Assessing Auditory Brainstem Response (ABR) Quality: A Retrospective Review of One Center's Findings

Area of Science:

• Pediatric Audiology
• Diagnostic Testing Quality
• Hearing Loss Evaluation

Background:

• Auditory brainstem response (ABR) is critical for pediatric hearing loss assessment.
• Variations in ABR protocols can lead to diagnostic inconsistencies.
• This study addresses the impact of ABR testing quality on pediatric diagnoses and management.

Purpose of the Study:

• To investigate the quality of pediatric auditory brainstem response (ABR) testing.
• To analyze changes in diagnosis and management following repeat ABR testing.
• To identify common deficiencies in ABR protocols used for pediatric patients.

Main Methods:

• Retrospective chart review of pediatric patients undergoing ABR testing between 2012 and 2019.
• Analysis of ABR test completeness against American Academy of Audiology, American Speech Language Hearing Association, and Joint Committee on Infant Hearing guidelines.
• Descriptive statistics to evaluate changes in diagnosis and intervention post-repeat ABR.

Main Results:

• Eighty pediatric patients were included in the review.
• Incomplete ABRs were frequently due to missing tone burst bone conduction (85.0%), polarity (82.5%), and tone burst air conduction (48.7%) components.
• Seventy-seven patients required repeat ABRs, leading to diagnostic changes in 37 cases and management changes in 23 cases.

Conclusions:

• Substandard ABR testing can result in misdiagnosis and delayed treatment for pediatric hearing loss.
• Identifying common ABR testing flaws can help Otolaryngologists establish screening protocols.
• Improving ABR quality is essential for accurate and timely pediatric hearing healthcare.