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Maintaining acceptably low referral rates in TEOAE-based newborn hearing screening programs
A B Maxon1, K R White, B Culpepper
1University of Connecticut, Storrs 06269-1085, USA. Maxon@uconnvm.uconn.edu
Insights
Newborn hearing screening using otoacoustic emissions (OAE) can achieve low refer rates when proper procedures are followed. Infant age did not significantly impact screening outcomes in this study of 1328 newborns.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Otoacoustic emissions (OAE) are a common method for newborn hearing screening.
- Refer rates in OAE screening can be influenced by various factors.
- Standardized screening protocols are crucial for accurate results.
Purpose of the Study:
- To identify factors affecting refer rates in OAE newborn hearing screening.
- To evaluate the impact of infant age on TEOAE screening outcomes.
- To assess the feasibility of achieving low refer rates with appropriate procedures.
Main Methods:
- Analysis of factors influencing OAE screening refer rates.
- Screening of 1328 newborns using transient evoked otoacoustic emissions (TEOAE).
- Comparison of TEOAE screening outcomes across different infant age groups (6-60 hours).
Main Results:
- Factors such as probe fit, software, ear conditions, and screener training affect refer rates.
- Infant age (6-60 hours) did not significantly alter TEOAE screening pass rates.
- Youngest infants (6-9 hours) showed a 90% pass rate, comparable to older infants.
Conclusions:
- Consistent and low refer rates (mean 6.9%) are achievable in TEOAE-based newborn hearing screening programs.
- Adherence to appropriate screening procedures is key to successful newborn hearing screening.
- Infant age within the first 60 hours is not a barrier to effective TEOAE screening.
Abstract:
This article describes factors that can affect the refer rate for otoacoustic emission (OAE) based newborn hearing screening, including the population of infants being screened, the adequacy of probe fit, software options used, external ear conditions, screener training, and baby handling. The effect of the infant's age on screening outcomes is also discussed using results of screening for 1328 regular nursery newborns, ranging in age from 6 to 60 hours, who were screened with transient evoked otoaoustic emissions (TEOAE) prior to hospital discharge. The youngest infants (6-9 hours old) were as likely to pass (90% pass rate) as the infants who were 24-27 hours old (94% pass rate). The results of this study are consistent with reports from many TEOAE-based screening programs that have demonstrated that acceptably low refer rates (mean = 6.9%) can be obtained when appropriate screening procedures are followed.