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Optimal Timing for Neonatal Hearing Screening in Well-Babies
Lisanne Vonk1, Paula van Dommelen1, Iris Eekhout1
1Child Health, Netherlands Organisation for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA Leiden, The Netherlands.
Insights
Optimal timing for neonatal hearing screening is between five and thirteen days old, reducing false positives. Newer screening devices may increase referral rates, warranting further investigation.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Preventive child healthcare (PCHC) in The Netherlands has conducted neonatal hearing screening since 2006.
- Transient evoked otoacoustic emission (OAE) testing is a common method for neonatal hearing screening.
Purpose of the Study:
- To determine the optimal age for neonatal hearing screening to minimize false positive referral rates.
- To evaluate the impact of different OAE screening devices on referral rates.
Main Methods:
- Analysis of data from the Dutch universal well-baby neonatal hearing screening program (2013-2023).
- Multilevel logistic regression models were used to assess referral probabilities.
- Inclusion of over 1.6 million newborns screened between 2013-2022 and 323,194 for 2022-2023.
Main Results:
- The lowest false positive referral rates (3.3-3.9%) were observed in newborns screened between five and thirteen days of age.
- The Echoscreen (ES)III device showed a significantly higher probability of referral (OR=1.84) compared to ESI/II devices.
Conclusions:
- The age of newborns at the time of screening significantly influences the false positive referral rate.
- The type of OAE screening device used impacts the likelihood of referral, with ESIII showing higher rates.
Abstract:
In The Netherlands, preventive child healthcare (PCHC) has been carrying out neonatal hearing screening in well-babies since 2006. The aim of this study was to examine the relationship between the age of newborns and the false positive referral rate of the first hearing screening using a transient evoked otoacoustic emission (OAE) test, to identify the most efficient timing for OAE screening. Additionally, we investigated the relationship between the type of OAE screening device (Echoscreen (ES)I/II versus ESIII) and the referral rate during the first screening. We used data from the Dutch universal well-baby neonatal hearing screening programme by PCHC between 2013 and 2023. Multilevel logistic regression analyses were performed to estimate the probability of a referral in 2023 for newborns screened in 2022 and 2023. We included a total of 1,650,506 newborns for 2013-2022 and 323,194 newborns for 2022-2023. The lowest false positive referral rates were found between days five and thirteen, ranging from 3.3 to 3.9%. ESIII significantly increased the probability of a referral compared to ESI/II (odds ratio = 1.84, 95% confidence interval = 1.65-2.06). In conclusion, the timing of neonatal hearing screening significantly impacts the false positive referral rate. Furthermore, the likelihood of a referral is significantly higher when using the ESIII compared to the ESI/II.
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