissions (OAE) are crucial. This study shows that performing OAE tests on the fifth day after birth significantly improves accuracy and reduces false positives for identifying auditory impairments.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Early identification of auditory impairments in newborns is critical for development.
- Otoacoustic Emissions (OAE) screenings are a key tool for newborn hearing assessment.
- The optimal timing for post-birth OAE screenings is not well-established.
Purpose of the Study:
- To evaluate the efficacy of OAE screenings within the first five days post-birth.
- To determine the most effective timing for neonatal hearing screening using OAE.
- To enhance diagnostic accuracy and clinical efficiency in newborn hearing assessments.
Main Methods:
- An observational study of 1,013 full-term neonates.
- Daily Transient Evoked Otoacoustic Emissions (TEOAE) screenings from Day 1 to Day 5.
- Follow-up screenings at one and three months for ambiguous results, adhering to WHO and JCIH guidelines.
Main Results:
- Screening efficiency increased from 8% pass rate on Day 1 to 98% by Day 5.
- False positive rates decreased from 92% on Day 1 to 2% by Day 5.
- Sensitivity and specificity peaked at 98% and 99.5% on Day 5, with false negatives below 1%.
Conclusions:
- Conducting OAE screenings on the fifth day post-birth optimizes clinical efficacy.
- This timing enhances diagnostic accuracy and reduces false positives/negatives.
- Adjusting protocols to Day 5 OAE testing can lessen burdens on families and healthcare providers.
Abstract:
Identifying auditory impairments early in newborns is essential to prevent developmental delays. Otoacoustic Emissions (OAE) screenings play a critical role in newborn hearing assessments. However, the ideal timing post-birth for these tests remains unclear. This study evaluates the efficacy of OAE screenings within the first five days after birth to determine the most effective timing. An observational study involved 1,013 full-term neonates at a tertiary care centre. These neonates underwent Transient Evoked Otoacoustic Emissions (TEOAE) screenings daily from Day 1 to Day 5, following WHO and JCIH guidelines. The study assessed pass rates, false positives, and false negatives, with follow-up screenings at one and three months for neonates with initial ambiguous results. The study found that screening efficiency significantly increased, with Day 1 pass rates at 8% (81 neonates) and 98% (992 neonates) by Day 5, marking a significant improvement in diagnostic accuracy (p < 0.001). False positive rates dropped from 92% on Day 1 to 2% by Day 5, and false negatives decreased to below 1%. Sensitivity and specificity reached their peak at 98% and 99.5%, respectively, on Day 5. Our study findings advocate for adjusting neonatal hearing screening protocols to include OAE tests on the fifth day post-birth, optimizing clinical efficacy through enhanced diagnostic accuracy and reducing the logistical and emotional burdens on families and healthcare providers.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s12070-024-04700-0.
