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Pediatric Quality Measures in Hearing Screening and Follow-Up
Renée F Wilson1, Genie Han1, Jennifer O Lambert2
1Evidence-based Practice Center, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
Insights
Pediatric quality measures for hearing screening and follow-up are essential for timely care. While many measures show reliability and validity, follow-up measure feasibility remains a concern, requiring further research.
Area of Science:
- Pediatric Healthcare Quality Improvement
- Audiology and Hearing Health
- Health Services Research
Background:
- Effective quality measures are crucial for ensuring children receive timely hearing problem screening and follow-up care.
- Existing measures need evaluation for reliability, validity, usability, and feasibility.
Purpose of the Study:
- To systematically summarize existing pediatric quality measures for hearing screening and follow-up.
- To identify evidence supporting the characteristics and implementation of these measures.
Main Methods:
- Comprehensive literature search of PubMed, Embase, CINAHL, Cochrane Library, and PsycINFO (2009-2024).
- Inclusion of systematic reviews, original articles, and gray literature from governmental and nongovernmental entities.
- Data extraction focused on measure definitions, characteristics, barriers, and research gaps.
Main Results:
- Identified 27 hearing screening and 97 follow-up measures, primarily for newborns.
- Evidence for reliability, validity, usability, and feasibility varied, with 14 follow-up measures showing feasibility concerns.
- Eight screening and eight follow-up measures demonstrated improved quality-of-care outcomes, but implementation barriers included data infrastructure and standardization issues.
Conclusions:
- Numerous pediatric hearing screening and follow-up measures possess documented reliability, validity, and usability.
- Feasibility of implementing follow-up measures presents a significant challenge.
- Future research should prioritize evaluating data infrastructure and systems to enhance follow-up implementation and standardize measures.
Context:
Quality measures are needed to ensure that children receive timely screening and follow-up for hearing problems.
Objective:
To summarize pediatric quality measures for hearing screening and follow-up.
Data Sources:
We searched PubMed, Embase, CINAHL, Cochrane Library, and PsycINFO from 2009 to December 7, 2024, including gray literature from governmental and nongovernmental entities.
Study Selection:
Systematic reviews, original articles.
Data Extraction:
Measure definitions, study characteristics, barriers, and research gaps.
Results:
We identified 27 hearing screening and 97 follow-up measures, mostly applied to newborns. In total, 9 systematic reviews identified 5 screening and 10 follow-up measures, 13 studies identified 13 screening and 47 follow-up measures, and 12 gray literature sources identified 11 screening and 42 follow-up measures. We found evidence for reliability, validity, usability, and feasibility in 8, 11, 3, and 4 screening measures, respectively, and for 22, 44, 17, and 13 follow-up measures, respectively. Of the follow-up measures, 14 had evidence against feasibility. Additionally, 8 screening and 8 follow-up measures demonstrated improvement in quality-of-care outcomes. Use of measures differed by state, targeted population, and clinician type. Barriers to measure implementation were related to data infrastructure, integration, collection, reporting, and lack of standardization.
Limitations:
Searches focused on identifying measures used in the United States. Studies were not designed to assess measure characteristics.
Conclusions:
Many pediatric hearing screening and follow-up measures have evidence of reliability, validity, and usability, although feasibility of follow-up measures is a concern. Future research should evaluate data infrastructure and systems for implementing follow-up and standardizing and stratifying screening and follow-up measures.
