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Infant hearing screening with an automated auditory brainstem response screener and the auditory brainstem response
Insights
This study screened 260 at-risk infants for hearing impairment using automated auditory brainstem response (ABR) screening. 15% failed, with a 5.4% incidence of conductive hearing deficit and 2.3-3.1% sensorineural hearing deficits.
Area of Science:
- Neonatal screening
- Auditory health
- Pediatric audiology
Background:
- Infant hearing impairment poses significant developmental risks.
- Early detection is crucial for timely intervention.
- Established risk criteria guide neonatal hearing screening protocols.
Purpose of the Study:
- To evaluate the effectiveness of automated auditory brainstem response (ABR) screening in identifying hearing deficits in at-risk neonates.
- To determine the incidence and prevalence of hearing impairments in a neonatal intensive care unit population.
- To assess the agreement between automated screening and diagnostic ABR testing.
Main Methods:
- Screened 260 high-risk infants using the Algo-1 Plus automated ABR screener.
- Followed up failed screenings with diagnostic ABR tests (air and bone conduction) and otological examinations.
- Calculated incidence, prevalence, and agreement metrics (kappa value, overall efficiency).
Main Results:
- 15% of infants (39/260) failed the initial automated screening.
- Confirmed incidence of conductive hearing deficit was 5.4%.
- Prevalence of sensorineural hearing deficits ranged from 2.3% to 3.1%.
Conclusions:
- Automated ABR screening effectively identifies infants requiring further audiological evaluation.
- A significant proportion of at-risk neonates exhibit hearing deficits.
- The Algo-1 Plus demonstrated good overall efficiency (83%) in predicting diagnostic ABR outcomes.
Abstract:
From 1653 babies hospitalized in the Veterans General Hospital-Taipei from 1993 to 1995, 260 infants at risk of hearing impairment were selected. The risk criteria of hearing impairment for neonates were based on the recommendation of the US Joint Committee on Infant Hearing, 1990 Position Statement. All these infants were screened with the Algo-1 Plus, an automated auditory brainstem response (ABR) screener at a mean postconceptional age of 40.7 +/- 4.5 weeks. Thirty-nine cases (39/260, 15%) involving 57 ears (57/520, 11%), failed the screening. Except for one infant who died, the babies had an ABR test for both air- and bone-conducted stimuli and an otological examination. The case-specific incidence of conductive hearing deficit at the initial ABR test was 5.4%. The prevalence of sensorineural hearing deficits was between 2.3% confirmed and 3.1% including infants who did not have follow-up tests. The kappa-value that indicated agreement between the Algo-1 and ABR results was 0.64, and the overall efficiency of using Algo-1 to correctly identify pass or failure of the ABR was 83%.