Comparative study of the efficacy between new and routine newborn hearing screening protocols in public hospital,
Krittipong Parangrit1,2, Jutatip Sillabutra3, Suwicha Kaewsiri Isaradisaikul4
1School of Health Sciences Research, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Insights
A new newborn hearing screening protocol significantly improved early diagnosis rates compared to the routine protocol. While screening coverage and diagnosis within 3 months increased, further improvements are needed for referral and follow-up rates to meet universal standards.
Area of Science:
- Audiology
- Public Health
- Pediatrics
Background:
- Newborn hearing screening (NHS) is crucial for early detection of hearing loss.
- Timely diagnosis and intervention significantly improve developmental outcomes in infants.
- Assessing the efficacy of different screening protocols is essential for optimizing NHS programs.
Purpose of the Study:
- To compare the effectiveness of a new NHS protocol versus a routine protocol.
- To evaluate key performance indicators including screening coverage, referral rates, and audiological diagnosis timeliness.
- To identify areas for improvement in NHS implementation at Chiangrai Prachanukroh Hospital.
Main Methods:
- An intervention study comparing historical (routine) and prospective (new) NHS protocols.
- Routine protocol: screening within 7 days, rescreening at 3 months, diagnosis by 6 months.
- New protocol: screening within 24-48 hours, rescreening at 1 month, diagnosis by 3 months.
Main Results:
- The new protocol showed significantly higher screening coverage within 1 month (95.29% vs 83.9%) and audiological diagnosis by 3 months (66.67% vs 5.26%).
- The referral rate was lower with the new protocol (7.74% vs 15.43%).
- No significant difference was found in follow-up rescreening rates (50.60% vs 43.42%).
Conclusions:
- The new NHS protocol demonstrates improved efficacy in early hearing screening and diagnosis.
- Implementation of national policies and multidisciplinary collaboration positively impacted screening indicators.
- Further enhancements in referral, follow-up, and diagnosis processes are necessary to align with Universal Newborn Hearing Screening (UNHS) standards.
Objective:
This study aimed to evaluate the efficacy indicators between new and routine newborn hearing screening protocols in Chiangrai Prachanukroh Hospital.
Methods:
This intervention study comprised a historical component, wherein data was extracted from electronic medical records of all live newborns born during July-September 2022, representing the routine protocol group (screening within 7 days, rescreening ∼3 months post-discharge, diagnosis by 6 months). The prospective study focused on newborns delivered from July-September 2023, classified under the new protocol group (screening within 24-48 h, rescreening ∼1 month, diagnosis by 3 months). The percentages of hearing screenings culminating in audiological diagnoses were compared between the two groups.
Results:
Of total 2250 newborns participated, significant differences were observed between the new and routine protocol groups (1126 and 1124 newborns) in screening coverage within 1-month-old (95.29% and 83.9%) (p < 0.001), referral rate (7.74% and 15.43%) (p < 0.001), and audiological diagnosis within 3-month-old (66.67% and 5.26%) (p = 0.001), but not in the follow-up rescreening rate (50.60% and 43.42%) (p = 0.282).
Conclusions:
This improvement was attributed to the implementation of the newborn hearing screening policy from Thailand's Ministry of Public Health. The policy was associated with improvement and multidisciplinary team cooperation improved some benchmark indicators. Nonetheless, referral, follow-up, and diagnosis rates require further improvement to meet universal newborn hearing screening (UNHS) program standards and control quality.
